Point of Care Testing issues

1. Point of Care Testing issues • Tietz • Freedman D, Clinical governance: implications for point-of-care testing. Ann Clin Biochem 2002; 39: 421- 423 • Price C, Point of Care Testing.BMJ 2001;322:1285-1288

2. POCT • Defined as diagnostic testing at or near the site of patient care. • Brings the test conveniently and immediately to the patient. • Increases the likelihood that the patient will receive the results in a timely manner.

3. History and growth • Marks 1983 “Bringing bichemistry nearer the patient” • 1997 $3 Billion • 2001 $5.4 Billion

4. Characteristics • Results in <1 min • Portable instrument/reagents • Simple SOP • Analyse whole blood/urine • Accuracy/precision similar to lab • Built in QC/calibration • Ambient temp storage for reagents • Result storage facility • Low instrument cost

5. Advantages • Reduced TAT • Improved patient management • Reduces admin • Minimise delays • Transport • Registering • Travel through lab

6. Clinical Governance 1997 • a framework through which the NHS organizations are accountable for continuing to improve the quality of the service and safeguarding high standards of care by creating an environment in which excellence in clinical care can flourish.

7. Link to POCT? • Laboratory central role in management of these devices • Director of Laboratory Medicine • POCT committees (MDT) • EQA • Professional development/accreditation of staff • Audit

8. Medical Devices Agency • Executive of Dept of Health • Takes quality standards from EU • Prevents recurrence of incidents • Adverse incidents must be reported • Lead to hazard labels

9. POCT • Weakness in Lab cannot justify expensive POCT • Requires trained operators • Testing only beneficial if action taken on result • Patient must benefit –evidence-Audit