In a word, Cost. Unless the price has come down significantly, these devices cost thousands. Same reason you don't see them on wards.
Also with the rise of the new anticoagulant agents (that don't require monitoring and dose adjustment) it is quite likely warfarin will be phased out eventually.
My trust is already using this on a 3 hour apart testing regime but the delay in sample taking and lab processing times together with inappropriate testing, 'troponinitis' still mean many chest pain patient's are admitted that could be discharged from the ED if the process were streamlined.
Comment on: 'How can costly student scheme be justified?'
However as I was unable to secure a HCA post before I started my training I do see some benefit in this idea. I was not 100% sure I could cope with the realities of basic care (day 1's bed bath of a morbidly obese, doubly incontinent stroke victim proved that I could).
You could achieve the same effect by putting students straight on a 6 week basic care placement, after a brief induction and preparation period. Make this a trial period of the course - fail to demonstrate compassion and a caring attitude and your out. You could over subscribe the courses knowing you would have a certain amount of attrition in the first couple of months. This would be a lot cheaper and ensure all students had proper exposure to the realities of care early on.
If these apprenticeships are degree level, still require 50/50 theory/practice split and have to be affiliated with an approved university how is it any different from the current degree? It's also not fair on traditional nursing students if their apprenticeship counterparts are being paid for their work on placements if they are not.
I would however welcome any move to support/upskill HCAs who don't have the entry qualifications for a degree.
Comment on: 'Look beyond nursing to give Francis legacy'
Very true. I'm glad to say that my trust staffing levels are definitely being taken more seriously with an end to unnecessary barriers to bank shifts being authorised and an emphasis on planning for and escalating shortfalls in staffing levels.
However I'm concerned that while everyone agrees basic care, compassion and communication are important the focus remains on efficiency, patient flow and performance markers. While important these all increase nursing (and medical) workloads and indirectly incentivise paperwork and speedy discharges and transfers over taking time to ensure high quality care and communication with patients and families