POCT AND PTPOINT-OF-CARE TESTING AND PROFICIENCY TESTING

Presented by Group 6 of BSMT III-B

POCTPoint-of-care testing

aka near-patient testing, alternate-site testing (AST) or patient-focused testing.

“Decentralization of Laboratory Testing” refers to the analytical patient testing

activities performed outside the physical facilities of a clinical laboratory

Brings laboratory testing to the site of patient rather than obtaining a specimen and sending it to the laboratory

POC is recognized by:

JCAHOCAPCLIA’88

Technology Evolution

Microcomputer chips and sensors

Instrumentation- Portable chemistry analyzers- Glucose meters- Blood gas analyzers- Hgb meters- Coagulation testing

Instrumentation

CRITERIA CHARACTERISTIC

•Cost•Accuracy•Ease of maintenance •Ability to self-calibrate•QC function•Reporting capabilities•Safety

•Durable•Simple to use•Cost-effective•Capable of rapid throughput (TAT)

Team Building Non-laboratory personnel

(nurses, surgery technician, therapists, others) Properly trained Laboratory has critical role Qualification of POC personnel are set by

federal, state, and local regulations. Top administrator- Responsible for setting additional

requirements, as long as the federal CLIA ‘88 regulations are also being followed.

EVERYBODY is required to provide quality service in a cost-effective

manner…

And the laboratory has the leading role

POCT Checklist Needs assessment Select method or instrument Commitment Identify patient type to be tested Identify instrument users Research and develop test procedure Establish QC/QA procedures Develop guidelines for staff training Risk management protocols Monitor and feedback Make changes and improvements

Benefits of POCT STAT ( survival rate) Rapid diagnosis Prompt medical attention More efficient use of resources Less hospital expenses Less trauma and more convenient to patients More collaboration of clinicians with the

laboratory. Decreased pre-analytical errors Cross-training Cost-effective

PT

Proficiency testing- Aka comparative testing- ISO/IEC 17025- involves a group of laboratories or

analysts performing the same analyses on the same samples and comparing results

ISO/IEC 17025

The philosophy behind the quality assurance section of ISO/IEC 17025 is to firstly

ensure that a single analyst within a laboratory is able to consistently reproduce the same result on the same sample.

the result produced by this analyst should reflect the result that would have come from any other analyst in the laboratory.

any results from the laboratory as a whole should reflect the results that are agreed upon by many other laboratories.

Benefits of PT to Company Group Leaders the company as a whole will meet the

requirements of ISO 17025 in the area of proficiency testing

assurance of the good performance and capabilities of analytical staff.

The company will have information that can assist in future planning for equipment upgrades and staff training.

the company has a valuable opportunity to demonstrate its commitment to laboratory staff as an integral part in the production of quality products and services.

Benefits of PT to Lab Staffs laboratory staff can gain confidence in their

abilities, and knowledge of their capabilities. laboratory staff will gain satisfaction in the

knowledge that they have improved or maintained a level of competence comparable with their colleagues.

They can detect any difficulties they may have with analyses and to identify training strategies.

 Overall, laboratory staff will have the knowledge that they are playing a valuable part amongst the company.

Reference Henry, John Bernard, M.D., “Clinical

Diagnosis and Management by Laboratory Methods” 19th Edition, 1998.

Turgeon, Mary Louise, “Linne’ & Ringsraud’s Clinical Laboratory Science: The Basics and Routine Techniques” 5th Edition, 2007.

www.proficiency.org http://www.ifmqs.com.au/what_is_PT.htm http://webstore.ansi.org/RecordDetail.as

px?sku=ISO%2FIEC+17025%3A2005#.UYCUEKKnAT0

THANKS FOR LISTENING AND NOT SLEEPING