Review: Policies, procedures and guidelines for point-of-care testing

Definitions - Point-of-care testing

Page last updated: 14 May 2013

Point-of-care testing (POCT) is a form of testing in which the analysis is performed where healthcare is provided close to or near the patient. Various definitions have been provided in the medical / scientific literature and alternative descriptions include: near patient testing (NPT), bed side testing, physicians office testing (POL), off site testing, alternative site testing, etc.

International standard ISO 22870, Point-of-care testing (POCT) - Requirements for quality and competence, defines POCT as: “testing that is performed near or at the site of a patient with the result leading to possible change in the care of the patient”.6

This definition of POCT provides an accurate but rather general description of the application of POCT. In practice, POCT may be undertaken in many locations including:

  • home use, self testing
  • pharmacy
  • paramedical support, ambulance
  • nursing home or aged care centre
  • general medical practice, primary care (US terminology: POL, physicians office laboratory)
  • rural (remote) hospital or health clinic
  • critical care facility in major hospital (ED, ICU, CCU, etc)
  • hospital ward or hospital clinic
  • sports clinic
  • workplace drug screening.

An interesting definition suggested by an Irish group who recently completed a survey of POCT in Irish hospitals is “Point of care testing is defined as a quality-assured pathology service using analytical devices (including test kits and analysers such as blood gas and critical care analysers and meters for glucose, urinalysis and other metabolites) provided near to the patient rather than in the traditional environment of a clinical laboratory”.7

The types of test and the manner in which a particular POCT device is used in each of the above situations may differ, the testing frequency will probably be different and the testing requirements or the fitness for purpose will almost certainly be different. In addition, if testing is required for diagnosis, monitoring or screening, different testing devices or testing regimes may well apply. The required fitness for purpose may also determine the quality management procedures and the specific requirements for quality control (QC) and external quality assessment (EQA). Thus, when discussing the application of POCT, the particular situation in which a given test or device will be used also requires consideration. POCT is not a single unified entity; different circumstances may require different solutions.