Point-of-Care Haematology Analyser Quality Assurance Programme: a rural nursing perspective
Catherine Beazley 1 4 , Katharina Blattner 1 2 , Geoffrey Herd 31 Hokianga Health Enterprise Trust, Parnell Street, Northland, New Zealand
2 Dunedin School of Medicine, Otago University, Dunedin, New Zealand
3 Northland District Health Board, Whangarei, Northland, New Zealand
4 Corresponding author. Email: catherine.beazley@hokiangahealth.org.nz
Journal of Primary Health Care 13(1) 84-90 https://doi.org/10.1071/HC20080
Published: 23 March 2021
Journal Compilation © Royal New Zealand College of General Practitioners 2021 This is an open access article licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License
Abstract
BACKGROUND AND CONTEXT: Rural health services without an onsite laboratory lack timely access to haematology results. Set in New Zealand’s far north, this paper provides a rural nursing perspective on how a health service remote from a laboratory introduced a haematology analyser suitable for point-of-care use and established the associated quality assurance programme.
ASSESSMENT OF PROBLEM: Five broad areas were identified that could impact on successful implementation of the haematology analyser: quality control, staff training, physical resources, costs, and human resource requirements.
RESULTS: Quality control testing, staff training and operating the haematology analyser was more time intensive than anticipated. Finding adequate physical space for placement and operation of the analyser was challenging and costs per patient tests were higher than predicted due to low volumes of testing.
STRATEGIES FOR IMPROVEMENT: Through a collaborative team approach, a modified quality assurance programme was agreed on with the supplier and regional point-of-care testing co-ordinator, resulting in a reduced cost per test. The supplier provided dedicated hours of staff training. Allocated time was assigned to run point-of-care testing quality assurance.
LESSONS: Having access to laboratory tests can reduce inequalities for rural patients, but natural enthusiasm to introduce new point-of-care technologies and devices needs to be tempered by a thorough consideration of the realities on the ground. Quality assurance programmes need to fit the locality while being overseen and supported by laboratory staff knowledgeable in point-of-care testing requirements. Associated costs need to be sustainable in both human and physical resources.
KEYwords: Haematology bench top analyser; point-of-care; quality assurance; rural health service; rural hospital; rural laboratory testing; rural nursing
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