NEAR PATIENT TESTING IN GENERAL-PRACTICE - ATTITUDES OF GENERAL-PRACTITIONERS AND PRACTICE NURSES, AND QUALITY ASSURANCE PROCEDURES CARRIEDOUT

Background. The evaluation of near patient testing in British general practice has largely been confined to studies examining individual tes ts or comparing equipment. Aim. This study set out to determine the at titudes of practice staff to near patient testing, and the extent to w hich staff undertook quality assessment. Method Four types of near pat ient testing machines were introduced into 12 general practices in two regions of England, south west Thames and west Midlands. General prac titioner and practice nurse attitudes to near patient testing were ass essed by semi-structured interview before and six months after the int roduction of the machines. The extent to which routine quality assuran ce procedures were carried out within the surgery and as part of local and national schemes was examined. Results. Although 80% of general p ractitioners anticipated changing patient management with near patient testing, only two fifths reported having done so after six months. Nu rses generally were enthusiastic at the outset, although one third wer e unhappy about incorporating near patient testing into their work sch edules. Time pressure was the most important factor restricting uptake of near patient testing. Nurses performed quality control regularly b ut complete local external quality assurance procedures were establish ed in only half the practices. All the practices participated in a nat ional scheme for cholesterol assays. Conclusion. General practitioners in this study did not find near patient testing a very useful additio n to their resources. Pressure on nurses' time was the most frequently reported limitation.