The Status of Point-of-Care Testing and Coordinators in Vietnam

Abstract

Supplemental digital content is available in the text. Objectives The goals of this study were as follows: (a) to enhance point-of-care testing (POCT) and improve standards of care throughout Vietnam; (b) to educate point-of-care (POC) coordinators who provide leadership, oversight, and quality assurance; and (c) to promote international dialog and knowledge of POCT in limited-resource settings. Methods Needs assessment of 16 provincial hospitals, 2 each randomly chosen from the 8 geographic regions of Vietnam, was performed. In Ho Chi Minh City, 10 referral, 5 provincial, and 7 district hospitals, and 8 community medical stations were surveyed. Emergency and intensive care unit nurses and doctors, and laboratorian were respondents. Results Glucose meters and blood gas analyzers were the most frequent POC devices in the 16 provincial hospitals. Cardiac biomarker, coagulation, and human immunodeficiency tests were the highest needs. Biomedical engineers managed locations and quality. Point-of-care coordinators were deficient. Generally, hospitals with POCT had no laboratory oversight. Users performed POCT without internal or external quality control (QC). In Ho Chi Minh City, coagulation and cardiac biomarker tests were most desired. Conclusions Clinicians were poorly informed about the availability of urgent, emergency department, and bedside POC tests. No provincial hospitals surveyed offered cardiac biomarker testing, despite the high prevalence of acute coronary syndromes. Challenges to the implementation of POCT comprise: (a) the quality assurance burden for non laboratory personnel; (b) limited human resources to support POCT programs, including virtually total absence of POC coordinators; and (c) no national POCT policy and guidelines. To rectify these deficiencies, we recommend fundamental education at all levels, promotion of POC coordinator user groups, heightened awareness of available POCT, and vigorous international exchanges to enhanced standards of care in Vietnam.