Still, J., Petley, L. & McDowell, G. (2016) ‘Point of Care Testing.’ In: Admed, N. (ed) (2016) Fundamentals of Biomedical Science Biomedical Science Practice. 2nd Edition. Oxford University Press. pp 377-399 (23 pages).
Learning objectives
After studying this chapter, you should be able to:
- Describe the basis and regulations that underpin POCT
- Discuss the requirements for POCT
- Discuss the differences between internal quality control, external quality assessment, and quality assurance in POCT
- Outline the equipment procurement process
- Describe the audit information required to minimize risk in the provision of a POCT
- Discuss the provision of a patient focused POCT service
Introduction
Point of care testing (POCT) is the provision of a diagnostic pathology testing service outside the traditional clinical laboratory setting and physically closer to the patient. This type of testing may be carried out by healthcare professionals in the ward, clinic, or GP surgery, by high street pharmacists, or by the patients themselves. This chapter describes point of care testing and its impact on the provision of pathology services, and outlines those aspects that must be considered when providing an effective POCT service.
Point of care testing is not a new concept, but earlier technologies paved the way for new devices in response to the demand for a more patient centred health service. Thus, urine dipstick testing has been an accepted practice in healthcare for many years and blood glucose meters were first introduced in the 1970s. Technological advances over the years have widened both the test repertoire and software capabilities available to POCT devices, with blood gas analyser manufacturers leading the marketplace in terms of quality standards for POCT. Indeed, POCT blood gas analysis is a well-established practice, having been developed in response to clinical requirements. Modern POCT now consists of a variety of devices from simple hand-held meters and test kits, some available for purchase and use by patients, to more sophisticated portable and bench top analysers, which provide a variety of tests in all disciplines of pathology.
This chapter introduces the basic concept of rapid testing for the benefit of the patient at the point of care. It illustrates how POCT is governed and regulated, and describes the requirements for a well-managed, reliable POCT service, and how such a service can be established and maintained. The training and competence of POCT practitioners is discussed, and the dangers associated with a lack of or poor quality training are highlighted.
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