Focus on blood coagulation

UK NEQAS for Blood Coagulation is an international External Quality Assessment (EQA) programme offering independent assessment of performance with a comprehensive range of coagulation testing for laboratories and individuals worldwide. At the organisation’s annual meeting, Clinical and Laboratory Haemostasis 2014, a variety of clinical, laboratory and research aspects of haemostasis and thrombosis were explored by internationally recognised experts.

Chaired by Dr David Perry (UK NEQAS BC Steering Committee Chairman), the opening session provided an insight into point-of-care (POC) EQA. The first presentation, entitled UK NEQAS for Blood Coagulation, Point of Care, was given by Dianne Kitchen (Sheffield). The advent and increasing use of POC coagulation testing led to the introduction by UK NEQAS BC of a POC programme for international normalised ratio (INR) testing. From humble beginnings in 1996, with just 30 participants, this programme grew rapidly. In 2002 there were 247 registered users and currently the figure exceeds 4,000 – a growth of 1500% in 14 years. Such a rate of growth is unprecedented when compared to the laboratory testing scheme and presents the organisers with significant logistical and communication challenges.

Users of POC testing are a diverse group of individuals, the majority being nurses based in general practice. Unlike the laboratory scheme, POC testers tend to be comparatively inexperienced in handling and processing analytical material, and UK NEQAS BC has modified some of its material and paperwork accordingly. Clear instructions for sample reconstitution, a colour-coded sample lid system (in an effort to reduce crossing over the results of two samples) and reports in a format acceptable to non- laboratory trained staff have all helped to improve performance.