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Point-of-care testing in a high-income country paediatric emergency department: a qualitative study in Sweden
Karolinska Inst, Dept Global Publ Hlth, Stockholm, Sweden.;Karolinska Univ Hosp, Paediat Rheumatol Unit, Stockholm, Sweden.;Stockholm Healthcare Serv, CAP Res Ctr, Paediat Immunopsychiat Unit, Stockholm, Sweden..ORCID iD: 0000-0001-7816-8338
Karolinska Inst, Dept Global Publ Hlth, Stockholm, Sweden..
Uppsala Univ, Dept Womens & Childrens Hlth, Int Maternal & Child Hlth, Uppsala, Sweden..
South Gen Hosp, Sachs Children & Youth Hosp, Stockholm, Sweden..
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2021 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 11, no 11, article id e054234Article in journal (Refereed) Published
Abstract [en]

Objectives In many resource-limited health systems, point-of-care tests (POCTs) are the only means for clinical patient sample analyses. However, the speed and simplicity of POCTs also makes their use appealing to clinicians in high-income countries (HICs), despite greater laboratory accessibility. Although also part of the clinical routine in HICs, clinician perceptions of the utility of POCTs are relatively unknown in such settings as compared with others. In a Swedish paediatric emergency department (PED) where POCT use is routine, we aimed to characterise healthcare providers' perspectives on the clinical utility of POCTs and explore their implementation in the local setting; to discuss and compare such perspectives, to those reported in other settings; and finally, to gather requests for ideal novel POCTs. Design Qualitative focus group discussions study. A data-driven content analysis approach was used for analysis. Setting The PED of a secondary paediatric hospital in Stockholm, Sweden. Participants Twenty-four healthcare providers clinically active at the PED were enrolled in six focus groups. Results A range of POCTs was routinely used. The emerging theme Utility of our POCT use is double-edged illustrated the perceived utility of POCTs. While POCT services were considered to have clinical and social value, the local routine for their use was named to distract clinicians from the care for patients. Requests were made for ideal POCTs and their implementation. Conclusion Despite their clinical integration, deficient implementation routines limit the benefits of POCT services to this well-resourced paediatric clinic. As such deficiencies are shared with other settings, it is suggested that some characteristics of POCTs and of their utility are less related to resource level and more to policy deficiency. To address this, we propose the appointment of skilled laboratory personnel as ambassadors to hospital clinics offering POCT services, to ensure higher utility of such services.

Place, publisher, year, edition, pages
BMJ , 2021. Vol. 11, no 11, article id e054234
Keywords [en]
paediatrics, qualitative research, protocols & guidelines, quality in healthcare, paediatric A&E and ambulatory care, public health
National Category
Nursing
Identifiers
URN: urn:nbn:se:kth:diva-306406DOI: 10.1136/bmjopen-2021-054234ISI: 000724352600010PubMedID: 34824122Scopus ID: 2-s2.0-85120632678OAI: oai:DiVA.org:kth-306406DiVA, id: diva2:1620703
Note

QC 20211216

Available from: 2021-12-16 Created: 2021-12-16 Last updated: 2023-08-28Bibliographically approved

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Gantelius, JesperGaudenzi, Giulia

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