Authors (including presenting author) :
LIU YK(1), KAURS S(1), CHAN YY(1), SIU CS(1), LAI KM(1), LAI KW(1), LI KL(1), PANG HN(1), WOO YP(1)
Affiliation :
(1) Department of Medicine and Rehabilitation, Tung Wah Eastern Hospital
Keyword 2: :
Point of care Testing
Introduction :
With the increasing complexity of patient conditions, the demand for rapid blood testing becomes crucial for clinical decision-making, particularly during emergencies. Nurses, as POCT operators, are required to exhibit a high level of competency to ensure test results reliability. The absence of 24-hour laboratory service at TWEH aggravated the issue, with extreme weather further disrupted the delivery of specimens to the cluster laboratory. The i-stat test is requested for patients experiencing deterioration. This challenge was compounded by junior nurses, who lacked proficiency in i-STAT operation, resulting in test failures. Thus, an initiative was developed to enhance nursing competency in i-STAT POCT and bolster communication skills.
Objectives :
i) To enhance nurses’ proficiency, knowledge, and confidence in the utilization of i-STAT POCT
ii) To enhance nurses’ confidence in employing the Crew Resource Management principles (CRM) and ISBAR (Introduction, Situation, Background, Assessment, Recommendation) for effective communication
Methodology :
A pre-post interventional design was employed, comprising (i) a Likert-scale survey to gauge nurses’ confidence level; (ii) a knowledge-based quiz; (iii) an observational skill assessment with a competency checklist. A multi-modal learning approach was implemented. In Nov 2025, a self-directed learning video, anchored by an operation quick guide, was distributed to Medical and Rehabilitation nurses. 7 identical workshops were conducted, which provided practice in device operation, blood filling techniques, troubleshooting with a focus on error-prone steps, and application of the CRM principles and ISBAR in simulated scenarios to enhance teamwork and communication.
Result & Outcome :
56 nurses participated in the program. Post-evaluation demonstrated marked improvements in knowledge, skills, and confidence level. The accuracy of the quiz increased from 15.4% to 98.6%. The mean confidence in operating the i-STAT analyzer increased from 2.57 to 4.41. The mean confidence in the correct interpretation of critical values increased from 2.71 to 4.41, and the mean confidence in using ISBAR increased from 2.5 to 4.4. All participants demonstrated correct blood filling technique and passed the skill assessment. Participants’ feedback confirmed a high satisfaction rate (4.5/5) in the context of achieved learning objectives. Implications:
The initiative incorporated a structured, competency-based curriculum with CRM principles, enhanced nursing proficiency and confidence in using i-stat POCT. By standardizing the POCT practice, test failures were avoided, thereby facilitating timely patient care.
