POINT-OF-CARE TESTING


her service achieving accreditation in the past, commenting that a strong two- way relationship with as many suppliers as possible was hugely beneficial. She discussed how her department had been able to influence product development and work with suppliers on new functionality, connectivity and patient literature.


Simon Rose, Commercial Manager


at Werfen UK was next to speak, shining a light on ‘Pitfalls in procurement’, considering how procurement works and how it can go wrong, before moving onto the NHS specifically and how trusts can set themselves up to gain the most from a difficult process and avoid falling into common traps.


The new GEM Premier 7000 blood gas analyser.


and challenges, along with 21 key recommendations.


One of the issues uncovered by a


search for unwanted variation at all stages of the pathology process was factitious hyperkalaemia; a problem in the measurement of potassium. Poor sample handling can increase potassium loss from the RBC, increasing serum potassium artefactually. There are numerous factors which result in haemolysis and leakage of potassium, creating challenges when considering test results. Proper treatment of factitious hyperkalaemia is a patient safety issue.


In analysing processes across the


country, significant variation in the quality of the pre-analytical phase was found. Areas included sample rejection (due to poor phlebotomy technique and sample handling), and transport (including variations in type of transport and temperatures across different seasons). GIRFT recommendations include better design, monitoring and control for the pre-analytical process, based around KPIs for the time from needle to centrifuge and for transport temperature, with systems to measure and audit.


Differences for the point-of-care


testing process were covered, including the use of whole blood – which increases the risk of haemolysis. Therefore all elevated potassium results from a POCT device must be confirmed by the laboratory, adding delays to treatment decisions. Published studies on the issue of haemolysis and blood gas analysis were discussed, including how to identify and deal with unsuitable results. Next up was Nicky Hollowood, Lead


Healthcare Scientist and POCT Manager at Integrated Pathology Solutions (Harrogate and District NHS Foundation Trust), who spoke about the process of attaining ISO 15189:2022 accreditation for POCT services. She covered the reasons to go for accreditation, including potential improvements, how the standards fitted the local service, as well as the previous accreditation journey in Harrogate. Changes in the new 2022 standards were covered, mainly the move to risk assessment, which is obviously very different for POCT devices when compared to those in the laboratory. One area of focus for Nicky was engaging with suppliers, which she said was key to


There are numerous factors which result in haemolysis and leakage of potassium, creating challenges when considering test results and treatment of factitious hyperkalaemia is a patient safety issue


46


Also speaking was Lorna Pentony, POC Coordinator at Rotunda Hospital in Dublin, who spoke about her department’s adoption and implementation of the ROTEM sigma thromboelastometry POCT system. With post-partum haemorrhage rates on the increase, Werfen’s ROTEM instrument provides a rapid assessment of clot development and what’s required to maintain normal clotting.


GEM Premier 7000 Later in the day GEM Premier Product Manager Bev Straker-Bennett gave the audience a complete introduction to Werfen’s new blood gas analyser, the GEM Premier 7000. The company says that the new analyser provides laboratory- quality detection of haemolysis, in whole blood, marking a transformative step toward enhancing patient outcomes in acute care.


The included iQM3 (Intelligent Quality Management 3) technology provides continuous quality management with integrity checks before, during and after every sample analysis. This works to ensure sample quality across the most common preanalytical errors (haemolysis, clots, bubbles, benzalkonium) and is able to detect haemolysis in as little as 45 seconds. The haemolysis detection demonstrates high correlation to the laboratory method, with 99.3% overall agreement across 279 samples. The GEM PAK cartridges used


across the GEM range now enable integrated haemolysis detection on the new machine. The all-in-one cartridges automate what was previously a labour- and skill-intensive processes, only needing changing every 31 days, with no additional handling required. Centralised, comprehensive management is offered by GEMweb Plus 500 Custom Connectivity, which provides customisable connectivity and automated management of systems, operators, and


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