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Lab Manual for UCSF Clinical Laboratories

Lab Manual for SFGH

Internal Resources

Point of Care Testing

Point of Care Testing encompasses all laboratory tests performed outside the formal walls of the Clinical Laboratory. At SFGH, three types of POCT are offered:

  • Waived Testing

    • Waived tests utilize technically simple methods and are expected to cause little or no harm to a patient if performed incorrectly. Waived tests can be further divided into instrument-based (e.g, glucose) and non-instrument based tests, which include fecal occult blood, vaginal pH, urine chemstrip and pregnancy tests.

  • Non-waived Testing (usually moderately complex testing in POC settings

    • Moderately complex tests are usually instrument-based, require a higher skill level, and generally carry a higher level of risk to the patient if performed incorrectly (e.g., blood gas testing).

  • Provider Performed Microscopy Procedures (PPMPs)

    • Tests in this category are considered moderately complex and include a set of defined microscopic procedures, i.e., saline wet mounts, that are performed by independently licensed (MDs, DOs) and mid-level practitioners (e.g., NPs, CNMs,PAs).

    POCT is regulated at the federal (CLIA '88) and state levels (CA Health & Safety, Business & Professional Codes). POCT activities on the SFGH campus are performed under the license of the SFGH Clinical Laboratory. Compliance with applicable regulation is verified through accreditation by the Joint Commission. Written Hospital and Clinical Laboratory policies and procedures reflect the expectations by the regulatory and accrediting bodies, and must be followed by all staff involved in POCT. A POCT Committee, with representation from the Clinical Laboratory, Hospital Administration and the Department of Nursing, oversees POCT at SFGH.

    For further information, please contact the Clinical Laboratory at 415.206.8588.

    Click links below for:

    I. Hospital POCT P&P 16.20

    II. POCT Forms (Request for New Point Care Test; Request for POCT Privileges; Temperature Record Form, Room AND Refrigerator; Temperature Record Form, Room ONLY)

    III. Clinical Laboratory POCT P&Ps

    IV. Technical and Clinical Information (package inserts) for non-instrument based waived POCTs (Hemoccult, Urine Chemstrip 2, Urine Chemstrip 7, Urine Chemstrip 10, Urine Pregnancy Test)

    V. Training Courses for non-instrument based waived POCTs (Hemoccult, Vaginal pH Test)

    VI. CDC POCT Guideline Ready? Set? Test?

    VII. Selected References, POC Glucose Testing Alert (Memo dated June 11, 2014)

    1. Ellis, M. F., K. Benjamin, et al. (2013). "Suitability of capillary blood glucose analysis in patients receiving vasopressors." Am J Crit Care 22(5): 423-429.

    2. Juneja, D., R. Pandey, et al. (2011). "Comparison between arterial and capillary blood glucose monitoring in patients with shock." Eur J Intern Med 22(3): 241-244.

    3. Lonjaret, L., V. Claverie, et al. (2012). "Relative accuracy of arterial and capillary glucose meter measurements in critically ill patients." Diabetes Metab 38(3): 230-235.

    4. Petersen, J. R., D. F. Graves, et al. (2008). "Comparison of POCT and central laboratory blood glucose results using arterial, capillary, and venous samples from MICU patients on a tight glycemic protocol." Clin Chim Acta 396(1-2): 10-13.

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