<p>Perspectives On Blood-Based Point-Of-Care Diagnostics</p>

Abstract

Background: Point of Care (POC) diagnostics are an essential component of modern medicine and are employed in a variety of clinical disciplines to improve patient outcomes and provider efficiency. Despite these benefits, there are aspects of POC testing which may still hold room for improvement. In the present study, a group of healthcare professionals familiar with different facets of blood-based POC testing provided their perspectives on the benefits and challenges of POC testing within their respective fields. Materials and methods: The study was conducted from April to June 2019, in Colorado, United States of America. Five healthcare professionals, each working in a distinct field (anesthesiology, nursing, emergency medicine, trauma surgery, and POC management) were interviewed. Results from each of the interviews were transcribed as qualitative perspectives on POC diagnostics. Discussion: The general consensus among participants in this study is that POC testing is tremendously beneficial, providing rapid test results, increased access to diagnostics, and improvements in hospital efficiency. However, significant challenges remain in blood-based POC diagnostics, particularly in maintaining sample quality, due to the fact that devices used for sample acquisition and handling are not designed for POC. This raises the possibility for interferents like hemolysis to occur, which may alter diagnostic results. Errors in POC diagnostics, whether due to sample, operator, or instrument error, may cause providers to lose confidence in the test. This lack of confidence can lead to duplicate testing and delayed patient diagnoses. Conclusion: The perspectives presented in this study suggest there is a significant need for improvement in the pre-analytical phase of POC testing, and that current practice employs specimen collection technology not designed for POC. Therefore, one hypothesis is that the introduction of a collection device designed specifically for POC could reduce pre-analytical errors, standardize sample quality, improve efficiency, and further benefit patient care.

Blood gas analysis syringes containing spray-dosed droplet liquid heparin may decrease sample rejection ratios

“…For this reason, follow-up, and evaluation of the preanalytical phase, which is the most vulnerable stage of TTP, can be more challenging for BGA and POCT (5). In this context, the organization of activities, symposiums, and work groups, involving other physicians, phlebotomists, and nurses, in addition to the laboratory staff as well as publishing guidelines can be beneficial for the determination of problems and finding possible solutions (6,13).…”

“…Based on the evaluation of the Total Testing Process (TTP) of BGA, it was reported that the most problematic part was the preanalytical (prior to analysis) phase (1,4). In addition to this, it can be concluded that preanalytical phase for BGA is more vulnerable in general and poses a higher threat to patient safety as it often involves sampling and use of analyzers by non-laboratory staff (5,6).…”

“…(12,13). Considering the fact that such equipment is also frequently used by non-laboratory staff, e.g., during the quality assessment of samples and equipment maintenance, etc., this process may turn into a difficult challenge for staff who works in an intensive environment under emergency conditions (6). Any failure to provide accurate BGA results in a timely manner may pose a potential threat to patient safety (11).…”

Promise and perils of paper-based point-of-care nucleic acid detection for endemic and pandemic pathogens

“…26 Blood sampling is considered a minimally invasive sample when collected from finger prick collecting capillary blood and can be performed at home and at the point of care. 27 Due to the low volume of blood collected from a fingertip (less than 50 μl), the collected blood is subsequently dispended to the blood collection card for downstream analysis of the dried blood spots (DBS). 28,29 Emerging microneedle-based devices using push-button initiated capillary blood collection from the upper arm have recently been demonstrated to draw up to 100 μl of blood and generated less pain than a finger prick-based device.…”

Microfluidic-Based Detection of AML-Specific Biomarkers Using the Example of Promyelocyte Leukemia

“…The short analysis times mean that a tailor-made therapy can be carried out more quickly [ 5 ]. This has a direct influence on the patients’ chances of survival [ 5 , 7 ]. The low use of assay reagents and sample material does not only save money, but also avoids cost-intensive techniques for the collection of patient samples.…”