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Clinical Chemistry > L.14 Near Patient Testing > Flashcards

L.14 Near Patient Testing Flashcards

1
Q

What is the definition of Near Patient Testing (NPT)?

A

Clinical laboratory testing conducted close to the site of patient care, typically by clinical personnel whose primary training is not in the clinical laboratory sciences, or by patients (self-testing)

NPT refers to testing performed outside of the laboratory setting.

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2
Q

What was Near Patient Testing historically called?

A

Point of Care Testing (POCT)

The term has evolved to Near Patient Testing (NPT).

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3
Q

In what settings is NPT used in hospitals?

A
  • Critical care setting (ICU/ED)
  • Hospital wards
  • Hospital outpatient departments (OPD)

These settings allow for immediate testing and results.

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4
Q

What community settings utilize NPT?

A
  • Community testing (e.g. pharmacy, sports clinic, workplace)
  • Primary care / GP
  • Nursing home
  • Ambulance triage

NPT in community settings can enhance accessibility to healthcare.

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5
Q

What is an example of self-testing at home under NPT?

A

Blood glucose, pregnancy test, INR testing

Self-testing allows patients to monitor their health conveniently.

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6
Q

List the NPT environments.

A
  • Laboratory (within hospital setting)
  • Ward/clinic (within hospital setting)
  • GP / primary care (community healthcare setting)
  • At home (non-healthcare setting)

These environments reflect the diverse locations where NPT can occur.

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7
Q

What are the types of NPT tests?

A
  1. Simple tests
  2. Moderate complexity tests
  3. High complexity tests

Types of tests include urine dipstick, capillary blood glucose, pregnancy test, urine microscopy, and blood gas analysis.

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8
Q

Name a simple test used in NPT.

A

Urine dipstick

Other examples include capillary blood glucose and pregnancy test.

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9
Q

What is a moderate complexity test in NPT?

A

Urine microscopy

This type of test requires more skills and equipment than simple tests.

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10
Q

What is a high complexity test in NPT?

A

Blood gas analysis

High complexity tests require advanced knowledge and equipment.

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11
Q

List three reasons to perform NPT.

A
  • Improve quality of patient care
  • Enhance efficiency of patient care
  • Increase clinical and patient satisfaction

Additional reasons include improving patient education and minimizing the burden on central laboratories.

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12
Q

What does the ‘A’ in WHO ASSURED criteria stand for?

A

Affordable

The criteria ensure that the cost of tests and devices is low.

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13
Q

What does ‘Sensitive’ mean in the WHO ASSURED criteria?

A

Test should be able to detect low levels of analyte

Sensitivity is crucial for accurate diagnosis.

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14
Q

What does ‘Specific’ mean in the WHO ASSURED criteria?

A

Test should be able to detect only the analyte of interest

Specificity prevents false positives.

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15
Q

Fill in the blank: The test should be easy to use and interpret, which is referred to as _______.

A

Useable

This aspect is important for effective implementation in various settings.

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16
Q

What does ‘Rapid’ mean in the WHO ASSURED criteria?

A

Test should provide results quickly

Rapid results are essential for timely patient management.

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17
Q

What does ‘Equipped’ refer to in the WHO ASSURED criteria?

A

Test should be able to be performed in a variety of settings

This ensures accessibility to testing.

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18
Q

What does ‘Deliverable’ mean in the WHO ASSURED criteria?

A

Test should be able to be performed in a variety of settings

This emphasizes the importance of versatility in testing locations.

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19
Q

What is one advantage of NPT related to diagnosis?

A

Results may lead to a critical diagnosis, e.g. glucose + ketones = DKA

DKA stands for Diabetic Ketoacidosis, a serious condition that can occur in diabetes.

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20
Q

What advantage does NPT have regarding speed?

A

Reduced turnaround time as sample transport and procedure delays are avoided

This means that results can be obtained more quickly compared to traditional methods.

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21
Q

How does NPT contribute to reduced waste?

A

Smaller sample volumes are required, and fewer reagents are used

This efficiency can lead to cost savings and less environmental impact.

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22
Q

What is an advantage of NPT in terms of clinician-patient interactions?

A

Improved clinician patient confidence and can be used to guide treatment decisions

This suggests that NPT can enhance the quality of care provided.

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23
Q

In what way does NPT improve patient education?

A

Improved patient education and counselling

This can empower patients to manage their health more effectively.

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24
Q

What convenience does NPT offer to patients and clinicians?

A

Reduces the need for patients to travel to a laboratory or clinic for testing

This can make healthcare more accessible for patients.

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25
List three advantages of NPT.
* Diagnosis leading to critical results * Reduced turnaround time * Improved patient education and counselling
26
What is a major disadvantage of NPT regarding accuracy?
Lower accuracy and precision, but always improving with technology ## Footnote Continuous advancements in technology can enhance the reliability of NPT.
27
What is a disadvantage of NPT related to personnel?
Less skilled personnel performing tests, but can be trained ## Footnote Training programs can help ensure quality testing.
28
What cost-related disadvantage is associated with NPT?
Higher cost per test, but can be offset by reduced costs in other areas ## Footnote Overall cost-effectiveness can still be favorable despite higher individual test costs.
29
What issue arises from the lack of comparability with laboratory results in NPT?
Lack of comparability with laboratory results, but can be improved with standardisation ## Footnote Standardisation can enhance the credibility of NPT results.
30
What management issue is associated with data in NPT?
Lack of data management, leading to difficulty in tracking results and trends over time ## Footnote This can hinder the ability to monitor patient health effectively.
31
Who are the potential testers for NPT?
* Laboratory staff * End-user (non-laboratory healthcare worker) * Self-tester (patient) ## Footnote Each group may require specific training to perform tests accurately.
32
What are some responsibilities related to NPT testing?
* Laboratory staff * Ward staff ## Footnote Clear delineation of responsibilities is important for quality control.
33
What documentation and monitoring issues should be considered in NPT?
* Are results linked to specific device and user? * Are results linked to patient record? * Need to keep log of use ## Footnote Proper documentation is essential for accountability and quality assurance.
34
What maintenance tasks are required for NPT devices?
* Calibration and quality control * Cleaning and maintenance * Replacement of consumables ## Footnote Regular maintenance ensures accurate and reliable test results.
35
Who is considered the end-user?
A person who ultimately uses or is intended to ultimately use a product.
36
What does non-laboratory HCW stand for?
Non-laboratory healthcare worker.
37
What is a characteristic of a non-laboratory HCW?
Good at results interpretation.
38
What type of interaction does a non-laboratory HCW have with patients?
Face to face interaction.
39
What is a key aspect of the medical scientist's work environment?
Works in a highly regulated environment.
40
What is one task that medical scientists do not perform?
Take samples.
41
What is a defining feature of the medical scientist's expertise?
Expert in results interpretation.
42
What type of testing environment does the self-tester typically use?
Home setting.
43
What limitation might a self-tester have regarding instructions?
May not read or understand instructions.
44
What is a common desire of a self-tester?
Desire discreet testing.
45
What is a key limitation of the self-tester in terms of results?
Limited knowledge in result interpretation.
46
Fill in the blank: A self-tester is typically an _______.
[untrained person]
47
True or False: Medical scientists have face-to-face interaction with patients.
False.
48
What does CORU stand for in relation to medical scientists?
A regulatory body for health and social care professionals in Ireland.
49
What type of experience do medical scientists possess?
Experience and knowledge of technology.
50
What is a common trait among non-laboratory HCWs regarding technology?
They may have limited experience with technology.
51
What type of guidance do self-testers lack?
Guidance on consequences of results.
52
What are lateral flow devices (LFDs)?
Disposable devices for detecting and quantifying analytes in a complex matrix ## Footnote LFDs are characterized by low development and production costs, enabling widespread use.
53
List three applications of lateral flow devices.
* Diagnostics * Environmental testing * Food safety testing
54
What types of samples can lateral flow devices test?
* Blood * Urine * Saliva * Sweat * Food * Water
55
What are the formats in which lateral flow devices can operate?
* Qualitative * Semi-quantitative * Quantitative
56
What is the key process in the operation of a lateral flow device?
Sample moves along the strip by capillary action ## Footnote This is a critical step that allows the sample to interact with antibodies on the test strip.
57
What does a visible test line indicate in a lateral flow device?
Formation of an antibody-analyte complex that is immobilized on the test line ## Footnote A visible control line indicates that the test has functioned correctly.
58
What is the purpose of a urinary dipstick?
Used as a screening test for various conditions ## Footnote Conditions include diabetes, urinary tract infection, kidney disease, liver disease, and pregnancy.
59
What substances can be detected using a urinary dipstick?
* Glucose * Protein * Ketones * Bilirubin * Urobilinogen * Blood * pH * Specific gravity * Nitrite * Leukocyte esterase
60
True or False: Urinary dipsticks can provide results before symptoms appear.
True ## Footnote Substances like glucose and protein may be present in urine before symptoms are evident.
61
Fill in the blank: A dipstick is a thin strip of plastic or paper with a series of pads that change _______ when they come into contact with urine.
colour
62
What is a glucometer primarily used for?
Capillary blood glucose reading ## Footnote Essential for Type 1 Diabetes Mellitus (T1DM) and may be used for Type 2 Diabetes Mellitus (T2DM) with certain medications.
63
What is the most common detection method used in glucometers?
Electrochemical ## Footnote Other methods include optical and enzymatic.
64
What does the optical detection method in glucometers utilize?
Light to measure glucose levels ## Footnote This method is also known as photoelectrochemical.
65
In what settings can glucometers be used?
Hospitals, clinics, homes, field testing ## Footnote They are versatile and can be used in various environments.
66
What is Continuous Glucose Monitoring (CGM)?
A portable subcutaneous sensor that continuously measures glucose levels in interstitial fluid ## Footnote It estimates glucose levels every 1-5 minutes.
67
True or False: Continuous Glucose Monitoring (CGM) is inexpensive.
False ## Footnote CGM is considered expensive.
68
What is the primary use of blood gas analysis?
To assess the acid-base status and oxygenation of a patient ## Footnote Key parameters include pH, pCO2, pO2, HCO3, and lactate.
69
What is the purpose of pre-treating the sample tube with heparin in blood gas analysis?
To prevent clotting ## Footnote Lithium heparin is commonly used for this purpose.
70
What technique is used to measure pH, pCO2, and pO2 in blood gas analysis?
Potentiometry ## Footnote This technique measures the voltage of an electrochemical cell.
71
Name two methods used to analyze HCO3 and lactate.
* Spectrophotometry * Potentiometry ## Footnote These methods are part of the blood gas analysis process.
72
What does the acronym WBIT stand for in sources of error in NPT?
Wrong blood in tube ## Footnote This refers to errors related to sample collection.
73
What can lead to poor sample quality in blood analysis?
* Hemolysis * Lipemia * Drip arm ## Footnote These factors can affect the accuracy of the results.
74
What are two common sources of error in blood analysis related to user actions?
* Poor training or understanding of end-user * Transcription errors ## Footnote These errors can lead to incorrect test results.
75
Fill in the blank: The lack of _______ and quality assurance can lead to errors in blood analysis.
quality control ## Footnote Quality control and assurance are essential for accurate test results.
76
What does incorrect interpretation of results in blood analysis refer to?
False positive and false negative results ## Footnote Misinterpretation can lead to inappropriate clinical decisions.

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