Point of Care Testing
POSITON STATEMENT
POINT OF CARE TESTING
Point of Care Testing (POCT) is laboratory testing performed at or near the patient, outside of a central laboratory environment. It is usually performed by non-laboratory health care professionals using a variety of methods which may include strips, kits or instruments/devices. Benefits of POCT may include improved turnaround times, improved patient outcomes, reduced diagnosis and treatment time, and decreased workload for laboratory staff. Technological advancements have produced portable, easy to operate instruments that can deliver rapid, high-quality test results. With improved technology and the development of sophisticated testing procedures, portability of some tests is feasible; however, the simplicity of operating the equipment and performing the POCT provides many challenges, in particular, the ability to determine the quality of the result and the value which POCT may bring to the client care process. POCT has the potential to improve treatment if undertaken within a comprehensive quality management system. It is expected that accuracy and reproducibility of the POCT result is comparable to that in an accredited hospital laboratory. In order to recognize the proper functioning of equipment and to provide reliable results, the operator must have education and training in the quality control procedures and knowledge of the analytical concept.
The New Brunswick Society of Medical Laboratory Technologists (NBSMLT) has a mandate provided by the Medical Laboratory Technology Act (1991). The purpose of this mandate is to advance and to maintain the standard of medical laboratory technology in New Brunswick, to govern and regulate medical laboratory technology services provided to the public and provide for the welfare of members of the public and the NBSMLT. The NBSMLT endorses Point of Care Testing (POCT) when it is under laboratory supervision and jurisdiction as supported by accreditation and legislative guidelines. POCT offers a unique opportunity for MLTs to work collaboratively with a broad scope of health care professionals by providing strong clinical laboratory expertise and leadership. A laboratory POCT program is a collaborative and coordinated process between an accredited clinical laboratory and other health care professionals, with clear evidence that the use of this technology improves the quality of patient care.
The NBSMLT endorses POCT programs which require:
1. Organizations to have a policy that clearly defines reporting and contractual relationships, roles and responsibilities for POCT.
2. Laboratory guidance, management and oversight by a licensed MLT.
3. An interdisciplinary professional committee to define the scope of services and oversee the delivery of POCT.
4. An established standard operating procedure (SOP) that clearly defines the roles and responsibilities of all health care professionals delivering POCT.
5. Laboratory accreditation by Accreditation Canada Diagnostics; personnel performing POCT must meet Accreditation Canada’s definition of a Health Care Professional delivering POCT.
6. All POCT users requesting, interpreting, and/or performing POCT must do so within their scope of practice and be licensed health care professionals.
7. All POCT users have formal educational and training and a competence assessment initially and periodically thereafter.
8. Organizations have POCT policies such POCT testing ordering and reporting of POCT testing.
9. Licensed MLT’s in collaboration with other relevant licensed health professionals are responsible for:
a. Evaluation and selection of instruments and test materials.
b. Development of the training and competence program.
c. Regular quality checks on all instruments, reagents and strips.
d. Selection and provision of standards and quality control material to operators and for the operation of a quality control program involving periodic simultaneous determinations by the laboratory.
e. A quality assurance program.
A point of care service has the potential of providing improved client care; however, there is the risk of harm if it is not introduced and maintained properly. The laboratory or organization must be responsible for the oversight of the service to ensure all quality standards are met. Any liability will be assumed by the employer, health care professional who performed the POCT and may include the licensed MLT who was involved in the training and competency assessment of the health care professional performing POCT and/or the licensed MLT that has oversight of POCT.
It should be noted that any POCT must be handled in a manner consistent with and meets Accreditation Canada Diagnostics requirements for POCT.
References
Accreditation Canada Diagnostics, Point-of-Care Testing requirements, version 9, June 2023.
Approved October 16, 2024