Responsibilities in point-of-care testing. An institutional perspective

Area of Science:

• Clinical Chemistry
• Laboratory Medicine
• Critical Care Medicine

Background:

• The increasing availability of user-friendly laboratory analyzers facilitates in vitro diagnostic testing at the point of care (POCT).
• Physicians value the rapid turnaround times (TAT) offered by POCT, particularly in critical care settings.
• Registered nurses, as primary caregivers in critical care units, are often delegated POCT responsibilities.

Purpose of the Study:

• To examine the implications of delegating point-of-care testing to nursing personnel in critical care.
• To address issues of authority, responsibility, regulation, and conflict resolution arising from POCT delegation.
• To explore alternative strategies for achieving efficient bedside or near-bedside testing in critical care.

Main Methods:

• Review of current practices in critical care point-of-care testing.
• Analysis of the impact of delegating testing to nursing staff.
• Discussion of potential alternative logistical models for critical care laboratory services.

Main Results:

• Delegation of POCT to nurses has introduced complexities regarding professional roles and regulatory oversight.
• Physician satisfaction with rapid TAT is high, but operational challenges exist.
• Several alternative strategies can support efficient critical care testing.

Conclusions:

• Point-of-care testing in critical care necessitates careful consideration of delegation, regulation, and operational efficiency.
• Alternative models like vacuum transport or specialized satellite labs may offer solutions.
• Balancing rapid testing needs with safety and regulatory compliance is crucial.