Point-of- Care Testing (POCT)- Definition and Application

Point-of-Care Testing refers to tests done in the primary care setting. In acute care settings (eg, critical care units, ambulances), state-of-the-art testing can produce rapid reporting of test results. 

Testing in the home care environment requires skill in procedures such as drawing blood samples, collecting samples from retention catheters, proper specimen labeling, documentation, specimen handling, and specimen transporting. Moreover, teaching the patient and his or her significant others how to collect specimens is an important part of the process.

Application

In occupational health environments, testing may be done to reduce or prevent known workplace hazards (eg, exposure to lead) and to monitor identified health problems. This can include pre-employment baseline screening, periodic monitoring of exposure to potentially hazardous workplace substances, and drug screening. Skill in drawing blood samples, performing breathing tests, monitoring chain of custody and obtaining properly signed and witnessed consent forms for drug testing is required.

More pretest, post-test, and follow-up testing occurs in nursing homes because patients are more frequently taken or transferred to hospitals for more complex procedures (eg, computed tomography [CT] scans, endoscopies), whereas this is not the case with routine testing.Increasing numbers of full code (ie, resuscitation) orders leads to greater numbers and varieties of tests.Additionally, confused, combative, or uncooperative behaviors are seen more frequently in these settings. An attitude adopted by nursing home patients of not wanting to be bothered or engaging in outright refusal to undergo prescribed tests can make testing difficult. Consequently, understanding patient behaviors and using appropriate communication strategies and interventions for this population are necessary skills for practicing in this arena.

For those who practice in the realm of public health, diagnostic test responsibilities focus on wellness screenings, preventive services, disease control, counseling, and treatment of individuals with problems. Case finding frequently occurs at health fairs, outreach centers, homeless shelters, neighborhood nurse offices, mobile health vans, and church settings. Responsibilities vary according to setting and may include providing test information, procuring specimens, and providing referrals to appropriate caregivers. These responsibilities may even extend to transporting and preparing specimens for analysis or actually performing specimen analysis (eg, stool tests for occult blood, TB skin testing, and procuring blood or saliva samples for HIV/acquired immunodeficiency syndrome [AIDS] testing).