Journal of Clinical Chemistry and Laboratory Medicine
Open Access

Abstract

Implementation of Point of Care Testing in the Emergency Department of a Teaching Hospital in U.A.E

Essam Howayyer, Kalthoom Alblooshi, Noor Almheiri, Ghada Ali and Fatima Turki

Background/objectives: Rapid and reliable diagnostic testing is important for clinical decision making and treatment initiation in emergency departments (ED). Point of care (POC) testing offers a unique alternative with fast, accurate and easy to use systems. The purpose of this study was to evaluate the performance and describe the implementation experience of using Abbott i-STAT Alinity point of care testing system in the emergency department of a tertiary care hospital in UAE.

Methods: Two i-STAT cartridges CG4+ (pCO₂, pH, pO₂, lactate and TCO₂) and CHEM8+ (Na, K, Cl, iCa, glucose, urea nitrogen, creatinine, hematocrit) were evaluated for precision, linearity and accuracy using aqueous solutions and blood samples (n=50). A post-training operator survey was conducted among the ED nurses to assess the level of confidence and satisfaction with the instrument and impact on patient care.

Results: Precision was high (<2% CV) for Na, K, Cl, pH, pO₂, pCO₂, ionized calcium (iCa) and satisfactory (2.1%-4.3% CV) for lactate, urea nitrogen, glucose, hematocrit and TCO₂ at all three concentrations. Linearity studies showed good linearity for the five different levels tested. Analytical ranges for all the tested analytes were within the reportable range except creatinine which was slightly higher. Findings from method comparison studies demonstrated close correlation of i-STAT Alinity results with laboratory methods. 75% of the survey participants reported high confidence with the use of i-STAT Alinity with easy connectivity to printer, extended battery life and on-screen error assistance ranking as the most satisfactory features. 100% of the responders indicated that the rapid availability and accuracy of the test results had a positive impact on the patient treatment decision and disposition, improving patient experience.

Conclusion: The study results suggest that i-STAT Alinity provides adequate precision, linearity and comparable accuracy to existing laboratory methods for blood gases and electrolytes testing. The user- friendly features, portability of the instrument and rapid results led to operator confidence and an overall positive implementation.