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The page below is a sample from the LabCE course Point-of-Care Testing (POCT): The Applications, Advantages, and Challenges. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Quality Assessment (QA) in Point-of-Care Testing (POCT)

QA is a program that monitors all aspects of laboratory testing. The laboratory was assessing the "quality" of its operation before it was required of other departments within the healthcare system. With this historical perspective, it is appropriate for laboratory staff to be involved in the QA program for POCT. Oversight of QA may be hospital-, clinic-, or central laboratory-dependent. Specific oversight is dependent on the structure of the total healthcare facility.
The QA program for any laboratory testing area must monitor all phases of testing, including preanalytic, analytic, and postanalytic phases. Quality control (QC) testing is a part of QA. Control materials (materials with known values) are used to monitor the analytic phase of the total testing process by verifying the reliability of the test results.
Every POCT program must have a comprehensive QA plan in place with corrective actions for monitors that are found to be unsatisfactory. An appropriate QA program will include periodic monitors of all of the following:
  1. Personnel records, to include verification of qualifications with a diploma or transcript, initial training records for all testing methods performed, and competency assessment at time of hire, 6 months post-hire, 1 year post-hire, and annually thereafter. Records should also include OSHA training and verification of hepatitis B vaccination or declination. Review of these records should be part of the QA plan on an annual basis.
  2. QC records and environmental conditions, such as temperature, humidity, centrifuge cleaning. These records should be reviewed at least monthly.
  3. Proficiency testing (PT) review and corrective action, if PT is required by test method, state, or accrediting agency. This review should be conducted following the completion of each event.
  4. Tracking of testing performed.
  5. Annual review of policy by appropriate personnel.
  6. Review and determination of completion of corrective action for incident reports and patients affected.
  7. Periodic review of communications between staff members and administration.
  8. Periodic review of sample collection, labeling, and documentation.
Integration of the laboratory staff into the quality assessment plan for the POCT system expands from laboratory operation to the bedside and continues to incorporate the laboratory staff directly into the patient-centered care approach.