PATHOLOGY
Role of POC CRP during the pandemic
Being able to streamline local healthcare and reduce unnecessary A&E and hospital admissions for frail and vulnerable patients has never been more relevant in light of the COVID-19 pandemic. Point of care CRP haematology analysers, installed in locations across Cornwall, are helping to reduce trips to hospital or get people home sooner, as Mandy Campbell reports.
At the start of the COVID-19 lockdown, the Royal Cornwall Hospitals NHS Trust (RCHT), in partnership with the Cornwall Foundation NHS Trust, purchased and installed five new Microsemi CRP point of care (POC) haematology analysers (Horiba UK). The installation of these POC analysers across Cornwall is now enabling patients to have pathology tests performed locally by clinical staff in acute and community settings, rather than visiting the main Royal Cornwall Hospital in Truro.
The Microsemi CRP (Fig. 1) can simultaneously deliver full blood count (FBC) plus CRP results to support the rapid near-patient distinction between bacterial and viral illnesses, as well as other acute applications highlighted in the scientific literature. For example, for triage, in addition to the early recognition of sepsis, CRP can assist in: guiding subsequent investigation in children with unexplained limping or pseudoparalysis; the detection and differential diagnosis of acute abdominal syndromes, particularly appendicitis; and recently risk stratification and management of Coronavirus patients.
These recent POC installs are not only relieving pressure on the main hospital, but also enabling patients to be treated in the community, closer to home, where possible. This is of course advantageous during COVID-19, but it also paves the way for future pathology provision across the county by supporting the improvement of patient pathways.
Install expedited by COVID-19 Originally the installations were planned to improve patient experience and access to pathology testing across the winter, and to aid the diagnosis of a wide range of conditions including flu. In light of the
OCTOBER 2020
Patient pathways improved Microsemi CRP analysers are now located in Bodmin and Camborne Redruth Community Hospitals, with another planned soon for St Austell. Unnecessary trips to hospital can be prevented as patients are tested close to home, providing GPs and community clinicians with immediate results so they can best manage treatment. This is enabling different patient pathways using community hospitals and minor injuries units for people who still need monitoring and support, but not urgent care. It is also keeping vulnerable patients, such as the elderly, away from risk in the main hospital while being reassured by test results that they are receiving appropriate care.
Figure 1: Horiba’s Microsemi CRP in use in the community in Cornwall
current COVID-19 pandemic, the Microsemi CRP analysers install was expedited. Horiba Medical responded rapidly to the Trusts’ order following a successful validation study of its POC analyser with main laboratory haematology samples. A Horiba team of two then ensured installation and staff training within just two days during ‘lockdown’. “Our focus on using new POCT such as the Microsemi CRP haematology analysers is supporting the population across Cornwall with a new way of triaging patients to help keep them out of hospital and A&E unless truly necessary,” said Lisa Vipond, lead BMS clinical chemistry & POCT, RCHT. “It is also helping to get many patients home sooner from hospitals where they previously had to wait for main lab results. All these factors are supporting patient safety, especially those that are particularly vulnerable to any infection.”
Due to the creation of green and red COVID-19 zones within the Trust, a further two new Microsemi CRP analysers are placed in the Surgical Assessment Lounge at Truro and St Michael’s Hospital, Hayle, to support surgical teams with pre- and post-surgery patient assessments. POCT in these locations is enabling faster turnaround times to results, so streamlining service and enabling patients to be discharged sooner which is helping to maintain social distancing, particularly where space is limited.
Lisa Vipond explained why the Trusts selected the CRP analysers to support them in their new POCT set-up, which is transforming the pathology service in Cornwall to enhance patient pathways. “We were looking for a very specific POCT haematology solution which was easy-to- use by non-laboratory personnel, quick at producing results and with minimal maintenance. The availability of full blood count with CRP in a POC analyser was a real winner as our clinical teams value CRP as a quick indicator on the best patient pathway and what to look for next.”
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