Bietenbeck Andreas, Wüst Katharina, Luppa Peter B
Clin Lab. 2020 Jan 1;66(1). doi: 10.7754/Clin.Lab.2019.190619.
Point-of-care tests (POCT) measure analytes close to the patients and are a complementary supplement to the test menu of medical laboratories. However, the involvement of many different stakeholders makes it challenging to ensure reliable results.
In a survey, we asked experienced POCT users how they control their total POCT process and what factors they consider essential for success. Results were verified in four in-depth interviews.
Overall, 73 German participants from various medical disciplines completed the survey. All but one participant regarded operator training as important but only half of the participants' institutions conducted operator training on a regular basis. Participants often requested e-learning, but face-to-face teaching is still preferred. Twenty-one percent of participants already used e-learning and reported mixed satisfaction. Fifty-five percent of the participants never refer to the quality management manual. Instead, 94% stated that if a POCT error arises a contact person for POCT is always available at their workplace. The majority of participants think that external and, in particular, internal quality controls are important for POCT. Only a few difficulties for performing quality control such as "temporal expenditure" and "lack of information about the importance of internal quality control" were commonly mentioned. For future developments, participants expect evolution and improvements especially with regard to "measurement quality and reliability". The answers of the experts in the in-depth interviews largely corresponded with the participants of the survey.
The importance of operator training is well established and confirmed in this work. How to conduct this training is less certain, but the answers in this survey suggest some form of blended learning with e-learning and practical elements. The discrepancy between the high importance that guidelines and other normative documents place on written information and their low practical usage was striking.
即时检验(POCT)在患者身边检测分析物,是医学实验室检测项目的补充。然而,众多不同利益相关者的参与使得确保结果可靠具有挑战性。
在一项调查中,我们询问了经验丰富的POCT使用者他们如何控制整个POCT流程以及他们认为成功的关键因素有哪些。结果在四次深入访谈中得到验证。
总体而言,来自不同医学学科的73名德国参与者完成了调查。除一名参与者外,所有参与者都认为操作人员培训很重要,但只有一半参与者所在机构定期进行操作人员培训。参与者经常要求采用电子学习,但仍更喜欢面对面教学。21%的参与者已经使用电子学习并表示满意度不一。55%的参与者从未查阅质量管理手册。相反,94%的参与者表示,如果出现POCT错误,他们工作场所总有POCT联系人。大多数参与者认为外部尤其是内部质量控制对POCT很重要。只有少数诸如“时间成本”和“缺乏关于内部质量控制重要性的信息”等实施质量控制的困难被普遍提及。对于未来发展,参与者期望尤其在“测量质量和可靠性”方面有所改进。深入访谈中专家的回答与调查参与者的回答基本一致。
操作人员培训的重要性在本研究中得到充分确立和证实。如何进行这种培训尚不太确定,但本次调查的答案表明某种形式的混合学习,包括电子学习和实践元素。指南和其他规范性文件对书面信息高度重视但实际使用率却很低,这种差异很明显。