4 - POINT-OF-CARE TESTING Flashcards
1
Q
- Combines medicine and technolog
- Involves engineering streams of Electrical, Chemical, Mechanical, and Materials
- Invent, design, and build new types of diagnostics, monitoring tools, and therapies
- 3D-printed body parts, cardiac pacemakers, 4D ultrasounds, x-ray machines, brain-machine interfaces and robotic prosthetics
A
Biomedical Engineering
2
Q
Analytical patient-testing performed outside the clinical laboratory
A
Point-of-Care Testing
3
Q
Other names for POCT
A
- Near-patient testing
- Extra-laboratory analyses
- Ancillary testing
- Bedside testing
- Physician’s office testing
- Alternative site testing
4
Q
POCT Checklist
A
- Quality management
- Specimen handling
- Reagents
- Instruments and equipment
- Personnel
- Quality control and calibration
- Safety
5
Q
- POCT providing equivalent results with those from the central laboratory
- Still, accuracy and imprecision concerns were observed in some POCT
A
Quality Management
6
Q
Quality Assurance
A
- Internal Quality Control
- External Quality Control
7
Q
- Onboard QC, internal checks, electronic QC, intelligent QC
- Performed in a specific time, interval or daily
A
Internal Quality Control
8
Q
- Proficiency testing
- “Blind samples” for participating labs
A
External Quality Control
9
Q
- A mechanism to perform a thorough systems validation
- Reliable, user-friendly device
- Training of operators
- Competency assessment of all individuals involved in POCT
- QC testing and monitoring
- Ensuring required maintenance
- Proficiency testing
- Connectivity and bar-coding technologies
A
Total System POCT Quality Assurance
10
Q
Advantages of POCT
A
- Major: faster delivery of results
- Work with flow of patient management and care
- Faster medical decision
- Smaller sample volume requirement
- Requires smaller amount of reagent
- Requires few steps
- Portability of the device
- Aids in the reduction of pre-analytical and post-analytical lab related errors
11
Q
Disadvantages of POCT
A
- Quality of results is a concern
- POCT performed by non laboratory personnel (nurses, physicians, emergency medical technicians, paramedics, pharmacists, medical office assistant, even patients)
- Training: “Value of Laboratory Quality Control)
12
Q
Phases of Microbiology Testing
A
- Preanalytical Phase
- Analytical Phase
- Post-analytical Phase
13
Q
- Patient assessment and test ordering
- Specimen collection
- Specimen transport
A
Preanalytical Phase
14
Q
- Specimen evaluation
- Specimen processing
- Validation results
A
Analytical Phase
15
Q
- Reporting
- Interpretation
- Diagnosis and treatment
A
Post Analytical Phase
16
Q
POCT Analyzers Desirable Characteristics
A
- Ease of use
- Method accuracy
- Comparable to central lab
- Portability
- Durability
- Low maintenance
- Simple QC
- Simple sample handling
- Barcode patient ID
- Lab Information System (LIS) ready
- Electronic Medical Record (EMR)
17
Q
Analytical Principles
A
- Reflectance
- Electrochemistry/Electrical Impedance
- Light scattering/Optical motion
- Immunoturbidimetry
- Lateral flow
- Spectrophotometry
- Fluorescence
- Polymerase chain reaction
18
Q
- Patient and operator ID
- Reference range
- Result documentation (permanent record)
- Analyzers connected to LIS or DM system
- Modem, internet, display screen, printer
A
Informatics
19
Q
- Patient, sample, operator, and device IDs
- Date and time: specimen collection and analysis
- Type of specimen
- Test requested and test result (unit)
- Error messages and action messages (if any)
A
Patient Information
20
Q
- Reference range
- Calibrator
- Reagent
- QC details (lot number and expiration date)
- Specific comments and alerts
A
Other Information
21
Q
Available POCT Tests
A
- Qualitative
- Quantitative
22
Q
examples of POCT tests
A
- hCG
- Glucose
- Hemoglobin (Hb)
- Rapid HIV
- Cardiac markers – troponin
- pH and urinalysis
- HbA1c
- Blood gasses (pH, O2, PCO2, HCO3)
- Electrolytes
