EPOC NXS Hospital Unit Patient Testing

Epoc testing in the NICU/PICU/CVICU;  These depts have RT assigned staff 24/7.

Who does the testing, Respiratory or RN...?

Do you use capillary samples for testing?

Does the EPOC go into the patient's room or do you have the Unit outside of the room?

Hello Erika, 

I have worked at multiple locations that used the epocs. 
In our NICUs the nursing staff are trained to run the epocs. 
Most locations have nursing run the epocs. 
In the OR the anesthesiologists usually runs the epoc. 

For NICU, they use the capillary tubes for heel sticks. 

The 2 hospitals that I worked at, had the setup for the epoc locations differently. 
1 place that I worked at, had epocs in each patient's room and another location, the epoc was at a central location. 

I prefer the central location setup as it enabled us to trouble shoot the device and retrieve it if necessary. 
When we had the epocs in the patient's room, we would have to introduce ourselves and sometimes the door was closed for contact isolation patients... It was not my favorite setup. 

For special precaution patients, they would need their own epoc, separate from others. 

I recommend it to be installed at a central location. 
If you were to have the epoc in a central location, during training - always inform them to always bring the device into the room when testing, rather than taking the specimen outside the room to be tested. I have had so many situations where, nurses bring the specimen out unlabeled and scan the patient's barcode on a loose sheet and evidently it is the wrong patient. 

Hope this helps. 

Hi Erika, 
We currently don't have EPOCs in use in our NICUs and do not use capillary samples.  Instead we preform a similar panel in the laboratory on our Radiometer ABL800s. 
For our adult population we have EPOC NXS. Testing is done by a mixture of RT and RN. RN in ED, and CT (Creatinine only), RT responses to all codes and brings the EPOC with for testing. 
Does the EPOC go into the patient's room or do you have the Unit outside of the room? For our CT department that EPOC is in a central location right next to their phlebotomy draw location. For ED and Codes the meter is brought into each room for testing and then returned to a central location to charge and to easily locate for the next use. 
What would you do for a special precaution patient?
The meter is disinfected after each patient use and we haven't had an issue with special precautions. However for our Glucose devices which are used more frequently it was decided by Infection Control to have separate meters that would stay in those contact rooms to minimize risk between patients. 
What special considerations would you suggest we prepare for?
The EPOC cannot load multiple reference ranges for different age groups or specimen types. So you cannot rely only on the display's color coded flagging for critical results and must check the EMR after the results post. 

We use the EPOC in our NICU, ED, Code Team and Perfusion departments. 
RN's run the EPOC.
We have a different configuration in RALS for the NICU EPOC, with the option of capillary, venous or arterial samples, and with reference ranges for infants.
We also have a different configuration for the Perfusion department, which allows the choice of checking "hemodilution" for CPB specimens.
The EPOC goes into the patient room and is cleaned between each patient. We have no special instructions for patients with precautions.
The biggest "errors" I see with the NICU EPOC compared to the other EPOC, is that the card times out before introducing the specimen (7.5 minutes), and sample insufficient error. This is most likely due to the difficulty in obtaining the specimen from a heelstick.