Essential considerations in the provision of near-patient testing facilities

(1) Near-patient testing (NPT) is both practicable and in some situations desirable. (2) Like all new technologies its apparent simplicity often belies its complexity and masks the need for attention to detail in order to achieve optimum effects and avoid disasters. (3) Though technically unskilled individuals are capable of using it, they must undergo training in the elements of safety, sample collection, quality control, quantitation and documentation before being authorized to provide analytical services for patients. (4) Health Authorities should be encouraged to adopt a policy of integration of NPT and clinical laboratory services in order to reduce unplanned use and abuse of NPT facilities which is not only wasteful and divisive, but also dangerous. This has recently been emphasized in the United Kingdom by the release of a Hazard Notice (HN (Hazard) (87) 13) by the Department of Health and Social Security. The experienced clinical biochemist will, by virtue of training and experience, usually be the most suitable person in a Health District to advise on many of the issues involved in NPT. It should therefore, be the responsibility of laboratory staff to work with management, clinical, and nursing staff to: choose appropriate sites for the various levels of service to be provided to meet a clinical need; select the equipment and reagents to be employed; provide training in the use of the apparatus, quality control and safety; authorize accredited users and oversee the quality assurance programme. (5) Laboratory staff will need to involve themselves closely in the financial implications of NPT both for the laboratory's benefit and that of clinical practice within the hospital and/or community as a whole.