RT Journal Article
SR Electronic
T1 Point-of-care testing in a high-income country paediatric emergency department: a qualitative study in Sweden
JF BMJ Open
JO BMJ Open
FD British Medical Journal Publishing Group
SP e054234
DO 10.1136/bmjopen-2021-054234
VO 11
IS 11
A1 Reza Rasti
A1 Johanna Brännström
A1 Andreas Mårtensson
A1 Ingela Zenk
A1 Jesper Gantelius
A1 Giulia Gaudenzi
A1 Helle Mölsted Alvesson
A1 Tobias Alfvén
YR 2021
UL http://bmjopen.bmj.com/content/11/11/e054234.abstract
AB Objectives In many resource-limited health systems, point-of-care tests (POCTs) are the only means for clinical patient sample analyses. However, the speed and simplicity of POCTs also makes their use appealing to clinicians in high-income countries (HICs), despite greater laboratory accessibility. Although also part of the clinical routine in HICs, clinician perceptions of the utility of POCTs are relatively unknown in such settings as compared with others. In a Swedish paediatric emergency department (PED) where POCT use is routine, we aimed to characterise healthcare providers’ perspectives on the clinical utility of POCTs and explore their implementation in the local setting; to discuss and compare such perspectives, to those reported in other settings; and finally, to gather requests for ideal novel POCTs.Design Qualitative focus group discussions study. A data-driven content analysis approach was used for analysis.Setting The PED of a secondary paediatric hospital in Stockholm, Sweden.Participants Twenty-four healthcare providers clinically active at the PED were enrolled in six focus groups.Results A range of POCTs was routinely used. The emerging theme Utility of our POCT use is double-edged illustrated the perceived utility of POCTs. While POCT services were considered to have clinical and social value, the local routine for their use was named to distract clinicians from the care for patients. Requests were made for ideal POCTs and their implementation.Conclusion Despite their clinical integration, deficient implementation routines limit the benefits of POCT services to this well-resourced paediatric clinic. As such deficiencies are shared with other settings, it is suggested that some characteristics of POCTs and of their utility are less related to resource level and more to policy deficiency. To address this, we propose the appointment of skilled laboratory personnel as ambassadors to hospital clinics offering POCT services, to ensure higher utility of such services.Data are available upon reasonable request. Deidentified transcripts in written Swedish will be shared upon reasonable request to the corresponding author. Audio files will not be shared, as they reveal the identity of study participants and risk their guaranteed anonymity.