Emergent in-home patient visits and POCT

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I have two questions surrounding emergent in-home programs where RNs/EMTs/Providers provide emergent care to patients in their homes to prevent them from having to make a trip to the emergency room. This is not a home health program or of that sort. This is to provide minimal emergent care to patients in their home to reduce the need to have them go to the emergency room. My questions pertain to providing/performing POCT during those visits. 
1. Are you providing POCT COVID testing and if so, does anyone have the patient's do an at home COVID kit on themselves as part of the visit? 
2. How are you monitoring temperatures for the POCT reagents that are being transported to the patient's home? 
Thank you! 

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Yes, we have this program in place, but we are recently no longer their oversight so I have limited info.  We call it Mobile Interactive Health.  Yes, they have COVID and Flue testing they do with a QuickVue kit.
Yes, they do monitor temperature.  They have a bag that is carried with supplies and there is a temp & humidity monitor in that bag.  I think they record it once a day which probably isn't ideal.  They do not leave any Lab supplies in their vehicles if not running. The bag is taken to and from the car once back at the home base.  If at a patient's house and the bag stays in the car, then they leave the car running and locked.

My site just recently went live with POC platforms for our Hospital From Home program a few days ago.  For Covid, they will use our supplied kits and the RN must be the one performing the test.
For temperature monitoring:  that is a huge can of worms for us.
I performed many cooler validations to see how our testing supplies hold up in various "cooler" bags with and without gel packs.  I even had specialty room temperature phase material gel packs ordered from a specific company just so we can maintain room temperature inside the cooler even when it is inside a hot car during the summer or a cold car during the winter.  We researched and invested in mobile continuous temperature devices that upload to an app that is loaded on all the RN's hospital issued cell phones and Ipads.  It records temperature every minute and an alert sent to the app as well as to my email and phone the second it drops out of range.
You would be surprised at how quickly an Igloo high quality cooler bag gets too hot or too cold during the season so logging the temperature once a day was not something I felt comfortable with.   We just officially went live with all of this 2 days ago so I don't know how this process will wind up working out, but we felt we tried our absolute best to mitigate as much of the risk that we could being the nature of this program.  POC tests and devices traveling around in cars and multiple types of environments throughout each day is relatively uncharted territory as I understand it.  And a compliance nightmare

Our system has done something similar but with POC cholesterol screenings as Health Fairs in which we have to transport instruments and reagents to and from the facility or mobile van. Wherever they are storing the supplies (overnight/weekends/when not in use) they should document temperature each day. When we arrive at the place of testing, we would retake temperatures. In this case because it may be multiple homes a day, in and out of cars, different temperatures in the homes I'd suggest documenting the room temperature before testing begins for each patient. If you don't think there will be temperature excursions throughout the travel day you could also use a min/max thermometer to make sure the temp fluctuations are still within range and just document the temperature at the beginning and end of the days of testing. 

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sarah ganje
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