In touch with …. Dr Brooke Spaeth

With her love for adventure, Dr Brooke Spaeth has lived a life with its fair share of excitement. As a Research Fellow with the International Centre for Point-of-Care (POC) Testing, we asked Brooke how she came to work in such a specialised field.

What is your role and what does your work focus on?

I work as a Research Fellow with the International Centre for Point-of-Care (POC) Testing within the College of Medicine and Public Health. Primarily I work on translational research by implementing, managing and researching the outcomes of remotely located Point-of-Care Testing networks across Australia. I’ve also been coordinating POC testing internationally in isolated and low-resource settings, such as detecting and treating anaemia in rural Pakistan and working on a multi-country POC device evaluation with the World Health Organisation.

In Australia, I focus on acute care POC testing within the remote Northern Territory (NT), coordinating the NT POCT Program which works across a network of 41 Aboriginal Community Controlled Health Services and 44 government-run Primary Health Care Centres.

I recently coordinated the NT rollout of molecular POC testing devices for COVID-19 testing as part of a national rapid response program. The rapid implementation has provided equity of access to SARS-CoV-2 testing in rural and remote Aboriginal and Torres Strait Islander communities, enabling gold-standard COVID-19 results to be provided in less than 1 hour.

As an independent researcher, I’m examining the psychological impacts related to waiting for pathology results and the impact that POC testing can have on reducing the stress and anxiety related to waiting for test results. Other areas of interest include increasing local workforce capacity in Aboriginal communities through developing new employment opportunities and investigating initiatives that support antimicrobial stewardship.

I recently put together a video that explains what Point-of-Care testing is and what it is used for – which is a helpful guide for those of you who may not know!

What journey brought you to this point in your career?

Coming from Port Augusta in the mid-north of South Australia, I’ve always had a particular interest in supporting health care in regional and remote locations due to the challenges associated with accessing health care services in these areas.

That’s why I decided to complete a Bachelor of Medical Science at Flinders University – it provided me with bridging options to different disciplines within medicine and public health. In my last year of study for the degree, I enrolled in a new topic called Point-of-Care Testing: Management, Evaluation and Effectiveness. It was here that I discovered a completely new field of pathology testing.

What really caught my attention was a guest lecture delivered by a member of the Australian Antarctic Division. The presenter described the extremely isolated locations where POC testing was applied, including the NASA space station and Antarctica. This led me to thinking: “If POC testing can be used in these extreme locations, it can be used anywhere.”

This appealed to my adventurous side. In 2009, I completed an honours project which evaluated the effectiveness of the then-recently-implemented NT POCT Program in 32 remote health services.

Can you describe a challenge in your life and how you dealt with it?

In 2013, on the way back from a camping holiday to Cape York in far north Queensland, I was involved in a major car rollover in a very remote location. Unfortunately, this resulted in a fractured spine and significant lacerations to my scalp. After waiting more than three hours for medical assistance, I was transferred via a very rough road to an outback hospital where I received care – and nursing staff at the hospital used the very same POC testing device (the Abbott i-STAT) that I had been training remote staff to use for more than 7 years!

While waiting, I overheard the nurses discussing which was the correct tube to collect my blood in and which cartridge to use to test for electrolytes (they were checking me for dehydration and blood loss). My response from the bed was: “Collect the blood into a green top tube and use the Chem8 cartridge for electrolytes…” Needless to say, the nurses were quite stunned and came to ask me how I knew this information. I commented that I usually train people to use the device – then said “I don’t want to know my results, thank you!”

This experience was my own personal case study into the importance of having POC testing equipment available for acute care in remote areas. It gave me another little push to ensure every remote health service in the NT has access to this device. In part, this resulted in expanding the NT POCT Program, which grew from having devices in 36 remote health services to 72 remote health services in 2015.

What is something you are most proud of?

During my honour’s year, I was required to complete a separate piece of work which involved writing up a theoretical research proposal. Knowing that sepsis was a major problem in remote NT, I decided to develop a research proposal on the use of a white blood cell count POC test for detection and monitoring of sepsis. At the time, such a device had not yet been invented.

Fast forward to 2011, I was lucky enough to present my research in Prague and sat next to the inventor of a very new POC device which measured a total and 5-part differential white blood cell count. In 2013, we evaluated this POC device in one of the most remote outback regions of Australia, where the device proved to be robust and clinically impactful. In 2015, we piloted the device in 6 remote health services and found it to be operationally effective and analytically sound. In 2017, I supervised my first honours student who researched the clinical and economic impact of the white blood cell count POC device in 12 remote health services.

This research project provided the final evidence needed for the NT Department of Health to provide funding to implement the white blood cell count device in 20 Top End remote health services in 2020, which is now being considered for expansion into more remote locations.

How do you like to relax or spend your spare time?

Despite my accident, my family and I continue to 4WD and camp around Australia. We love visiting some of the most remote locations in the country. Our destinations have included several more trips to Queensland, the Victorian high county, outback South Australia and throughout NT, where I’m able to pop in and visit many of the remote clinics I work with. Next on the wish list is a long trip through Western Australia to the Kimberley region and across to Darwin.

 

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