the mobile laboratory unit Örebro, sweden september 28 ......• abx micros-crp 200 • abx pentra...
TRANSCRIPT
![Page 1: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/1.jpg)
The Mobile Laboratory Unit Örebro, Sweden September 28th 2016 Laboratory technician, lecturer Susanne Andresen
![Page 2: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/2.jpg)
How did the idea to the Mobile Laboratory Unit emerge?
• Final diagnose
• 20-25 % Lung Disorders (COPD pneunomi , dyspnea etc.)
• 20-25 % Cardiovascular diseases
• 40-60 % of the remaining diagnoses allow for the prevention of admissions. Statement on the diagnosis of Stroke, Dehydration, Constipation, pneumonia, cystitis, COPD, heart failure, intestinal infection, Fracture.
Age ≥ 67 years
![Page 3: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/3.jpg)
Purpose of the Mobile Laboratory Unit
• The purpose of the mobile laboratory unit is to prevent unnecessary hospitalizations and rehospitalizations of senior citizens in the municipality of Koege.
• When the test results are available after less than 30 minutes, the emergency room nurse will contact the patient’s General Practitioner, the out-of-hours doctor or a doctor in the Emergency Department at Zealand University Hospital Koege to assess whether the patient requires treatment at home or needs to be hospitalized.
”Shared care model”
![Page 4: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/4.jpg)
Diagnoses
• UTIs (urinary tract infections)
• COPD (chronic obstructive lung disease)
• Dizziness
• Dehydration
• Diarrhea
• Constipation
• Infections (pneumonia, erysipelas, pyelonephritis, etc.)
• Terminal patients
• The primary target groups are chronic patients, elderly and frail patients, and possibly terminal ill patients, who can advantageously be treated in their own homes
![Page 5: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/5.jpg)
The Mobile Laboratory Unit
![Page 6: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/6.jpg)
Workflow in the Mobile Laboratory Unit
The requestor calls the nurse in the Mobile Laboratory Unit and gives information about - reason to referral - comorbidity - which observations and tests are needed When everything is ready the Mobile Laboratory Unit visits the patients at their own address. The workflow is at the patients own home.
![Page 7: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/7.jpg)
Triage
• Assessment Report
• Medical Records
• Documentation of
treatment
• Statistics
![Page 8: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/8.jpg)
Responsibility for the receipt of results
• Testresults are automatically transferred via edifact to the General Practitioner, the out-of-hours doctor or a doctor in the Emergency Department. ECGs are faxed to the General Practitioner.
• The nurse gives the General Practitioner or the doctor in the Emergency Department a short report on the phone.
• When the testresults are available the requestor and the doctor in the Emergency Department will together assess whether the patient requires treatment at home or needs to be hospitalized.
• The Mobile Laboratory Unit brings an assortment of drugs for treatment of the most common medical diseases.
![Page 9: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/9.jpg)
From idea to “The Mobile Laboratory Unit”
• Small residential streets < 3500 kg.
• Reversing camera
• Diesel Generator
Starting point
![Page 10: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/10.jpg)
![Page 11: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/11.jpg)
Equipment
• Monitor: BP, pulse, SAT, resp .
• Frequency alcohol meter
• Thermometer
• Bladder Scanning
• Defibrillator
• Port- a'neb (atomizer for bronchiedilating medicine)
• Various medications for oral or iv . infusions
• Blattercatheters, Peripheral vein catheters
• Peak flow meter
• ABL 90
• Clinitek
• Statspin
• ABX Micros-CRP 200
• ABX Pentra 400
• Cobas h232
• Coaguchek
• HemoCue WBC Diff (back up)
• EKG
• 2 PCs
• PTB printer
• Fax
![Page 12: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/12.jpg)
Time spent at the citizen
0
20
40
60
80
100
120
01
-09
-20
15
07
.09
-20
15
08
.09
-20
15
07
.09
-20
15
11
.09
-20
15
16
.09
-20
15
17
.09
-20
15
25
.09
-20
15
30
.09
-20
15
01
.10
-20
15
23
.09
-20
15
24
.09
-20
15
13
.10
-20
15
19
.10
-20
15
20
.10
-20
15
27
.10
-20
15
29
.10
-20
15
02
.11
-20
15
04
.11
-20
15
06
.11
-20
15
11
.11
-20
15
13
.11
-20
15
18
.11
-20
15
26
.11
-20
15
26
.11
-20
15
02
.12
-20
15
04
.12
-15
11
.12
-15
17
.12
-15
18
.12
-15
05
.01
-20
16
11
.01
-20
16
14
.01
-20
16
19
.01
-20
16
22
.01
-20
16
26
.01
-20
16
29
.01
-20
16
02
.02
-20
16
08
.02
-20
16
12
.02
-20
16
22
.02
-20
16
03
.03
-20
16
08
.03
-20
16
15
.03
-20
16
22
.03
-20
16
31
.03
-20
16
01
.04
-20
16
06
.04
-20
16
08
.04
-20
16
13
.04
-20
16
14
.04
-20
16
20
.04
-20
16
25
.04
-20
16
26
.04
-20
16
04
.05
-20
16
min
utt
er
dato
![Page 13: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/13.jpg)
Hospitalization / readmissions after visiting the Mobile Hospital Laboratorium
O = Inpatient same day
7 = Hospitalization within 7 days
N = No admission
0
50
100
150
200
250
0 7 N
anta
l
![Page 14: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/14.jpg)
Review of testresults after Year 1
Orange lines shows the
reference interval
![Page 15: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/15.jpg)
Our experiences • Paradigm shift. The citizens are very happy and thankful – they do not
want to be hospitalized
• The citizens (>80 years of age) ask the GP to send the Mobile Laboratory Unit. They have read about the Mobile Laboratory Unit in the newspaper or seen us visiting the neighbors.
• The GPs are satisfied – the cooperation has improved.
![Page 16: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/16.jpg)
The impact of interdisciplinary cooperation– Anne (nurse)
• Common understanding of the job
• Testresults supports the clinical findings – other findings evolve
• We are proud of what we accomplish together
• In the cab: Common sharing of knowledge
• Respect for different competences
![Page 17: The Mobile Laboratory Unit Örebro, Sweden September 28 ......• ABX Micros-CRP 200 • ABX Pentra 400 • Cobas h232 • Coaguchek • HemoCue WBC Diff (back up) • EKG • 2 PCs](https://reader035.vdocuments.mx/reader035/viewer/2022062609/61003a26074a5b0116381ebd/html5/thumbnails/17.jpg)
A perfect day.
We want to be on the road! Thank you for your attention.