Earlier clinical decision-making with POCT in emergency paediatrics

In work recently undertaken and published as a case study by the Oxford Academic Health Science Network (AHSN), Horiba UK Medical’s Microsemi CRP point-of-care testing (POCT) analyser was found to enable more rapid clinical decision-making, saving time and reducing costs, in emergency paediatric units.

 The study found that using POCT as a replacement for laboratory tests resulted in earlier decision-making in approximately 75% of cases across three hospital sites. Economic analysis across these sites found that this could result in net annual cost savings due to reduced staff time, as well as faster decisions on antibiotic use.

The multi-site evaluation study was undertaken in emergency paediatric units at John Radcliffe Hospital (Oxford), Stoke Mandeville Hospital (Aylesbury) and Wexham Park Hospital (Slough) with the aim of assessing if POCT in such units could improve quality of care. The AHSN selected Horiba’s Microsemi CRP as the POCT device for evaluation as it is an automated analyser able to measure C-reactive protein (CRP) with full blood count simultaneously. Both parameters are used commonly in conjunction in paediatric emergency care to assist with clinical decision-making, with CRP being a proxy indicator for the presence or absence of bacterial infection.

C-reactive protein tests are usually performed in the hospital laboratory. Once the sample is received in the laboratory, results can take 60–90 minutes; but the time from needle to result can be considerably longer. The study found the mean delay between the POCT result and the laboratory result being available was just over three hours. Results are available from the Microsemi CRP within four minutes for FBC and CRP, meaning that a decision on subsequent care, including admission or discharge, can be made far more quickly.            

Key conclusions from the study found that overall POCT was useful in decision-making and could have enabled earlier decision-making in 75% of cases. It could also have shortened the time to decision-making on antibiotic use.



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