Haematology analysis in the A&E setting

Remote haematology analysers offering full blood counts (FBCs) are now being identified as an increasing benefit to medical staff and patients alike. These analysers save time and costs for patients, medical and laboratory staff by reducing waiting times, enabling rapid turnaround of results and reducing the workload of busy central laboratories. Consequently, Point-of-Care (POC) analysers are now fundamental to achieving Governmentrecommended targets and providing the best possible patient care. For central hospital laboratories, the management of these remote analysers and their users is achieved through complying with the core standards and requirements for medical laboratories and POC testing facilities set out by Clinical Pathology Accreditation UK (CPA). Meeting CPA requirements is a fundamental requirement for all POC tests, as it is essential to ensure that only trained personnel who understand the correct operation of these remote analysers are able to access them. Guaranteeing the quality of results that clinicians ultimately act upon is crucial to patient safety, while achieving compliance to CPA standards demonstrates confidence and a level of trust in the pathology services provided by hospitals, clinics and POC testing (POCT) facilities. In the accident and emergency (A&E) department at Watford General Hospital, part of West Hertfordshire Hospitals NHS Trust, POC haematology analysis has been available for the past 10 years. Providing FBCs, the department was running an ABX Micros 60 from Horiba Medical, which provides a three-part differential, managed by the main haematology laboratory but located in the A&E department. However, following a CPA audit, it was agreed that a POC analyser able to deliver full audit trails was required to ensure complete CPA compliance. “In order for our POC haematology analysis to be fully CPA-compliant we had to make some changes,” explained Jo Nicholson, special haematology section manager at Watford General Hospital. “We needed an analyser that would provide comparable results to the laboratory system, including a five-part differential. We also needed a system that would link with the laboratory information management systems (LIMS) and keep a record of all results. Finally, we required password protection and user ID so that we could track and manage operators and ensure only trained personnel were using the analyser.”

A CPA-compliant solution

Approaching Horiba Medical UK, the haematology laboratory requested a suitable solution to the issue of password protection and user ID, a key requirement to achieve POCT CPA compliance. With customer care high on the agenda and using many years of expertise, Horiba Medical’s technical team was already developing a solution to address the POCT CPA requirements. “We had been working in partnership with our customers in a variety of POC settings to trial a new solution for POCT, providing password protection, remote monitoring and full audit,” commented Simon Aylen, technical support specialist at Horiba Medical UK. “As a result of this evaluation programme we have launched the Pentra SAfe solution for Horiba Medical CPA-compliant haematology and clinical chemistry analysis, providing remote bidirectional access with user ID, password protection and full audit trails. Our objectives were to ensure quality results and patient safety wherever our analysers were placed outside the central hospital laboratories. Together, the ABX Pentra 60C+ haematology analyser and the Pentra SAfe solution enable full POCT CPA compliance.” The ABX Pentra 60C+ is a compact bench-top haematology analyser offering a five-part differential, including atypical lymphocytes and large immature cells, comparable to that achieved in laboratory analysis. The system automatically detects and counts abnormal cell populations to assist with rapid diagnosis and treatment of haematological disorders. Frequently used in satellite or smaller laboratories and clinics, as well as being used as a competent back-up system in larger laboratories, the analyser can process up to 60 samples an hour. Offering 26 parameters, the unit is capable of closed-tube microsampling from whole blood, requiring sample volumes of only 30 μL for a complete blood count (CBC) and 53 μL for the five-part differential.