Nurses' perceptions of point of care testing in critical care: A cross-sectional survey.

BACKGROUND: Nurses working in critical care (intensive or high dependency care units) perform a multitude of tasks including point-of-care testing (POCT), where diagnostic tests are performed at or near a patient's bedside. POCT can speed up clinical decision-making, but errors can occur at any point in the pre-analytical phase. AIM: To investigate nurses' perceptions of current POCT practice in critical care pre and post the COVID-19 pandemic. METHODS: An online cross-sectional survey of critical care nurses undertaken 2019-2021. Nurses across Europe were invited to participate during a conference and via communication from professional organizations. RESULTS: A total of 158 critical care nurses responded to the survey. All respondents who stated their location reported being residents of the UK. Alongside challenges related to training and competence, frequency of sampling and sampling volumes were key concerns, seen to be associated with increased blood wastage and nursing workload, potentially increasing the potential for error, and leading to poorer patient and staff outcomes. CONCLUSION: Results from this study highlight the impact of POCT on nurses' workload, patient care provision and staff wellbeing. RELEVANCE TO CLINICAL PRACTICE: Alongside exploring feasible and effective training models, innovative roles, which provide technical support, including undertaking POCT could enable nurses more time to provide care to patients and families. Any future changes in workforce allocation must, however, be fully evaluated from the perspective of both patient and staff outcomes.

Blood sampling in adult critical care: a mixed methods study.

There are few studies exploring blood sampling practice in critical care. In particular, the views of nursing staff are missing from the literature. The aim of this mixed methods study was to understand blood sampling practice at a single centre National Specialist Orthopaedic NHS trust in London, England. Following an audit of sampling practice over a four-week period, two focus group discussions explored nurses' views and experiences. Daily blood samples were in keeping with volumes reported in other studies of a similar size and nature, with routine sampling practice common. Although we did not seek associations between data sets, the daily reported losses from blood sampling may be a contributory factor in patients' overall post-operative haemoglobin fall resulting in blood transfusion. Four key themes emerged from the qualitative focus groups: training and responsibility, influences and impacts, nursing time and errors. The routine nature of blood sampling practice may be specific to the elective setting, but raises questions around the need for a more patient centred, needs based approach. In addition to reducing the number of potentially unnecessary tests, small-volume phlebotomy tube (SVPT), closed sampling systems and increased use of Point of Care Testing (POCT) should be considered. Education and development of clear localised protocols could also help reduce the amount of unnecessary blood taken from patients in elective adult critical care settings.