POC pH testing on gastric secretions

I am interested in this as well. This question was circulating a few months ago but it seems no one responded they were actually using the right spot device at the time. My hospital chose to go with the Hydrion pH paper. This was implemented a couple months ago here at Children's because it was the quickest way to get the test online.

I am still interested in the right spot though.......

A year and a half ago I came to work for a major Children's Hospital, and one of the first things that absolutely floored me was the amount of pH paper we are purchasing for this hospital. I have come to accept this as part of life in pediatrics. I too considered the Right Spot, it looks cool, but the cost is high and the nurses were not interested. We use Hydrion pH paper, and basically our patient families are given the whole roll to take home. We do not store open boxes on the shelf. The nurses use the roll to show the parents how to test, then give it to them. That way we are never in the predicament of following the only QC requirement for that paper, which is to perform QC if the roll has been OPEN for more than three months.  I have also heard conflicting view points on whether or not using pH paper for NG tube placement is truly a POC test. We obviously do not bill for it, and they do not document the "result" because they are simply using it to determine placement. 

We use the Hydrion paper. QC is performed daily(using 5.0 and 7.0 buffer). MD orders test. Results are documented in EMR with reference ranges for gastric and non-gastric and specimen color. We consider it a POC laboratory test.

We use pH strips put out by Ricca for most gastric pH testing (we use Hydrion for ocular pH). Our PICU actually utilizes radiology for tube placement.

One of our units did approach us about Right Spot. It was too costly to consider.

Our results are placed into the EMR along with control documentation, which is performed each day of patient testing.

Our nursing supervisor wanted to add this as a nursing POC test last year. They quickly realized that all of the maintenance required (QC and competencies) was more than they wanted to do. I work in a 300 bed hospital and they wanted to add it to basically every unit.

We were already performing fluid pH in the lab, usually as part of a fluid count or crystals. They ultimately decided that sending it to the lab was their best choice. We use the Hydrion paper and do two levels of QC every day of testing using our manual urine QC. Super quick and easy.

For those of you running so much QC -why?

Hi Silka - our nursing staff performs the gastric pH in the NICU for tube placement and they also perform QC daily. They use the MColorpHast test strips. They've been asking me if they can reduce the QC frequency, but I was under the impression that 2 levels of daily QC was required for waived tests. Is that not what is required by CAP or CLIA?

Hi! No CLIA, CAP, and Joint Commission simply instruct you to follow manufacturer recommendations. For Hydrion paper, the manufacturer only requires QC on open rolls after three months.

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We use NitraTest, rolls of paper from BMS, and there are no instructions.  Utilization is isolated to mother/baby for vaginal/gastric pH.  I QC new shipments and have the units QC open rolls with 2 levels of buffer monthly with their QA reports, which is doubling as ongoing competency.

Thanks to all who responded about gastric pH and QC frequency. Does anyone else use the MColorpHast pH test strips from MilliporeSigma? If so what QC regimen do you use for those?
As far as I can tell there is no written recommendation from the vendor related QC frequency. I also called their technical support and they couldn't provide any direction either. I want to move from daily QC, which is difficult for the nurses to remember to do, to something similar to what others are doing for their strips, but need some data on the MColorpHast strips to back up my reasoning.

Thanks!

At my previous institution we had this implemented in the NICU to verify feeding tube placement. We used single pad pH strips. These were QC'd per manufacturers directions (I think it was every 30 days). The roll-out was for about 75 NICU nurses over the course of 3 weeks. A test was built for this, and results were manually entered into the patients EMR.

Same reply as Kathleen Haselden:

We use the Hydrion paper. QC is performed daily(using 5.0 and 7.0 buffer). MD orders test. Results are documented in EMR with reference ranges for gastric and non-gastric and specimen color. We consider it a POC laboratory test.

Of course for all of our troubles, our peds units do far fewer patient tests then was estimated when they caused a fuss to have the test implemented.