Clinical Impact of Point-of-Care Testing Using the OMNI-S Blood Gas Analyzer in a Neonatal Intensive Care Setting

Background: Point-of-care (POC) testing is widely used in neonatal intensive care units and allows increasing numbers of assays to be performed immediately on smaller volumes of blood. The use of these systems simplifies staff training and reduces maintenance costs and blood sampling. We initially trialed the Roche OMNI-S analyzer (Roche Diagnostics, Burgess Hill, United Kingdom) in late 2003 alongside existing POC equipment and laboratory assays. The aim of this study was to assess the clinical impact of the formal introduction of this POC analyzer in 2004 in the number of laboratory tests and blood transfusions performed and the cost savings to the unit. Methods: The study was over a 3-year period, including 12 months immediately before and 24 months immediately after the introduction of the Roche OMNI-S analyzer to our neonatal unit. We assessed laboratory workload by retrospective review of hospital clinical information systems and pathology databases, as well as patient admission rate and clinical workload. Results: Activities in neonatal intensive care units increased over this 3-year period: there was an increase in the number of admissions (15.7%) and total days of neonatal activity (21.8%). There was a concurrent decrease in the number of laboratory assays (−38.0%) and transfusions performed over the same time (−8.6%). Given the increase in admission rate, this equates to a 46.4% reduction in laboratory testing and a 21.0% reduction in transfusions per admission. Overall laboratory costs including transfusion costs were reduced by £39,000 (−24.5%) per annum after the change in practice. Conclusions: Despite increased admissions and neonatal service activity over the study period, there was a significant reduction in laboratory workload and transfusions given, after the introduction of a POC analyzer. This translates into significant financial savings. The OMNI-S POC analyzer has changed our clinical practice, yielding cost savings for the service and reduced transfusion requirements for neonates.