POC creatinines for radiology
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My question is if you are doing POC creatinines for Radiology CT scans who is performing the testing- radiology or lab? Why did you choose to go with one group over the other?
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Going back 10 years, our facility went from priority processing in main lab on a large analyzer, to lab staff performing on whole blood on an iSTAT (still within main lab), to ultimately moving those iSTATs to the Radiology departments for their staff to do it themselves, under our CLIA.
It all comes down to time; what was initially "fast-enough" gradually became "not fast enough" - even though we did a fine job in maintaining tight TAT via lab.
The Radiology Techs are trainined to run their own creatinines. I monitor results through RALS.
It became a preception of time - lab was never fast enough even though we are next door to radiology.
It is a combination. If the patient hasn't had a creatinine in the lab before they come, the the rad tech will preform it on the Nova StatSensor.
The techs in radiology do the testing on the I-STAT. We monitor through middleware.
We dispatch lab personnel with an i-STAT to Radiology. The Patient Registration desk notifies the lab and radiology simultaneously that the patient has arrived and that a Creatinine is needed prior to CT. Lab responds to CT and performs testing prior to the patient changing into a gown.
We chose this process because we it would minimize training and competency assessment demands. We also felt it was a better patient care model having the specimen collection experts manage the front end process.
For the creatinine tests performed on the ISTAT, how do you report out the eGFR associated with the creatinine result? Currently our LIS calculates this when the result comes through RALS into Sunquest. We will be switching to a different LIS interface
in a few months and our new interface will no longer have the capability to calculate this.
Hi Linda,
Radiology techs perform the iSTAT creatinines. There was really no other choice; no other source of employee to perform was an option.
Stephanie - regarding your particular question about eGFR calculation - do you have the option in your facility's HIS to perform the calculation? We actually have never had our LIS calculate this value and rely entirely on the HIS to provide.
We have CT and MRI techs performing our POCT creat testing. We use the Alere EPOC where you can customize which analyte you want them to see and use. It is working really well so far and the techs are competent and love to use it.