Quality assurance, practical management, and outcomes of point-of-care testing: laboratory perspectives, Part I

Pathologists and nurses have only recently cooperated in point-of-care testing (POCT), after accreditation organizations recommended that the laboratories take responsibility for managing the quality of patient-care testing conducted at the bedside. Laboratories are charged with ensuring that patient-care tests generate comparable results, regardless of the location or method. Many home testing devices, when used in hospitals, physicians' office laboratories, and mobile nursing practices, have presented technical and operational issues that were not foreseen from home use. These problems arise from a number of factors: the way the devices are used, the patient population, and even differences in sample type. Thus, to be successful, management of POCT in the health-care environment requires interdisciplinary cooperation of clinical nursing staff and laboratory staff. The article identifies problems in POCT, describes some solutions, and examines how well these solutions have worked from a laboratory perspective.