Use coordinator to ensure quality of tests
When using point-of-care testing in the ED, maintaining quality can be problematic, according to Michelle Myers Glower, RN, MS, former director of emergency and trauma services for Elmhurst (IL) Hospital and a Glencoe, IL-based consultant specializing in staffing issues. She argues that there should be one individual responsible for implementing and coordinating all the laboratory tests performed at your facility. "It is a wise choice to have this in place when considering point-of-care testing in your ED," she says.
There should be a documented system in place to detect clinical errors, significant analytical errors, and unusual test results, says Glower. "If not, you may be cited," she warns. She gives the following responsibilities of a point-of-care coordinator:
- governing and administrating staff competencies;
- implementing a quality assessment program that includes quality control and proficiency testing;
- developing and distributing procedure manuals;
- coordinating test method selections;
- reviewing patient and quality control results for technical and clerical problems;
- initiating and facilitating proposals for new point-of-care testing instruments;
- chairing the point-of-care testing committee;
- ensuring standardization in recording and reporting of results.
The point-of-care coordinator must have a working knowledge of standards and regulations of various accrediting agencies, such as the Clinical Laboratories Improvement Act, says Glower. "ED staff typically do not want the muss and fuss of calibrating and all the paperwork that is required," she says. "They could care less how those results are processed and delivered. They just want it now."
ED staff have enough things to check daily, such as the temperature in all the refrigerators, argues Glower. "When point-of-care testing is in the ED, they will love it," she says. "But the quality assurance and the calibrating get missed without a designated person from the lab who loves that kind of detail."