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Principles of Analysis > POCT > Flashcards

POCT Flashcards

1
Q

ISO15189 (2022) POCT defitiniton

A

examination that is performed near or at the site of a patient

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2
Q

what is the most common POCT test

A

glucose

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3
Q

how many more POCT glucose than lab glucose?

A

10 x more

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4
Q

advantages of POCT for pt on insulin

A

assess insulin requirements
better glycaemic control

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5
Q

what type of blood do glucose meters use?

A

capillary blood

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6
Q

sensors under skin

A
  • Small sensor automatically measures & continuously stores glucose readings day and night
  • Scan patch to get results
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7
Q

Blood Gas analysers samples

A

Arterial, venous or capillary samples

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8
Q

How long to POCT BG takes and how many analytes

A

<2 mins 15-20 simultaneous analytes

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9
Q

what analytes to BG POCT test

A

gases, electrolytes, metabolites, haemoglobin and derivatives

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10
Q

what is INR used for

A

warfarin monitoring, how well blood is clotting. usually need INR testing on a weekly basis - warfarin dose may be adjusted

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11
Q

urine dip sticks number of analytes

A

5-11 analytes on 1 strip, semi-quantitative

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12
Q

HIV POCT

A

lateral flow- follow up with lab confirmation

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13
Q

fetal fibronectin use

A

diagnostic test to assess the risk of delivery in preterm labour

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14
Q

why is fetal fibronectin test used

A

may need to be admitted and monitored, steriod treatment to protect baby, does mum need to be transferred to specialist centre

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15
Q

where is fetal fibronectin detected

A

in the vaginal secretions prior to delivery

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16
Q

multi-test POCT analysers test

A

multiple tests simultaneously, technology is in the test cartridge. 1 blood sample for a whole panel of tests.

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17
Q

POCT DDIM

A

? DVT/PE - treat and refer for scan

18
Q

creatinine POCT

A

prior to emergency contrast radiology

19
Q

benefits of POCT testing

A
  • quicker TAT
  • smaller sample volume
  • portability of devices
  • simplicity of measurement
  • lots of advantages
20
Q

decentralised testing…

A

secondary care, primary care, community services and far beyond. Patients usually would prefer to have their healthcare needs met at home.

21
Q

drivers for decentralised testing

A
  • Rising demand for diagnostics
  • Manage common conditions outside of the hospital setting
  • Deliver healthcare where it is required
  • Covid-19 has highlighted the importance of diagnostic services
22
Q

POCT helps to address

A

waiting lists
delays to care
escalating costs
poor outcomes- relieve pressure on phlebotomy/pathology, preserve lab testing, improve pt experience

23
Q

challenges of POCT

A

expensive
duplication of equipment
CE/FDA Approved
comparability of methodology/results
increased risk of adverse incidents and litigation
pre-analytical, analytical and post-analytical errors
lack of IT connectivity
adds to clinical staff responsibility

24
Q

benefits of a lab environment

A

well-maintained, quality-controlled analysers operated by highly competent staff

25
Q

management of POCT

A

governance, overseen by MDT committees
devices - validated and verified
users - trained and competent
defined testing pathway
results recorded correctly

26
Q

POCT NHS requirements:

A

subject to the same level of public, professional and judicial scrutiny as conventional lab testing
NHS assessment - mandatory
device training and maintenance
incidents
CQC- may come under remit

27
Q

governance of POCT

A

organisation accountable for quality
clinical and cost effectiveness
resources
accuracy
responsbility/accountability

28
Q

POCT specific guidance / standards:

A

MHRA - advice on the management and use of POCT in vitro diagnostic devices dec 2013
ISO 15189:2022 POCT standards have been incorporated
national strategic guidance for POCT 2023 - key recommendations when developing a POCT service

29
Q

0-49 fetal fibronectin result

A

low risk - reassure and return home

30
Q

how much is fetal fibronectin test

A

40

31
Q

50-200 fetal fibronectin test result

A

admit and prescribe steroids £300/night

32
Q

fetal fibronectin >200

A

very high risk, transfer to tertiary unit £200 + £300/night

33
Q

examples of governance features

A

password access
QC lockout
barcode readers -pt ID
connectivity

34
Q

what IQCs are ideal

A

2 different levels, the critical concentrations of the test

35
Q

what are most POCT errors linked to

A

the operator

36
Q

disadvantage with non connected devices

A

handwritten pt notes, transcription errors, time, legibility, storage

37
Q

what are primitive devices

A

results book
QC log
visually read tests
non connected devices e.g. pregnancy
handwritten results

38
Q

intermediate POCT devices

A

results, QC, lots stored on device
printed results stuck to pt notes
manually enter result into pt record
advantages - can record results in electronic pt record
disadvantages - transcription errors, time consuming

39
Q

interfaced devices

A

remote login to devices, add trained users, review QC data. results automatically added to the electronic pt record. full audit trail. verification of pt ID. expensive, requires IT support,

40
Q
A

Principles of Analysis (8 decks)

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