Point-of-Care Testing (POCT or Near Patient Testing, NPT)
The use of all point-of-care devices from simple dip-stick tests to blood gas analysis machines is governed by a comprehensive Trust policy and procedure. Please ensure that you are aware of the requirements of this policy before you embark on point-of-care testing. The POCT services managed by the team are rapidly expanding and include:
Blood Glucose Meters
Ward based glucose meters that measure blood glucose using a 'dry-chemistry' stick are used throughout the Trust. These meters must only be used by authorised staff that have received training via the scheme organised in conjunction with the meter manufacturer.
The working range of all glucose meters is limited and for accurate determination at the extremes of the range (2.5 - 20.0 mmol/L for the UHB meters), blood should be taken into a grey-top vacuette tube and sent to the laboratory. If the result is unexpected, send a sample to the laboratory or a sample can be processed on one of the blood gas analysers located throughout the Trust.
In hypoglycaemia, values below the working range must be confirmed by a laboratory glucose measurement. Consult the biochemist/consultant on duty prior to taking the blood so that appropriate samples can be collected for the investigation of insulinoma, should this be warranted.
Blood Gas Analysers (QEHB, Heritage Building, ROH, Moseley Hall)
The department has rationalised blood gas instrumentation in the Trust and identical instruments are sited throughout the Trust. All analysers measure pH, pCO2, pO2, sodium, potassium and ionised calcium. They provide full co-oximetry and derive values for base excess and bicarbonate. Glucose and lactate measurement is available on both sites, but not on all analysers.
The blood gas analysers are located throughout QEHB, Heritage Building and the POCT team also manage analysers at the Royal Orthopaedic Hospital and Moseley Hall Hospital.
Ward based operators and doctors are trained by staff of the POCT team. The laboratories do not have blood-gas analysers in the department and there is no in-house lactate measurement.
Throughout the Trust the POCT team manage the INR devices used for rapid testing. These meters have been installed in areas where a clinical need has been identified and approved. Operators are trained by the members of the POCT team.
To comply with the DKA guidelines and to support the diagnosis and management of patients with DKA the POCT team manage the ketone meter service within the Trust. Meters have been installed in areas where a clinical need has been identified and approved. Training and full service report is provided by the POCT team.
Other POCT Services
As well as these tests the POCT team are currently managing or are reviewing the following services:
DDimer testing, urine analysis including hCG testing (pregnancy testing) and dipsticks for screening, Haemostasis testing (ACT, APTT, ROTEM, TEG), Haematology clinics, Biochemistry one stop clinics and sexual Health testing.
If any clinical areas require advice or guidance on the installation or use of POCT systems please contact us to discuss further.
The POCT team can be contacted by: Telephone – extension 15976
Bleep - 1189
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