Background
Methods
Ethical approval
Eligibility and recruitment
Data collection
Data analysis
Results
Themes | Sub-Themes |
---|---|
1. Engagement with POCT | a) Why Clinicians use POCT b) Usability of POCT c) The future of POCT in psychiatry |
2. Perceptions of Impact of POCT on Clinicians and Patients | a) Improving Patient Experience b) Disrupting Patient Experience c) Uncovering and Communicating Abnormality d) Change in Clinician’s Role |
Engagement with POCT
Why clinicians use POCT
“I was a bit anxious to begin with; the thought of stabbing someone with a needle”. (C006, Allied Health)
“Is it really all about just about meeting targets again?” (C001, Nursing)
“[The POCT device] seemed to be specifically designed to collect those two pieces of information [Lipid panel and HbA1c] at the same time … To me, that seemed like it was an answer to everything I’d been asking for.” (C011, Nursing)
“It’s important for me to be able to do this myself, and that that would give me responsibility; it would also ensure that in all areas of what they need I can provide for that. So, it was being a more complete practitioner that was really the driver for me...” (C007, Allied Health)
Usability of POCT
“I tried to remember exactly all the routines that there were … the sequence, trying to reassure the service user … So, it was about trying to reassure her and myself, and just focus on what it was that I was trying to do and do it in such a way that it was going to be first time right.” (C007, Allied Health)
“Yeah, that wasn’t too tricky, no. And the cartridges can only go in one way, so it wasn’t like rocket science.” (C010, Allied Health)
“Because of the amount of time that I will spend chasing results, I’ll just go and do it myself [on the POC device] and get the results there and then. So it’s making my work a lot easier.” (C013, Nursing)
“When you have got that physical health bag (and device), it is a lot to carry.” (C002, Nursing)
“… if it was going to go wrong it would go wrong with the lipids” (C006, Allied Health)
“… the more you do it the more you kind of come across the different things that will happen and the more confident you are in just reassuring them but also still getting a result.” (C002, Nursing)
The future of POCT in psychiatry
“I think it’s the way forward; it’s what we should be doing, and we should be doing it with all different types of test.” (C009, Psychiatric)
“… if it could be used for other things as well- like full blood count, renal function – if you could measure those things it would be amazing. For those refusing bloods, and you could take those bloods, it’d be so much easier and better for everybody.” (C014, Psychiatric)
“I would see it in the long term as taking some pressure off the GP services and enabling us to work with them more” (C003, Allied Health)
Perceptions of impact of POCT on clinicians and patients
Improving patient experience
“The more skills and the wider they are, should give that service user more confidence in that [clinician].” (C007, Allied Health)
“… she’d been in the team for a long time and she would never want to get her bloods done … she’s always refused … and then she said, ‘OK, yeh, I’ll have it done,’ And so, for her to actually have that change of attitude was brilliant.” (C006, Allied Health)
Disrupting patient experience
“It’s getting the sequence … which is not very easy. And it looks bad in front of the patient” (C001, Nursing)
“… it just seemed a little bit unprofessional when I was in somebody’s house that was quite willing to participate, and then I couldn’t complete the whole thing.” (C010, Allied Health)
“… I didn’t know how to correct what I’d done wrong, so I didn’t want to put them through the same situation again.” (C004, Nursing)
“… sometimes once I’ve just pricked a patient and they’re talking and you get side-tracked with talking to them and obviously, it needs to go into a test capsule and straight into a machine for it to be a valid test.” (C003, Allied Health)
Uncovering and communicating abnormality
“… it kind of reminded me why it is important to do it and it’s not just a tick box exercise and you know we are … we’re doing it, because these people that … particularly this client as well, didn’t , you know, didn’t have any obvious risk factors in terms of diabetes.” (C002, Nursing)
“It was easier to then put their responses to the questions together with the blood results. And then the patient could see how the diet and lifestyle choices could be impacting on the results they got from the blood.” (C002, Nursing)
“‘This is what diabetic … from forty eight upward you know; you’re forty seven; just one.’ And it looks clear, and it look … I know, I said, ‘It’s verified, and I’m sorry I’m bearing you the bad news, but this is wat you need to do.’ … And he was onboard with it.” (C013, Nursing)
“I’m more concerned about their health knowing those numbers … I have one patient with forty one and the other is something like forty two. They’re absolutely refusing to do any exercise and can say its my choice...” (C001, Nursing)
Change in Clinician’s role
“Personally, I think it makes my work easier, because of the amount of time that I will spend chasing results. I’ll just go and do it myself and get the result there and then. So it’s making my work a lot easier.” (C013, Nursing)
… you know, it’s a fun little different thing to do.” (C005, Nursing)
“So, that was really useful to know; important. I guess I need to be more aware of lipids and cholesterol and triglycerides and that sort of thing.” (C001, Nursing)
“I did do the training for having a blood test … but I found the opportunities to practise doing it were quite few and far between.” (C011, Nursing)
“I’ve seen results … I can see like it’s really helpful for [patients]; it’s really important that we know that they’re not at risk of all these disease, metabolic disease. So, we’re doing something about it, and something that I do believe in really.” (C013, Nursing)
“… it’s not just nurses now. The OT’s and the social workers are doing [physical health] clinics too because it’s accessible to everyone.” (C008, Nursing)
“… it was clear to me that that was going to be easier to achieve if you’re a [nurse] or possibly an [occupational therapist]. But it would represent quite a shift for a social worker to be comfortable and able to do that … [POC] certainly has helped in as much as the kind of imaginary wall or difficulties that I may have thought there were about collecting this information, have been demolished wholesomely.” (C007, Allied Health)