• Point-of-care testing in primary care in the Netherlands : Management of patient safety related aspects

      de Vries CGJCA; Doggen CJM; Geertshuis M; Hilbers-Modderman ESM; Kusters RGCM; Verheij RA; Geertsma RE; GMT; vgc (Rijksinstituut voor Volksgezondheid en Milieu RIVMHealth Technology and Services ResearchUniversity of TwenteClinical Chemistry and Haematology laboratoryJeroen Bosch ZiekenhuisNetherlands institute for health services research, 2013-05-01)
      Point-of-care (POC) tests are devices or test strips that can be used near or at the site of patients for a relatively fast diagnosis. Examples are blood glucose meters for diabetes or nitrite test strips to detect a urinary tract infection. Although a majority of general practitioners in the Netherlands is using POC tests in their practice, little is known on how they manage the corresponding patient safety aspects. To maintain good and safe use of POC tests it is important that POC tests are used correctly. Results of the explorative study performed by the RIVM show that some quality aspects receive insufficient attention in GP practices. Results There is not always sufficient attention for quality control measures such as checking the storage conditions, calibration, and maintenance. Furthermore, only half of the respondents take universal hygienic measures, such as washing hands before taking a blood sample. Refresher courses on the use of POC tests are hardly organized. Only a few of the general practitioners contact the manufacturer of the device when a device failure occurs. Without informing the manufacturer of device problems, the manufacturer does not have the opportunity to improve the device or instructions for use, whatever is applicable, so that the problem does not recur. Well-controlled aspects include patient identification, and actions taken when ambiguous test results are obtained. Recommendation To maintain a good quality of care and to prevent the risks of errors with POC tests in GP practices, it is recommended to expand existing general guidelines for GPs with regard to the use of point-of-care tests.