Hilton S, Rink E, Fletcher J, Sibbald B, Freeling P, Szczepura A, Davies C, Stilwell J
Division of General Practice and Primary Care, St George's Hospital Medical School, University of London.
Br J Gen Pract. 1994 Dec;44(389):577-80.
The evaluation of near patient testing in British general practice has largely been confined to studies examining individual tests or comparing equipment.
This study set out to determine the attitudes of practice staff to near patient testing, and the extent to which staff undertook quality assessment.
Four types of near patient testing machines were introduced into 12 general practices in two regions of England, south west Thames and west Midlands. General practitioner and practice nurse attitudes to near patient testing were assessed by semi-structured interview before and six months after the introduction of the machines. The extent to which routine quality assurance procedures were carried out within the surgery and as part of local and national schemes was examined.
Although 80% of general practitioners anticipated changing patient management with near patient testing, only two fifths reported having done so after six months. Nurses generally were enthusiastic at the outset, although one third were unhappy about incorporating near patient testing into their work schedules. Time pressure was the most important factor restricting uptake of near patient testing. Nurses performed quality control regularly but complete local external quality assurance procedures were established in only half the practices. All the practices participated in a national scheme for cholesterol assays.
General practitioners in this study did not find near patient testing a very useful addition to their resources. Pressure on nurses' time was the most frequently reported limitation.
英国全科医疗中即时检测的评估主要局限于对单个检测项目或设备比较的研究。
本研究旨在确定全科医疗工作人员对即时检测的态度，以及工作人员进行质量评估的程度。
在英格兰的两个地区，即泰晤士河西南部和西米德兰兹，将四种即时检测设备引入12家全科诊所。在引入设备前及引入后六个月，通过半结构化访谈评估全科医生和全科护士对即时检测的态度。检查了在诊所内部以及作为地方和国家计划一部分而开展常规质量保证程序的程度。
尽管80%的全科医生预计即时检测会改变患者管理方式，但六个月后只有五分之二的人报告确实如此。护士们一开始普遍热情高涨，尽管三分之一的人对将即时检测纳入工作安排感到不满。时间压力是限制即时检测应用的最重要因素。护士定期进行质量控制，但只有一半的诊所建立了完整的地方外部质量保证程序。所有诊所都参与了一项全国胆固醇检测计划。
本研究中的全科医生并未发现即时检测对他们的资源有很大帮助。护士时间紧张是最常被提及的限制因素。
