NT POCT Program Quality Framework and Initiatives Flinders University International Centre for Point-of-Care Testing in partnership with NT Department of Health 11 th November 2015
i-stat Cartridges for different tests Cartridge Cartridge POC tests Chem8+ Electrolytes, Total CO 2, urea, creatinine, glucose, ionised Calcium, Haematocrit (Haemoglobin) Time for Result 2 min PT/INR INR (international normalised ratio) 5 min ctni Troponin I cardiac marker 10 min CG4+ Blood Gases, lactate 2 min
NT i-stat POCT Program In 2008, i-stat devices were purchased by the NT DoH for selected NT DoH Remote Health Centres (based highest need at the time). Since that date the NT DoH and the Flinders ICPOCT have been lobbying for further funding the extend the program to all remaining remote health services in the NT, both DoH and CCHS. In June 2015 the NT DoH were successful in obtaining some extra funding from the Federal Govt for the purchase of new i-stat devices for all remaining health services. Separate funding was also sought to fund the quality testing and training program. Ongoing cost of consumables must be met by DoH and CCHS. Currently there are 36 health services enrolled in the NT i-stat Program, 30 DoH remote health centres and 6 CCHS. This number is expected to double to 72 health services by June 2016 to include all remaining remote health services.
NT i-stat POCT Program Overview Proven training and quality framework in place Training & competency assessment adheres to International Standards Organisation Requirements (ISO/FDIS 22870:2005 - Point-of-care testing (POCT) - Requirements for quality and competence) Quality Testing Framework is the same as what laboratories use and ensures i-stat results are of equivalent quality to what laboratories in Australia are achieving Support provided by the Flinders ICPOCT (over 20 years experience in delivering POCT programs to primary care settings nationally and internationally) Funding and ongoing support provided by NT DoH Primary Health Care, Professional Practice Nurse (PPN) and team in Top End and Central Australia DoH PPN positions not currently funded to provide ongoing support to CCHS, they are happy to provide support however are requesting a POCT Resource Person from health service to assist All i-stat devices connected to a central data station where incoming de-identified patient and quality results can be monitored and important feedback on testing can be provided to the Health Centre Manager / CEO to inform on any ongoing issues and monthly i-stat testing statistics
Example of i-stat Program Reports Error Report
Example of i-stat Program Reports
Example of PHCM Feedback Report
Example of PHCM Feedback Report
NT i-stat POCT Program Individual Health Service Requirements: i-stat device with downloader/recharger cradle connected to an active internet port so that: all tests and errors can be monitored and reported on Customisation profiles and Date/Time can be constantly refreshed Newly assigned Operator IDs can be uploaded to the i-stat analyser Designated area for i-stat device storage, room for testing and training and quality resources to be kept Process for ordering, receiving & storing i-stat consumables (test cartridges and QC material) in place (including fridge space for storage) All current staff trained at an official i-stat training session One staff member nominated a i-stat resource person at health centre to ensure all Quality Testing is completed regularly and new staff attend a training session etc.
Other issues to consider: Services performing patient testing but no Quality Control Testing, what might be the issue here? i-stat Troponin I cartridge vs Troponin T strips, why might this be a problem? i-stat INR vs Coagucheck INR, use both devices or use just one?