Respiratory POCT


Technology is changing the healthcare industry all across the different areas of medicine. As the need for faster diagnosis continues to increase, and the equipment available to medical professionals becomes more mobile, the emergence of point-of-care testing (POCT) assays stands as a landmark for improved care. For respiratory departments around the country, the impact of POCT technology can be seen in the diagnosis, monitoring and subsequent treatment of patients
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In a recent interview with ADVANCE, Jeanette Kieffer, RRT, PICC, MBA, director of respiratory service and cardiac rehab at John C. Lincoln North Mountain Hospital, discussed the role of the respiratory department and the impact of POCT for respiratory therapists (RTs), nurses and physicians as they work together in the facility. When it comes to ease-of-use and patient safety, the decision to transition to more POCT-based technology was fairly easy. With handheld assays, the respiratory staff at John C. Lincoln North Hospital can actively monitor and treat a patient on-the-spot without having to wait for results.

“I think that, as a director, because we’re constantly being approached by changes in technology and advancements in different types of devices to deliver care, that truly what helps you make a decision is your own personal experience as a respiratory therapist at the bedside,” said Kieffer.

As a level one trauma center, RTs at John C. Lincoln North Hospital are constantly on the move. Prior to POCT techniques, running tests such as blood gases was an elaborate process with some unnecessary risks involved. It required running sample through a single machine, which printed out the data for a patient’s chart. The process led to a number of potential delays in care, including lost results, hemolyzed or lost samples (requiring additional blood to be drawn and increasing the risk of infection), and difficulty locating the treating physician. With the introduction of POCT technology, the process has been simplified, with the patient data available immediately through wireless interfaces

“I can do one blood gas there and wash my hands and everything, and move on to another room and do another blood gas on another person,” explained Kieffer. “The handheld holds all of that information, and then it just downloads right away to the computer system and it’s a direct report into the electronic medical record.”

By utilizing POCT, not only can RTs read results in real-time at the bedside, but also distribute that information via electronic medical records (EMRs) by connecting through specific docks or even cloud-based platforms. Along with the data storage capacity, allowing for repeated use without having to run back-and-forth to the laboratory, the ability to communicate results between departments adds an additional layer of convenience and efficiency in both larger and smaller healthcare facilities. This keeps the hospital community informed on an individual level across departments despite treating multiple patients in various areas of the facility.

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“When I take the handheld instrument over to the printer, the dock machine, it docks and goes into the system,” continued Kieffer. “So, if our physician is at home and he’s able to log in, he can see that result if he’s waiting for it or it goes right to the patient’s chart – all that is happening in seconds. It interfaces.”

Kieffer also discussed the evolution of staff relationships in her healthcare community, noting the original concept of separated specialties. Just as the role and prestige of RTs on staff has steadily increased, the idea of a team-based approach to patient treatment has become the norm. For level one trauma centers like John C. Lincoln North Hospital, POCT technologies are also heavily utilized and relied on in rapid response and coding teams for immediate and accurate results as they work to stabilize patients. While Kieffer pointed out that the cartridges for her RT handhelds are more expensive than syringes, the effectiveness and convenience of the POCT technology for both patients and the facility as a whole more than make up for the cost.

“[POCT] plays a critical role in in allowing respiratory care professionals stay closer to their patients in order to optimize care,” said Joe Freels, Point-of-care, Abbott. “The closer respiratory therapists are to the patient, the better positioned they are to collaborate as an active member of the bedside care team, contribute to clinical decisions and quickly react to changing patient conditions.”

As the healthcare industry continues to evolve, the influence of improved technology is reaching more and more facilities. Along with the impact on patient care, Kieffer also mentioned some of the benefits POCT has had on her staff in every aspect of care. The technology has not only cut down on mislabeling and misdrawing samples, but has also limited the risk of exposure to needles for RTs taking the samples. Regardless of the size of a healthcare organization, the switch to more POCT assays has the potential to streamline and improve care.

Michael Jones is on staff at ADVANCE.

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