Point of Care Testing (POCT) for Advanced Practitioners (Paramedics) in Urgent and Emergency Care: a Single Site Feasibility Study
试验速览
- 阶段
- 不适用
- 入组人数
- 100
- 主要终点
- Self-reported impact of using POCT device
研究概览
简要总结
Point of care testing (POCT) is described as a laboratory test conducted near the patient with a rapid result obtained through a portable analysing device, as opposed to the collection of a blood sample being transferred to a central laboratory for analysis and reporting.
Over the past 15 years increasing emphasis has been placed upon the paramedic profession as a possible solution to addressing the increasing demands placed on emergency departments. This is largely viewed through the ability of paramedics to assess patients calling 999 and manage a patient's condition away from the emergency department, with sufficient evidence supporting the role of the paramedic to develop competencies to manage larger volumes of patients.
This feasibility study will seek to understand whether paramedics report that the use of POCT devices is useful in safe clinical decision making with patients in the community, and if it is possible to use the Abbott i-STAT device in the urgent and emergency care setting for those patients where management within the community is being considered.
Given that there is very little evidence in this subject area, the research should start to inform the potential for future innovations in paramedic and community practice, and build on the body of evidence regarding POCT by paramedics related to community management.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Diagnostic
- 盲法
- Single (Participant)
盲法说明
Patient is randomised to control or intervention arm after consent obtained.
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Paramedic Participants
- •Inclusion criteria:
- •HCPC registered paramedics employed as advanced practitioners
- •From the selected advanced practitioner team (Sheffield)
- •Able to provide informed consent
- •Willing to undergo training and to deliver intervention
- •Willing to undergo training to participate in study measures and processes
- •Willing to take part in the focus group
- •Patient Participants
- •Inclusion criteria:
- •Adult patients aged 18 years old and over.
- •Registered with a GP Surgery in the Sheffield CCG boundary.
- •In their normal home environment, care home, nursing home or step up intermediate bed service, experiencing an ambulatory sensitive presentation related to falls, frailty, mild to moderate breathlessness, or non-specific general illness and receiving an ambulance service response from participating advanced practitioners (paramedics).
- •Who do not require immediate life-saving intervention/immediate transfer to ED.
- •Able to give written consent during the call-out.
排除标准
- •Paramedic Participants:
- •Any HCPC registered advanced practitioner (paramedic) who is currently under investigation for fitness to practice.
- •Patient Participants
- •Patients requiring emergency intervention and immediate transfer to hospital.
- •Patient does not have mental capacity.
- •Clinical presentations that should not have any delayed on scene time, meeting the criteria outlined in the YAS policy for the assessment, conveyance and referral of patients, for example detailing the NEWS2 score and other appropriate clinical screening tools that assist in the decision making regarding the decision to convey or refer for community management.
- •Non-English speaking patients.
- •End of life care patients.
- •Patients residing in prison.
结局指标
主要结局
Self-reported impact of using POCT device
时间窗: 1.5 hours focus group at end of study
Qualitative focus group data measuring perceived self-reported impact by advanced practitioner (paramedic).
次要结局
- Number of POCT cartridges used.(During the procedure)
- 72 hour re-contact rate(Through study completion, expected to be 6 months)
- Length of time on scene.(immediately after the patient care episode has ended)
- Feasibility of patient randomisation process(Through study completion, expected to be 6 months)
- Patient demographics and presentations where POCT is applied - age, gender, NEWS2 score, clinical condition.(Through study completion, expected to be 6 months)
- Type of POCT cartridges used.(During the procedure)
- Non-conveyance rate(Through study completion, expected to be 6 months)
- Number of successful and unsuccessful attempts in using the POCT device.(During the procedure)
- Number of patients who receive POCT.(Through study completion, expected to be 6 months)
研究者
Dr Fiona Bell
Head of Research & Development
Yorkshire Ambulance Service NHS Trust