QC net in hospitals POCT. Marija Prezelj Institute of Clinical Chemistry and Biochemistry University Medical Centre Ljubljana, Slovenia
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1 QC net in hospitals POCT Marija Prezelj Institute of Clinical Chemistry and Biochemistry University Medical Centre Ljubljana, Slovenia Dubrovnik, oktober 2013
2 University Medical Centre Ljubljana Patient beds In-patient admissions Out-patient visits 5,59 days Average length of stay Employees Physicians and dentists Nurses, midwives 5, Number of lab. test (Institute for Clinical Chemistry and Biochemistry) Dubrovnik, oktober 2013
3 2004 Legislation, Standards, Guideline, Regulatory requirements By-law Pravilnik o pogojih, ki jih morajo izpolnjevati laboratoriji za izvajanje preiskav na področju laboratorijske medicine (Ur.list RS 64/2004) Standards, Guidelines ISO Medical laboratories Requirements for quality and competence ISO 22870: 2006 Point-of-care testing - Requirements for quality and competence CLSI POCT Guidelines (> 12) Dubrovnik, oktober 2013
4 Institute for Clinical Chemistry and Biochemistry organized seminar for nurses, midwives and technitian in UMC Ljubljana Guidelines - How to perform Point-of Care Testing Institute for Clinical Chemistry and Biochemistry & Nurses and Midwives Association of Slovenia Seminar with hands on workshop: Guidelines How to perform Point-of Care Testing Dubrovnik, oktober 2013
5 2007 Project at the tertiary level UMC Ljubljana Creating qaulity improvement opportunities for point-of-care testing in UMC Ljubljana Implementation and management of a safe and effective POCT service within the hospital environment. Number of POCT devices Interdisciplinary committee for POCT in UMCL Organizing sheme of POCT responsibility Quality assurance audit at all sites External Quality Assessment Sheme in UMCL Connecivity to LIS Dubrovnik, oktober 2013
6 2008 ( ) Governance of UMC Ljubljana Interdisciplinary committee for POCT in UMCL Central role of Institute of Clinical Chemistry and Biochemistry Institue of Clinical Chemistry and Biochemistry is responsible for the quality assurance programme. A quality assurance audit was set up to audit all sites that perform POC testing. The committee is responsible for the selection and procurement of the most POCT equipment The group is responsible for implementation, monitoring of processrelated protocols Internal quality control and participation in external quality assessment scheme POCT co-ordinator responsibility determining budgetary responsibility for individual POCT services Dubrovnik, oktober 2013
7 2008 (15. may 2008) Situation in UMC Ljubljana LIST of POCT devices Glucose meters 139 Blood gas analysers 25 Hemoglobin meters 16 Coagulation meter 10 Troponin 10 Urinalysis (including analysers)?????? GLUCOSE METERS ABBOTT HEMOCUE ROCHE BAYER J & J??? GAS ANALISYS ABBOTT RADIOMETER ROCHE??
8 Number of tests (glucose, urea and creatinine) in Institute of Clinical Chemistry and Biochemistry Glucose reagent slide Year glucose creatinine urea
9 External Quality Control Results
10 80 Number of Participants 70 Kontrolni vzorec 2013/ ABBOT BAYER HEMOCUELIFESCAN ROCHE 1,0 Standard deviation 0,8 ABBOTT HEMOCUE ROCHE BAYER N mediana CV SD Standard deviation 0,6 0,4 J&J ,2 0,
11 Barcode identification label for POCT For users For patient ID
12 Bar code printer, Bar code reader. Barcode printers 91 (150) Barcode readers Dubrovnik, oktober 2013
13 Hospital Information Systems in UMC Ljubljana HIPOKRAT List d.o.o Division of - Internal Medicine - Gynaecology - Neurology Departement of - Dermatovenereology - Otorinolaringology - Ophthalmology BIRPIS Infonet d.o.o. Division of Surgery Department of Infectious Diseases Department of Orthopaedic Surgery Division of Stomatology IMDPŠ ISPEK (ThinkMed) Marand d.o.o Division of Paediatrics Department of Nuclear Medicine LABIS HEM.lab. LIS Institute of Clin.Chem. KOŽB. lab. IML. lab. Pediatric.lab Neurolog. lab. KNM lab.sistem
14 Connectivity System Components Point Point of Care Connectivity (POCT 01-A2) (CLSI Clinical and Laboratory Standards Institute)
15 Connection Systems in UMC Ljubljana i-stat System (Abbott) IT 1000 (Roche) Direct Connection to LIS
16 Blood gases i-stat System (Abbott) Division of Neurology Neurological Emergency Unit Department of Vascular Neurology and Intensive Therapy Division of Surgery Department of Anaesthetics and Surgical Intensive Care Division of Paediatrics Unit of Pulmonary Diseases Radiometer (direct connection to LIS) Division of Surgery Department of Paediatrics Surgery and Intensive Care Department of Anaesthetics and Surgical Intensive Care Department of Infectious Diseases and Febrile Illnesses
17 Glucose Accu-Chek Inform II System (IT-1000 Roche) Division of Internal Medicine, Department of Intensive Internal Medicine Department of Infectious Diseases and Febrile Illnesses Coagulometer i-stat System (Abbott) Division of Neurology Neurological Emergency Unit Department of Vascular Neurology and Intensive Therapy Division of Surgery Department of Anaesthetics and Surgical Intensive Care Division of Paediatrics Unit of Pulmonary Diseases
18 POCT workflow Historic access to any observations Electronic Medical Records Registration of POC order & observations Immediate decision Point of care observations Accepted observation Data Manager LIS Patient administration HIS Laboratory supervising the POCT process
19 Quality control results Dubrovnik, oktober 2013
20 Quality control results Dubrovnik, oktober 2013
21 Dubrovnik, oktober 2013
22 The definition of connectivity is the ability to reliably transfer test information between a point-of-care testing device and an information system. Connectivity means no manual transcription in order to move test data into the LIS. Labs need point-ofcare devices that capture all of the necessary information accurately and effectively. So, connectivity is the best solution for POCT quality assurance.
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