POCT-POINT OF CARE TESTING

Learning Objectives
 
At the end of this experiment, the learner will be able
to:
1. Define point-of-care testing (POCT) and discuss
different advantages of POCT
2. Enumerate the tests and instrumentation commonly
used in POCT
3. Perform point-of-care glucose testing
Introduction
 
 Point-of-care testing (POCT), also referred to as
alternate site testing, near-patient testing, or bedside
testing

 is the performance of diagnostic tests at or near the

patient’s location rather than in a central laboratory.

 POCT is essential for the rapid detection of analytes

near to the patient, which facilitates better disease
diagnosis, monitoring, and management.
Tests are often accomplished through the use
of portable and handheld instruments

Examples:
 blood glucose meter
 hemoglobin analyzer
 test kits (e.g., pregnancy test, dengue NS1, etc.) which
can be operated by both laboratory and non-
laboratory personnel
Advantages of POCT include:
 Decreased turn-around time (primary
advantage to POCT)
 Decreased sample volume (requires less
sample volume than tests performed in the
laboratory)
 Ease of use
 Portable
 Elimination of sample transport
Bedside glucose monitoring is one of the
most common tests done by POCT, primarily to
monitor persons with diabetes mellitus. Glucose is
determined with dermal puncture and reagent strips
and the specimen tested is whole blood.
The following are the other common tests
performed at the point of care:
Cholesterol testing
Reagent strip urinalysis
Urine pregnancy test
Hemoglobin determination
HBA1c
Blood Coagulation Testing (PT/APTT)
Transcutaneous bilirubin testing
Occult blood testing
Infectious disease testing(Group A Strep, Influenza A &
B, HIV kits)
Principle

To determine the blood glucose level of the patient at

the bedside for fast and accurate result.
 
Resources:
 
 Glucose meter
 Reagent strips
 Lancet/pricking device
 70% alcohol
 Wet and Dry Cottons
 Gloves
Procedure: Glucose Testing
 1. Greet and identify the patient.
2. Examine the requisition form and check the type of glucose test ordered by the
physician.
(In Fasting Blood Sugar (FBS), this measures the blood glucose level after the
patient had nothing to eat or drink for at least 8 hours overnight. In Random Blood
Sugar (RBS), this measures the blood glucose level at any given time of the day. In
2-hour postprandial blood sugar, this measures blood glucose exactly 2 hours after
eating a meal). 
3. Verify the patient’s preparation prior to glucose testing (depending on type of
glucose test ordered) by asking his or her last meal. Explain the procedure to the
patient.
4. Prepare all the necessary equipment needed.
5. Perform hand hygiene and wear gloves before patient contact.
6. Position the patient and choose a puncture site. (Lateral side of the middle
finger or ring finger)
7. Clean the puncture site with alcohol, and allow the area to dry.

(Ensure that puncture site is completely dry prior to skin puncture because the
presence of alcohol can result in an error code or inaccurate result.)
8.While allowing the puncture site to dry, remove a reagent
strip from container and close tightly.

(Glucose strips must not be allowed to be left in an open container because the
strips will absorb moisture and cannot absorb the correct amount of blood
producing falsely low results)

9.Insert the strip in the into the glucose meter strip slot
towards the direction of the arrow until it locks in place (This
will automatically turn the meter on. Wait until the flashing drop appears in the
display before applying the blood sample)

10.Perform the puncture and wipe away the first drop of

blood.
11. Gently squeeze the fingertip to produce a large drop of
blood (The droplet of blood needs to be large enough to fill the test reagent strip)

12. Hold the glucometer firmly and gently touch edge

portion of the glucose strip toward blood drop until it has
absorbed enough volume to begin the test.

Note: Do not bend or move the test strip before or while applying blood, or while the
test is in progress.

13. Wait for a few seconds until the test is complete and the
result will appear on the display window of the glucometer.
14.Apply dry cotton over the puncture site and ask patient to
apply pressure.
15. Read the result and record it on the requisition form.
16. Remove the test strip from the meter and discard all
wastes in biohazard container.

17. Remove gloves and perform hand hygiene.

18. Thank the patient.