FEATURE ARTICLES

The AQT90 FLEX analyser combines laboratory quality measurement accuracy with point-of-care convenience to provide rapid immunoassay testing for cardiac, coagulation and infection markers. Point-of-care (POC) testing offers a range of benefits for patients, nursing staff and laboratory personnel, but guaranteeing the same quality, sensitivity and reliability as laboratory testing can be difficult to achieve with some instruments.

Microbiology is one of the oldest disciplines of laboratory medicine yet one of the last to embrace automation. Now, an imposing acronym is set to change the status quo and place bacteriology firmly in the 21st century. Molecular methods of microbial identification have long been regarded as the way forward for clinical laboratories, providing fast and accurate results for a wide range of pathogens, without the need for long incubation times. Mass spectrometry (MS) represents one of the most flexible technologies in this arena, offering precise classification of organisms based on unique spectral signatures.

Dry chemistry systems have come to the aid of a pathology service network that operates across an Australian state larger than Western Europe. Andrew St John looks at some of the problems encountered and how they have been addressed. Forming the backbone of the PathWest laboratory network that stretches across the 2.5 million square kilometres of Western Australia are 23 VITROS analysers. They provide pathology services to many different and often remote communities, and one of their special attributes in one of the driest countries in the world is that they do not require water.

The latest in coagulation automation has facilitated improved efficiency in haematology services across the two main hospitals in Gloucestershire, as Stephan Bates, Kevin Willett and Ceinwen Davies explain. Gloucestershire Hospitals NHS Foundation Trust provides haematology services to a population of around 600,000 through its two acute hospitals, Cheltenham General and Gloucestershire Royal. There is a haematology laboratory located at each site, reflecting the way that clinical services are organised within the trust. Tests have been organised across the two sites to ensure maximum efficiency. Cheltenham General is the centre for haematology in-patient services, oncology and bone marrow transplantation. It also performs haematinics (vitamin B12, folate and ferritin estimations) and specialist flow cytometry for leukaemia typing. Immunology, haemoglobinopathy and thrombophilia screening take place at Gloucestershire Royal, while both hospitals perform coagulation screens (international normalised ratio [INR], D­dimer and factor assays), as results are often required immediately; however, some non-urgent work is also sent to the Oxford Haemophilia and Thrombosis Centre.

Staff at Stockport NHS Foundation Trust undertook an evaluation of the latest Roche blood gas analyser, the cobas 123 b POC system, during a four-week point-of-care trial. Stockport NHS Foundation Trust serves a population of approximately 350,000, predominantly across Stockport and the High Peak area of Derbyshire. The trust employs over 3600 staff across four sites. Its main hospital site is Stepping Hill Hospital in Stockport, with additional services provided at Cherry Tree Hospital and The Meadows in Stockport, and the Corbar Maternity Unit based 18 miles away in Buxton. The trust supports point-of-care testing (POCT) through a POCT coordinator and a POCT committee. The committee is a multidisciplinary group set up to ensure that all POCT is performed appropriately, accurately and safely. All POCT devices (eg blood glucose meters, blood gas analysers, urinalysis test strips, coagulation meters etc) must be registered by the committee so that issues such as training, maintenance and internal and external quality control can be addressed.

The first in a series of seminars dedicated to Lean in the laboratory was held in February. It focused on enhancing histopathology laboratory efficiency and accuracy, and Pauline Connor demonstrated how her department at the North Middlesex University Hospital is embracing Lean processes.

Clostridium difficile has gained notoriety as a hospital ‘superbug’, which has led to strict monitoring and controls on infection rates for hospital trusts. Accurate diagnosis, effective infection control and the use of good screening tools is a major contributor to success, as Charlotte Duncan explains.

Biomedical scientist Barry Hill examines some of the specific problems posed by working conditions in the laboratory, focusing here on lighting, noise and temperature.

A pathology team at the Royal College of Surgeons in Ireland recently switched from manual to fully automated HER2 fluorescence in situ hybridisation staining, using Leica Microsystems’ BOND-III staining platform and the Leica HER2 FISH system. Here, Tony O’Grady discusses the switchover and the advantages of automation.

Edward Burnham looks at the use of procalcitonin as a biomarker for sepsis, which could provide greater specificity than previously possible, ensuring timely, effective and cost-effective treatment.

The next-generation separation method for HbA1c, launched by Sebia, has been tested successfully in France. Frank Mentz responds to questions on the Biologie-Prospective-Réalité (BPR) initiative and gives his views on the latest Capillarys technology.

The debate about erythrocyte sedimentation rate versus plasma viscosity has gone on for a considerable length of time. Here, Sabrina Chetcuti provides an update on current thinking.

Recently, Roche set up a co-marketing agreement with a private laboratory to support greater access to human papillomavirus testing. In an innovative commercial agreement, leading healthcare company Roche and foremost private cellular pathology laboratory Unilabs-IHS are collaborating to facilitate state-of-the art testing for signs of cervical cancer more accessible to thousands of women around the UK.

Elevated protease activity in chronic wounds is currently under-recognised yet it has a significant impact on treatment. Now, a point-of-care test is set to improve the outcome for patients who have diabetic, venous or pressure ulcers.

Roche equipment has helped Stepping Hill Hospital in Stockport and York Teaching Hospital meet Clinical Pathology Accreditation standards for data management and audit at the point of care. Stepping Hill Hospital and York University Hospital are in the vanguard of trusts that are using Roche packages to help them comply with Clinical Pathology Accreditation (CPA) standards for point-of-care testing (POCT), as this article illustrates.

Pathology networks and challenging geography are not immediately compatible but the latest automation solutions from Beckman Coulter can minimise the inherent problems, as the following case study from north-west England demonstrates.

Strong partnership working between Siemens and its customers was the focus of recent user group meetings, the objectives of which were to promote close relationships and share knowledge in the areas of plasma proteins, chemistry, immunoassay, haematology and point-of-care testing.

A new point-of-care blood gas analysis system offers easy-to-use, trusted technology that delivers laboratory-quality test results and a comprehensive menu of critical care parameters.

In the 21st century, information technology is set to plays a leading role in the commercialisation of pathology and in delivering cutting-edge services.

Good technique when using liquid-handling devices is vital in order to achieve accurate and reproducible results with a wide range of pipette types. The information here is designed to provide a step-by-step guide to facilitate the consistent transfer of liquids.