CLINICAL LAB SCIENEC

170
ESSENTIALS OF CLINICAL LABORATORY SCIENCE
Table 7-1 Elements of Point-of-Care Testing
Elements Involved in Institutional Point-of-Care Testing
1. Orientation, training, and checkoffs for operators of instruments
2. Documented training in safety procedures for self and patient
3. Observing applicable requirements promulgated by regulatory agencies (government and
institutional policies and procedures)
4. Quality assurance program that includes quality control documentation
5. Periodic retraining and assessment of testing personnel
6. Technical support from manufacturers and suppliers
7. Support from institutional technical personnel (biomedical, clinical laboratory)
8. Computer program for input of results from Quality Control and reporting of patient results
performance of POCT by nontechnical personnel. However, at this point, most
training for performing POCT and maintaining of maintenance records and quality
control documentation is still performed by technical laboratory personnel.
Regulation of POCT
POCT at this point is chiefly provided for CLIA-waived procedures, so it is not
regulated as stringently as those procedures performed in the clinical laboratory.
In explanation, CLIA 88 terms a number of these simpler tests performed
on small easy-to-use instruments as “waived” tests, in which the operator needs
only basic orientation and training. However, in cases where the instrumentation
is used in physician’s office laboratories, clinics, and hospitals, certain components
related to quality assurance must be observed. Table 7-1 combines all of
the elements usually included in the policies and procedures manuals for health
care facilities. These activities are points for accreditation agencies to access during
their site visits for inspecting operation of the facility.
FIGURE 7-1 Triage MeterPlus provides a number of tests
related to cardiac health.
Source: Delmar/Cengage Learning.
Where is POCT Performed?
POCT is actually performed in two major sites—that
of the home and in critical care units and emergency
departments of hospitals. In addition, nursing assistants,
EMTs, paramedics, and others often perform
glucose testing with small hand-held meters for quick
action by the medical team. This type of testing is also
used in screening for health risks at health fairs. Basic
chemistry tests, such as the determination of cholesterol
and glucose levels using small portable instruments
such as the one pictured in Figure 7-1, may be
simply and conveniently performed in only minutes
using whole blood. Patients may even be able to monitor
test results themselves in their homes with minimal
instruction (Figure 7-2).
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