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Meeting Minutes
April 2, 2008
The 2008 spring
meeting was held at the Doubletree Hotel in Alsip, Illinois on
Wednesday, April 2 from 9:00 AM to 3:00 PM. The meeting was
attended by 51 registered healthcare professionals and
representatives from MAS, Metrex, Radiometer, Roche, and Telcor.
The meeting
commenced with opening remarks by Joanne McEldowney, RN.
Members of the core group include: Wendy Denk, Ingalls
Hospital, Harvey, IL; Joanne McEldowney, RN, Univ of Illinois –
Chicago, Chicago, IL; Gil Salas, Univ of Illinois – Chicago,
Chicago, IL.
The first
topic, “Systemic Anticoagulation Management: A Response to the
Joint Commission”, was presented by Mark Wurster, M.D., Ohio
Sate University and sponsored by Roche. Dr. Wurster outlined
the steps that need to be taken for complete implementation of
the new National Patient Safety Goal 3E by January 2009. TJC
(The Joint Commission) have set guidelines to aid hospitals and
clinics in achieving this goal by establishing timelines. The
first timeline is to form a committee by July 1 comprised of
pharmacists, dietary nutritionists, nurses, medical
technologists and at least one physician to determine the risk
factors related to anticoagulation management. He stated that
an INR goal must be established for use in monitoring and
therapy adjustment for patients receiving warfarin as well as
establishing a baseline and on-going lab tests for heparin and
LMWH. There are currently 650 medications that interfere with
warfarin and stresses that patient education is critical. Dr.
Wurster sees POCT as a benefit to the in-patient sector and a
definite in the out patient setting. He recommends the use of a
POC device for the last test performed in the hospital before
the patient leaves to the out patient setting. Why? POC
devices have a tighter CV than the larger, higher volume
laboratory instruments so the variance between POC devices in
the out patient areas (clinics, coumadin clinincs, physician
offices, etc) allows for more consistent results and therefore
easier monitoring. And for information sake, the new series
Coagucheck device does not demonstrate interference with
heparin.
Sandy Curren
conducted a roundtable discussion”Pitfalls and Peril” – Running
a POCT Program. As the POCT program at UIC was recently
surveyed, Sandy and Gil Salas shared some of their experiences.
One issue they mentioned was ensuring there was documentation
for the initial orientation for PPM.
Following
lunch, Becky Clarke, Executive V.P., Telcor, discussed “POCT
Connectivity: Connecting Multiple Instruments”. She outlined why
POCT devices should be “connected” (electronic medical records,
reduce errors and omissions from manual charting and billing,
program management to name a few) and defined point of care
testing and devices. Some considerations for connectivity:
determine if the device is interfacable, does it allow for
scanning of operator/patient, can it differentiate between
patient and QC, does it allow for comment entry, what type of
connectivity software is needed, is the interface uni or
bi-directional, is it network wired or wireless or connected via
modems. Becky’s power point presentation demonstrated POC
Middleware as a proven technology and how it provides value to
POCT. MW (Middleware) solutions don’t have to change when the
LIS changes, they offer quick deployment and allows for freedom
to select “best of breed”.
The final
presentation “Active Surveillance for MRSA: What are the
options, what is our experience so far?” was given by Paul
Schreckenberger, PhD., Director, Clinical Microbiology, Loyola
University Medical Center. MRSA (Methicillin Resistant
Staphylococcus Aureus), was reported by the Chicago Tribune in
2002 and since, there has been mass media coverage to increase
public awareness as well as mandate legislative surveillance.
The State of Illinois Public Act 95-0312 mandates hospitals to
reduce the risk of MRSA in all intensive care units and other at
risk patients (such as dialysis or previous MRSA infections)
identified by the hospital through active surveillance testing.
Prisons are also targeted by the same act. The statistics
indicate a growing problem. In 1974, 2% of Staph infections
were MRSA, in 1995 the number increased to 22%, and many
hospitals today are reporting 60-70%. The main mode of
transmission in hospitals is via hands contaminated with
colonized or infected patients, body sites of the hospital
personnel themselves, and devices, items or environmental
surfaces contaminated with infected body fluids. MRSA can remain
persistent on dry surfaces (such as the hand rail of a bed) for
7 days to 7 months. MRSA cannot be eradicated without active
surveillance and is costly but through surveillance, lives are
saved and costs go down. The Gold-standard for MRSA detection is
sensitive but slow. Real time PCR is the most effective method
for detection of MRSA from patient specimens. The Cepheid
GeneXpert is the next generation PCR technology and can be
performed in the POC setting (moderate complexity).
Joanne
presented the results of the survey conducted during the day:
The next
meeting with a vendor fair will be October 1 or 8, 2008 at the
Doubletree Hotel in Alsip.
Respectfully
Submitted,
Wendy Denk,
MT(ASCP) |
