EXPANSION OF POC TESTING TO NON-CRITICAL UNITS

Hi Ivy!
For heaven's sake, no! There is also a nursing shortage and I cannot imagine adding POC testing to their duties, let alone the POC management team.  We are collaborating on how to support the nursing staff during the shortage not add to their duties.

My 50 cents :)

Not surprised.  Seems that instead of addressing the tech shortages, the obvious solution is to move more platforms to POC.  Not good for patients, and not good for the lab.  And if POCCs aren't appropriately supported for the added volume, it won't be just lab techs in a staffing crisis, it'll be POCCs too.

Oh man. 
Moderate complexity user competency assessment is so time consuming and complicated, I would push back hard unless you have the proper staffing to support it. I can't even keep up with ~200 CCU, OR and RT staff for their moderate complexity by myself. Especially since JCAHO wants me to actually observe direct patient testing as part of competency assessment now.

Hello, my facility has iSTATs in non-critical areas. We utilize RALS as our middleware. You can message me if you would like to discuss our processes.

Hi Ivy, nice to see another long-timer's name!
Ivy, I'm not suggesting that you are empowered to 'just say no' or consider pushing forward my suggestion. But I'll make it because it is an example of a university program who 'just said no'.

For the last 20 some years our Respiratory program has been involved in performing blood gases 'at the bedside' both in critical care and non-critical care areas. They do not use handhelds. 
We have not overall (yes, in very few pockets for special needs in OR, for example) ever had blood gases 'governed, managed' within the POC Program, by POC team.

I seriously think with all the other waived and nonwaived testing we have across 4 campuses and extensive outreach and ambulatories (currently) that not having blood gases included in POC Program allowed us to survive.

Good Luck friend.

Hi Ivy,
I was tasked with a feasibility study for placing iStats in our ER 6 years ago.  

My original knee jerk reaction was "NO WAY" but once I laid it all out, they saw it was not a reasonable or sustainable process.
Good Luck

Great responses above. We have not expanded our POC BG use beyond OR/critical care/ED, other than in MRI for only Crea. That being said, our main labs are still in the same building as the hospital and can easily support blood gases from critical care and outside critical care. I do know that the non-critical care areas BG volume would NEVER support placement of POC in those areas - they just don't have the need. 
If I ever had to go down this road, I would have a LONG list of requirements like Amanda listed above. The only way I could see this working in any way would be if this was owned by a much smaller group that is potentially already trained (respiratory - but they are seriously struggling with 
staffing as well!). 

Thank you for all the feedback. We only have 3 POC staff members but do have great cooperation with nursing education department for training and competency.   We've used i-STAT for gases for years in ICU, OR, ER, Procedures then moved to EPOC after the "blue" cartridge debacle which has been a long transition.  Then our director started discussing reducing iCA coming to the lab to help Lab staff; which in areas that already have EPOC would make sense.  But adding the other 7 adult floors and the hundreds of RN's that don't have an EPOC now is overwhelming.  It's good to know my hesitation is not unwarranted. 

WE have expanded our EPOC ABG's thru the entire Health System, Which consist of 4 hospitals all in a 45  - 1 Hr. driving time, our respiratory therapist preform them. I do all competency check offs going to all locations for ABG's and Creatinine's and I'm the only one that is qualified to do them  it's hard to keep up but doable. I would never let nursing run them. All Creatinine's are performed by CT and MRI tech's that are qualified. I think we have around 30 EPOC's.