scholarly journals Point-of-care testing: is it a paradox in international normalised ratio measurements?

2020 ◽  
pp. 109-113
Author(s):  
W Maule
Keyword(s):  
Clinical Laboratory ◽  
Point Of Care ◽  
Vitamin K Antagonists ◽  
Anticoagulation Therapy ◽  
Brand Names ◽  
Point Of Care Testing ◽  
Oral Anticoagulation Therapy ◽  
International Normalised Ratio ◽  
Control Programmes ◽  
Support Mechanisms

Point-of-care testing (POCT) in haemostasis has shown a steady state increase in the range of tests available with an exponential increase in the number of tests that are performed annually. The most commonly performed test remains the out of hospital measurement of the international normalised ratio (INR). The INR is used to monitor oral anticoagulation therapy (OAT) with vitamin K antagonists. Such drugs include some of the following: warfarin (Coumadin®), phenprocoumon (Marcumar®) and acenocoumarol (Sintrom®, also sold as other brand names). Contrary to laboratory testing, POCT is often performed by general practitioners (GPs), nurses, pharmacists, patients and other healthcare professionals. In many cases these individuals do not have access to the same support mechanisms that exist in the clinical laboratory regarding strict quality control programmes. When an INR test is performed in the clinical laboratory, it has to be accredited, monitored and inspected. Accreditation is also advisable and part of these requirements is to be involved in external quality assessment (EQA). In the case of POCT haemostasis assays, EQA programmes do exist, however these programmes are still relatively few in number. Over the last decade there has been a significant increase in the scope of POCT, particularly in the field of haemostasis. This brief review summarises POCT in haemostasis, highlighting some of its benefits, challenges and future perspectives, especially with regard to the measurement of the INR.

Point-of-care testing: inspection preparedness

Perfusion ◽  
2000 ◽  
Vol 15 (2) ◽  
pp. 137-142 ◽  
Author(s):  
John Bennett ◽  
Cindy Cervantes ◽  
Scott Pacheco
Keyword(s):  
Clinical Laboratory ◽  
Point Of Care ◽  
Health Care Financing ◽  
Well Being ◽  
Regulatory Agencies ◽  
Human Beings ◽  
Point Of Care Testing ◽  
Human Specimen ◽  
Testing Site ◽  
Clinical Laboratory Improvement Amendments

Point-of-care testing (POCT) in the operating room has changed dramatically since the implementation of the Clinical Laboratory Improvement Amendments (CLIA ‘88), which became effective in September 1992. With the implementation of CLIA ‘88, the Health Care Financing Administration (HCFA) mandated that human specimen testing ‘for the purpose of diagnosis, prevention, or treatment of any disease or impairment of, or the assessment of the health of human beings’, must be performed by a certified laboratory or testing site. To attain and maintain accreditation, the need for more stringent and comprehensive documentation has become imperative. The Joint Commission for the Accreditation of Hospitals (JCAHO), the College of American Pathologists (CAPS), HCFA, and state regulatory agencies require data such as staff credentialling, staff training/competency, procedure manuals, quality control logs, quality assurance/corrective action plans, correlation studies, proficiency testing results, and equipment maintenance logs to assure specimens are analyzed in a reliable manner by competent personnel so as not to jeopardize the safety and well being of the patient. Developing a comprehensive, ongoing survey readiness plan that includes a pre-survey checklist of all the documentation required and having this documentation in order and up to date well in advance of the survey will greatly enhance the probability of a successful survey conducted by the various regulatory agencies.

scholarly journals Point-of-care testing in the cardiovascular operating theatre

2006 ◽  
Vol 44 (9) ◽  
Author(s):  
Urs E. Nydegger ◽  
Erich Gygax ◽  
Thierry Carrel
Keyword(s):  
Healthcare Professionals ◽  
Cardiovascular Surgery ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Operating Table ◽  
Standard Laboratory ◽  
Rapid Progress ◽  
Point Of Care Testing ◽  
Laboratory Procedures ◽  
Major Equipment

AbstractPoint-of-care testing (POCT) remains under scrutiny by healthcare professionals because of its ill-tried, young history. POCT methods are being developed by a few major equipment companies based on rapid progress in informatics and nanotechnology. Issues as POCT quality control, comparability with standard laboratory procedures, standardisation, traceability and round robin testing are being left to hospitals. As a result, the clinical and operational benefits of POCT were first evident for patients on the operating table. For the management of cardiovascular surgery patients, POCT technology is an indispensable aid. Improvement of the technology has meant that clinical laboratory pathologists now recognise the need for POCT beyond their high-throughput areas.Clin Chem Lab Med 2006;44:1060–5.

Evaluation of point-of-care testing in critically unwell patients: comparison with clinical laboratory analysers and applicability to patients with Ebolavirus infection

Pathology ◽  
2015 ◽  
Vol 47 (5) ◽  
pp. 405-409 ◽  
Author(s):  
Jen Kok ◽  
Jimmy Ng ◽  
Stephen C. Li ◽  
John Giannoutsos ◽  
Vineet Nayyar ◽  
...  
Keyword(s):  
Clinical Laboratory ◽  
Point Of Care ◽  
Point Of Care Testing

scholarly journals Quality Management for Point-Of-Care Testing of Pathogen Nucleic Acids: Chinese Expert Consensus

2021 ◽  
Vol 11 ◽  
Author(s):  
Xi Mo ◽  
Xueliang Wang ◽  
Zhaoqin Zhu ◽  
Yuetian Yu ◽  
Dong Chang ◽  
...  
Keyword(s):  
Public Health ◽  
Nucleic Acid ◽  
Quality Management ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Conventional Polymerase Chain Reaction ◽  
Laboratory Medicine ◽  
Expert Consensus ◽  
Nucleic Acid Detection ◽  
Point Of Care Testing

COVID-19 continues to circulate globally in 2021, while under the precise policy implementation of China’s public health system, the epidemic was quickly controlled, and society and the economy have recovered. During the pandemic response, nucleic acid detection of SARS-CoV-2 has played an indispensable role in the first line of defence. In the cases of emergency operations or patients presenting at fever clinics, nucleic acid detection is required to be performed and reported quickly. Therefore, nucleic acid point-of-care testing (POCT) technology for SARS-CoV-2 identification has emerged, and has been widely carried out at all levels of medical institutions. SARS-CoV-2 POCT has served as a complementary test to conventional polymerase chain reaction (PCR) batch tests, thus forming an experimental diagnosis platform that not only guarantees medical safety but also improves quality services. However, in view of the complexity of molecular diagnosis and the biosafety requirements involved, pathogen nucleic acid POCT is different from traditional blood-based physical and chemical index detection. No guidelines currently exist for POCT quality management, and there have been inconsistencies documented in practical operation. Therefore, Shanghai Society of Molecular Diagnostics, Shanghai Society of Laboratory Medicine, Clinical Microbiology Division of Shanghai Society of Microbiology and Shanghai Center for Clinical Laboratory have cooperated with experts in laboratory medicine to generate the present expert consensus. Based on the current spectrum of major infectious diseases in China, the whole-process operation management of pathogen POCT, including its application scenarios, biosafety management, personnel qualification, performance verification, quality control, and result reporting, are described here. This expert consensus will aid in promoting the rational application and robust development of this technology in public health defence and hospital infection management.

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