What is a POCT test?
What is POCT test? POCT is medical abbreviation of Point-of-care testing, also known as bedside testing. It’s a form of testing which is designed to be used at or near the site where the patient is located.
What is the purpose of POC?
The purpose of POCT is to produce immediate results that can affect patient care, treatment, and disease management. This section will look at three of the most common POC devices in use. Both of these devices can be used either in a clinical setting or in a patient’s home.
What are the characteristics of POCT devices?
2. the examples of POCT devices. Compare with other in vitro diagnostic (IVD) products, POCT products have three distinctive features: 1.Detection time: short detection time, POCT products shorten the detection cycle from sample collection and detection to result report; 2. Detection space: POCT belongs to the detection of the object being tested;
Why is POCT data management important for healthcare?
Because point-of-care testing sites can be widely scattered across a healthcare campus, it is important to have a robust POCT data management system to capture important testing information, manage quality control, and support regulatory guidelines.
What does a POCT test for?
Point-of-care (POC) testing involves performing a diagnostic test outside of a laboratory that produces a rapid and reliable result, aiding in identifying or managing chronic diseases and acute infections.
What are examples of POCT?
Examples of POCTs include the measurement of glucose levels by diabetic patients and home pregnancy tests. Other tests that are less well known to the general public can also be performed with POCT: antigen and antibody testing, drug screens, anticoagulant treatment follow-ups, etc.
What is a POCT in a hospital?
The expression “point-of-care testing” (POCT) refers to the use of the procedures of laboratory medicine in the immediate vicinity of the patient (box 1). This is a recent development in laboratory medicine driven by the clinical need to obtain investigation results without delay.
What is the most common POCT test?
Glucose testingGlucose testing is the most commonly used POCT item in the field of clinical chemistry. The most common POC glucose test is glucose testing strips, which comprise 53.7% of the total global POCT market.
What are the POCT devices and their uses?
POCT Testing POC diagnostic devices are used to test glucose and cholesterol levels, do electrolyte and enzyme analysis, test for drugs of abuse and for infectious diseases, and for pregnancy testing. Blood gases, cardiac markers, and fecal occult blood tests can also be done with POC diagnostic devices.
Who performs point of care testing?
In 52% of the institutions, POCT is performed by nursing staff members. Only 8% of the survey respondents indicated that medical technologists perform POCT. Medical laboratory technicians perform less than 1% of POCT.
What are the disadvantages of POCT?
The disadvantages of POCT such as incorrect handling and/or maintenance of the analyzers by nontrained clinical staff, inadequate or even absent calibrations and/or quality controls, lack of cost-effectiveness because of an increased number of analyzers and more expensive reagents, insufficient documentation and ...
What problems might occur with using a POCT at home?
Manual POCT does not provide all the necessary information including material handling data, result reporting and comments, and in some cases (depending upon the device) test results have to be manually entered into the facility's database—which is not only time consuming but is also increases the risk of human error.
What is another name for point of care testing?
Point of care (POC) testing is medical testing that is performed outside of a laboratory setting. POC testing is also known as bedside testing, near-patient testing, remote testing, mobile testing and rapid diagnostics.
What is POCT urinalysis?
It is used to detect urinary tract infections (UTI) and other disorders of the urinary tract. In patients with acute or chronic conditions, such as kidney disease, the urinalysis may be ordered at intervals as a rapid method to help monitor organ function, status, and response to treatment.
Which of these is considered a POCT test?
Chemistry tests can be performed as POCT include glucose, cardiac troponin T, cholesterol, blood gases, and electrolytes (See chapter discussion on specific tests and how to perform them.)
What is the most common method of blood collection used for POCT?
INR testing may be performed at the doctor's office or by the patient (“home testing”). For the most popular devices see Table 3 . All these systems use unit-use test strips and whole blood obtained by finger prick, making them most convenient for the patient [10].
What is another name for point-of-care testing POCT )?
“Point of care“ testing (POCT), also known as bedside testing, involves any type of diagnostic test that isn't done in the laboratory. More specifically, this type of testing is performed as close as possible to the patient, be it at their bedside or near them — hence the name “point of care”.
What is POCT urinalysis?
It is used to detect urinary tract infections (UTI) and other disorders of the urinary tract. In patients with acute or chronic conditions, such as kidney disease, the urinalysis may be ordered at intervals as a rapid method to help monitor organ function, status, and response to treatment.
What is POCT in medical terms?
Point of Care Testing (POCT) is the delivery of a test at the point in time at which the result will be used to make a decision and taking appropriate action resulting in an improved health outcome. It is also known as near patient, bed-side, extra-laboratory, decentralised, and ancillary testing [1]. It has been shown to reduce hospital stay time, reduce complications, and improve adherence to treatment [2].
Where to obtain QC material for POCT?
QC material for POCT should be obtained from a third party provider and not rely on material provided by the device manufacturer, the benefits of which are well documented. It should also contain analytes at clinically relevant concentrations, be provided ready-to-use, and be stable at ambient temperatures.
What is EQA for POCT?
EQA for POCT is, in theory , similar to EQA in a large laboratory. There is a significant difference however, the POCT participants are usually health care professionals with little knowledge of laboratory medicine. A lack of understanding of the importance of EQA had led to a smaller percentage of sites participating than large laboratories.
How many phases are there in the POCT cycle?
There are three phases in the POCT cycle: pre-analytical phase, analytical phase, and post-analytical phase. About 90% of quality issues are attributed to the pre-analytical and post-analytical phases [3].
Is point of care testing a recent practice?
It has been shown to reduce hospital stay time, reduce complications, and improve adherence to treatment [2]. Point of care testing is not a recent practice; many early diagnostic tests were administered at the bedside. However, analytical technology has progressed and multiple tests can be performed within minutes in a laboratory.
Who can use POCT?
Typically, the most frequent users of POCT are nurses, however, any medical personnel who have been through the proper training can perform waived testing. Training and competency programs are designed by the laboratory Point-of-Care Coordinator (POCC) and approved by the laboratory director. The POCC must be a formally trained MLS/MT. The actual training of the staff using the POCT testing devices is done by nursing education in cooperation with the POCC.
What is POCT test?
The purpose of POCT is for the clinician to make a change in a patient’s treatment in real-time. For example, a patient who is on blood thinners goes to the doctor because they notice increased bruising. In the office, the MA/nurse/doctor can perform a simple point-of-care test to determine the patient’s PT/INR.
How much does a POC test cost?
Expense: POC tests are much more expensive than traditional laboratory testing. For example, running a POC glucose test may cost $3.00 per test, whereas a serum glucose sample sent to the lab may cost 10 cents. While $3.00 may not seem like a lot, it adds. Consider a large health system that runs 100,000 POCT glucose tests per year.
How are POC results recorded?
In the case of an automated POC device, such as a glucometer, results are stored in the instrument and uploaded into the device management system , which then automatically cross over into the patient’s medical record. In the case of manual POC tests, such as a pregnancy test, results may be either directly entered into the patient’s MR or recorded on a log sheet to be entered at a later time. In the case of either testing situation, critical results and proper follow-up must be properly documented.
Why is it important to have a POCT program?
It is important that the POCT testing program remains organized and open lines of communication between each department involved are well established.
What is a point of care test?
Point-of-care tests are less complex versions of tests performed by a standard hospital or reference laboratory. Due to its convenience, many different types of facilities utilize this form of testing, from schools to urgent care centers to hospital emergency rooms. Point-of-care tests are easy to perform and do not require much technical training.
Do point of care tests require technical training?
Point-of-care tests are easy to perform and do not require much technical training. Therefore, the range of people able to perform the testing is greatly expanded from college-educated and trained medical laboratory scientists. Basically, any person who has gone through the proper training and competency procedures for a particular point-of-care test can perform that test. It is not uncommon for medical assistants, CNAs, or x-ray techs to perform simple POCT tests in most medical facilities.
Why is POCT used?
Because POCT devices provide rapid results, they also help reduce the risk of developing the visual and neurological disorders that may be associated with this disease.
What is POCT testing?
This article presents the current and emerging status of Point-of-Care Testing (POCT) devices and its growing range of applications. It presents the current available devices, its testing applications, and its future developments.
What is POCT in healthcare?
Point of care testing (POCT) has the potential to deliver rapid blood gas and other critical care test results in close proximity to the patient. When properly incorporated into the patient care process, POCT can translate to faster therapeutic intervention, reduced preanalytical errors, and improved patient care. However, POCT also requires a higher level of supervision and quality management to avoid the pitfalls of improper sample handling, test inaccuracy, training and continued competency assessment of nonlaboratorians, and justification of the additional costs of analyzers and test units or cartridges. The benefits of POCT are also dependent on the test volume and proximity of the care area to a clinical laboratory. For example, POCT becomes very labor intensive for high volume testing and may have limited benefit if a clinical laboratory is located near the patient care area.
Why is POCT used in the laboratory?
POCT beyond the laboratory is increasingly popular in some countries and it is particularly useful when patients live a distance away from a hospital laboratory. Instrument manufacturers are now producing tabletop or hand-held devices that are simple to use, are autocalibrated and require minimum maintenance.
What is POCT testing?
Point-of-care testing (POCT) is laboratory testing conducted close to the site of patient care. POCT provides rapid test results with the potential for improved patient care. However, when incorrectly performed or inappropriately utilized, POCT can generate misleading results that require additional follow-up at increased cost and risk to the patient. While most POCT is waived under the federal Clinical Laboratory Improvement Amendments of 1988, there are several considerations that challenge its implementation. This chapter will focus on the advantages and limitations of POCT and will describe how to manage the quality of POCT in order to achieve optimal patient outcomes.
What is peripheral testing?
Some of the terms may be more general in meaning, as ancillary or peripheral testing can describe any testing outside of a main laboratory. Other terms are more specific, like bedside testing that describes testing conducted solely at the patient’s bed. The multitude of words used to describe POCT adds confusion.
What is a point of care test?
Point-of-Care Testing (POCT) is defined as laboratory testing conducted close to the site of patient care, typically by clinical personnel whose primary training is not in the clinical laboratory sciences, or by patients (self-testing). POCT refers to any testing conducted outside a main, central, or core laboratory setting. Other common terms for POCT are ancillary, bedside, decentralized, near-patient, patient-focused, peripheral, portable, and satellite testing. Some of the terms may be more general in meaning, as ancillary or peripheral testing can describe any testing outside of a main laboratory. Other terms are more specific, like bedside testing that describes testing conducted solely at the patient’s bed. The multitude of words used to describe POCT adds confusion. In general, discussions of POCT should limit the number of terms and always define the exact meaning whenever changing POCT terminology.
Is POCT a reliable test?
However, POCT devices may not be as reliable as laboratory-based drug testings as greater rate of falser positive and some false negative results may be observed using POCT devices compared to laboratory-based urine drug screening using immunoassays and automated analyzers.
Is POCT labor intensive?
For example, POCT becomes very labor intensive for high volume testing and may have limited benefit if a clinical laboratory is located near the patient care area. View chapter Purchase book. Read full chapter.
Why is Point-of-Care Testing Growing?
As healthcare becomes more consumer-focused, the need for convenient diagnosis, monitoring, and screening tests is expanding worldwide. In some cases, technology has caught up; testing devices that are smaller, more portable, and easier to operate have been developed.
Benefits
When used properly, point-of-care testing can lead to more efficient, effective medical treatments and improved quality of medical care.
Cautions
While many point-of-care tests are designed to be relatively simple and low risk to use, they are not error-proof. Individuals using point-of-care tests, even healthcare practitioners, must carefully follow test directions and be familiar with the test system.
The Future
For some conditions, like diabetes, point-of-care testing has already drastically altered how care is delivered and managed.
Examples
There are many point-of-care tests available in a variety of settings. Here are some that you may encounter:
What is PoCT connectivity?
In its simplest terms, PoCT connectivity essentially refers to a set-up where instruments have the ability to be connected to a dedicated computer that has specific software to manage data it receives from the instrument. This middleware is referred as the “data manager” and allows both device management and data management.
What is the most critical error in PoCT testing?
Incorrect or missing ID may be one of the most critical errors in PoCT testing. ID errors may lead to noncompliance with local and national regulatory requirements, misdiagnosis of a patient’s condition, incorrect treatment of a patient, need for resampling and lost billing opportunities from tests that cannot be accounted for.
What are the most common post-analytical errors in POCt?
Transcription errors are by far the most common post-analytical errors seen when using PoCT. These can be further sub-divided into single digit errors, incorrect rounding and accidental switching of digits. Sometimes the result is not written in the patient record or diary chart, either due to the need for urgent patient care or the judgement to disregard data that was not conducive to making a clinical decision. Misinterpretation of the result, especially if it is a color change where it has to be matched to several different shades of the color, is also a common post-analytical error.
Why is it important to select a point of care device?
Selection of a suitable point of care device is an important process as it will ensure the device is the most appropriate for the patient care setting and the population served. For an inexperienced user, the diversity of different instruments available can lead to inappropriate selection which can result in wasted money and failure to achieve the anticipated improved patient outcomes.
What sites are used to draw blood?
The tourniquet should be applied tight enough to occlude venous supply but not arterial. The median cubital, basilic and cephalic veins sites are generally used to draw blood and the choice of the site will also depend on several factors. These include patient related factors such as age, medical history, general condition and previous venepunctures, condition of veins, expertise of the collector and the volume of blood required. Sufficient pressure must be applied to the area post-collection to control bleeding. When collecting an anticoagulated sample, the specimen should be adequately mixed by gentle inversion 8 – 10 times.