Mobile computing devices are capable of changing how healthcare is delivered in the future, since they aim to merge and integrate all services into one device that is versatile, customisable, and portable. The aim of this study was to explore and describe the experiences of professional nurses with regard to accessing information at the point-of-care of the patient, in order to develop guidelines that could assist other professional nurses with implementing the mobile computing device for accessing information at the point-of-care of patients. To achieve the purpose of the study, a qualitative, explorative, descriptive, and contextual design was used to conduct this research – to gain an understanding of how the professional nurses experienced accessing information at the point-of-care via mobile computing devices. The study was conducted among the professional nurses employed at the public hospital, who were trained and provided with the mobile computing device for accessing information at the point-of-care for more than two years. In-depth interviewing was conducted to obtain the data. Data analysis was done using Tesch‘s method to make sense out of text and data. Four themes were identified, namely, the professional nurses‘ expression of various experiences regarding the training received; the need for support in implementing the mobile computing device; the accessing of information at the point-of-care as beneficial for educational purposes; and the accessing of information at the point-of-care as beneficial to patient care. Two main guidelines were developed. The study concludes with recommendations made with regard to the areas of nursing practice, education and research. Throughout the study, the researcher abided by the ethical considerations. The aspects of trustworthiness implemented in this study, included dependability, credibility, transferability and confirmability (Holloway & Wheeler, 2010:298).

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Rapid, point-of-care infectious disease diagnostics have the potential to dramatically improve health care provision in low-income world regions. However, the development of technologies such as electrochemical DNA biosensors is hindered by slow turnaround times from design to working prototype. In order to facilitate biosensor development, a rapid prototyping method has been applied to the fabrication of wrinkled nano-/micro-structured electrodes in this work. An electrocatalytic DNA hybridization detection scheme is optimized for use with the wrinkled electrodes by adjusting the concentrations of redox agents FiCN and RuHex. Characterization of the electrodes by electrochemical and fluorescence-based methods showed tunability of important detection-related parameters – namely, the density of DNA probe molecules and the hybridization-induced electrocatalytic signal change – by altering parameters of deposition time, molar fraction of DNA probes relative to diluent molecules, and thickness of the wrinkled gold film. / Thesis / Master of Applied Science (MASc)

Diseases are often diagnosed by detection of disease-specific biomarkers in fluid samples. However, many state-of-the-art detection methods require a lab with complex machinery, trained operators, and/or lengthy analysis time. In contrast, point-of-care (POC) devices are brought to the patient's location, they are easy to use, and results are obtained almost immediately. Many current POC devices are too difficult to be used without a skilled assistant, and although many are able to detect analytes above a threshold value, they give little or no quantitative information. This work presents the development of polymer-based microfluidic devices capable of sensing and quantifying biomarkers in fluid samples in a straightforward manner using a novel biomarker assay termed "flow valve diagnostics". In this assay, an antibody-modified polydimethylsiloxane (PDMS) microchannel constricts due to the binding force between antibodies and antigens, stopping fluid flow. The flow distance is measured and correlated to antigen concentration. This detection method is an improvement over other methods because it is an innovative, non-instrumented, label-free, easy-to-use approach. These devices are small, portable, disposable, inexpensive, and thus ideal for use in POC testing. I have successfully fabricated flow valve devices with standard micromachining techniques, including photolithography, replica molding with PDMS, and plasma oxidation. Following fabrication, I compared two methods for attaching receptor biomolecules (e.g., antibodies) to the microchannel surfaces: non-specific adsorption and silanization with 3-glycidoxytrimethoxypropylsilane (GOPS). I used laser-induced fluorescence to determine that silanization with GOPS was the better method for biomolecule attachment. Finally, I tested antibody-modified flow valve devices with target antigens to determine if the antibody/antigen binding force was strong enough to cause channel pinching and flow stoppage. By modifying the device design and using higher antigen concentrations, I was able to show that flow valve devices can detect antigens in a concentration-dependent manner. Future work to improve the device design and to modify and test these devices with different receptor/target pairs will bring flow valve diagnostics closer to becoming a valuable asset in biomarker detection and POC testing.

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Thesis (MBA)--Stellenbosch University, 2014. / There is a growing trend towards the use of point of care testing in resource poor settings, in particular in the diagnosis and treatment of infectious diseases such as Human Immunodeficiency Virus (HIV), Tuberculosis (TB) and Malaria. The Alere PIMA CD4 counter is widely used as a point of care device in the staging and management of HIV. While the instrument has been extensively validated and shown to be comparable to central laboratory testing, little is known about the error rates of these devices, as well as the factors that contribute to error rates. This research was a retrospective analysis of error rates from 61 PIMA point of care devices deployed in nine African countries belonging to Medisciens Sans Frontiers. The data was collected between January 2011 and June 2013. The objectives of the study were to determine the overall error rate and, where possible, determine the root cause. Thereafter the study aimed to determine the variables that contribute to the root causes and make recommendations to reduce the error rate. The overall error was determined to be 13.2 percent. The errors were further divided into four root causes and error rates assigned to each root cause based on the error codes generated by the instrument. These error rates were found to be operator error (48.4%), instrument error (2.0%), reagent/cartridge error (1%) and sample error (4.3%). It was found that a high percentage of the errors were ambiguous (44.3%), meaning that they had more than one possible root cause. A systems-based knowledge management approach was used to create a qualitative politicised influence diagram, which described the variables that affect each of the root causes. The influence diagram was subjected to loop analysis where individual loops were described in terms of the knowledge type (tacit or explicit), the knowing type (know-how, know-who, know-what and know-why), and the actors involved with each variable. Where possible, the variable was described as contributing to pre-analytical, analytical or post-analytical error. Recommendations to reduce the error rates for each of the variables were then made based on the findings.

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<p>Objective: The aim of this study was to evaluate a new underfill-function in a POCT-instrument from HemoCue AB (Ängelholm, Sweden). The instrument is in use today among diabetes patients for self-monitoring blood glucose (SMBG). The new function is supposed to guarantee that measuring only will be performed on a sufficient sample volume to assure that the correct glucose value is received.</p><p>Methods and results: Blood samples (whole blood) from 12 patients were analysed with the instrument. Measuring were performed using different volumes in the cuvette. Full cuvette, 3µL, 2µL, 1µL and a measuring on an empty cuvette. The instrument performed measurements on all volumes added to the cuvette except for the empty cuvette. The less sample volume that was used the lower glucose values were reported by the instrument.</p><p>Conclusions: The new under fill-function did not work satisfactory. If such function would be more reliable it would be beneficial for the patient controlling hers/his bloodglucose provided that the testing procedure is being correctly done. This is very important because the results are often used to treat the patient.</p>