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 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.
I. Hospital POCT P&P 16.20
III. Clinical Laboratory POCT P&Ps
Waived Tests, Instrument based (Glucose, HemoCue)
PMPPs (Saline Wet Mount, Vaginal KOH Prep, Skin KOH Prep, Fern Test, Urine Sediment, Qualitative Semen Analysis)
VI. CDC POCT Guideline Ready? Set? Test?
VII. Selected References, POC Glucose Testing Alert (Memo dated June 11, 2014)
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.
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.
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.
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.