School of Medicine and Health Sciences Poster Presentations

Creating Emergency Department Point-of-Care Testing Protocols: An Expert Panel and Delphi Process

Poster Number

206

Document Type

Poster

Publication Date

3-2016

Abstract

In recent years, point-of-care (POC) testing has gained popularity in emergency departments (EDs) to facilitate rapid laboratory test results 1 2 3 4 . Despite increasing popularity, few studies have addressed POC use early in ED care, specifically around ED triage. Availability of laboratory testing may help risk-stratify patients by providing additional information early in ED care. In a prospective study, triage POC testing changed patient management in 14% of cases, Emergency Severity Index (ESI) triage level in 15%, and 56% found POC testing to be helpful in the triage process [5] . In addition, POC may hasten ED care through early ordering of symptom appropriate diagnostic tests—a process called rapid posttriage assessment [6 7] .

In this project, we convened an expert panel to identify priorities for ED POC testing and created 2 protocols intended for early care of ED patients. One protocol focuses on early prioritization for time-sensitive conditions, and a second is a rapid posttriage assessment POC protocol.

We convened a technical expert panel and used a Delphi process to create 2 protocols for ED POC testing. The goal was to seek input to develop these protocols using a consensus-seeking methodology using expert guidance followed by multiple rounds of structured questionnaires. In our study, we used 2 rounds of structured questionnaires to solicit opinions; resolve areas disagreement; and, where possible, achieve consensus. The protocols were designed to aid nurses in deciding which POC to order for ED patients with specific symptoms.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

Open Access

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Presented at: GW Research Days 2016

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Creating Emergency Department Point-of-Care Testing Protocols: An Expert Panel and Delphi Process

In recent years, point-of-care (POC) testing has gained popularity in emergency departments (EDs) to facilitate rapid laboratory test results 1 2 3 4 . Despite increasing popularity, few studies have addressed POC use early in ED care, specifically around ED triage. Availability of laboratory testing may help risk-stratify patients by providing additional information early in ED care. In a prospective study, triage POC testing changed patient management in 14% of cases, Emergency Severity Index (ESI) triage level in 15%, and 56% found POC testing to be helpful in the triage process [5] . In addition, POC may hasten ED care through early ordering of symptom appropriate diagnostic tests—a process called rapid posttriage assessment [6 7] .

In this project, we convened an expert panel to identify priorities for ED POC testing and created 2 protocols intended for early care of ED patients. One protocol focuses on early prioritization for time-sensitive conditions, and a second is a rapid posttriage assessment POC protocol.

We convened a technical expert panel and used a Delphi process to create 2 protocols for ED POC testing. The goal was to seek input to develop these protocols using a consensus-seeking methodology using expert guidance followed by multiple rounds of structured questionnaires. In our study, we used 2 rounds of structured questionnaires to solicit opinions; resolve areas disagreement; and, where possible, achieve consensus. The protocols were designed to aid nurses in deciding which POC to order for ED patients with specific symptoms.