Point of Care Testing (POCT)

Point of Care Testing (POCT), sometimes known as Near Patient Testing, refers to tests that are performed on the ward or in clinics, usually by non-laboratory staff. As test results are immediately available, POCT significantly improves patient care by providing accurate and timely results to help with patient management and within Alder Hey.

Across the Alder Hey trust, we currently have facilities for the following to be performed as Point of Care tests:

• Blood Glucose
• Blood Ketones
• Blood Gases, Electrolytes and Lactate
• ​Blood Co-oximetry
• Coagulometry
• HbA1c
• Urinalysis
• Sars-2 Covid rapid testing
• RSV rapid testing

Contacting us

The Point of Care Testing Team are here to provide the following advice and services:

• Device maintenance help and troubleshooting
• Staff training and competence
• Implementing and overseeing Quality Control (including External Quality Assessment)
• Procurement of new POCT devices where appropriate
• Creating and Issuing of Standard Operating Procedures

Kelly Mayes (the POCT Coordinator) and the POCT team can be contacted on weekdays between 9am and 5.30pm on bleep 141, or on the following extensions: 2488 or 2126. Please note we are not always available by phone, and if you cannot reach us, a message can be left with the Biochemistry department on x2488.

If you require clinical advice on POCT investigations, please call the Duty Biochemist on x2486 (available Monday – Friday between 9am and 5.30pm).  Outside of these times clinical advice is available from the on call Clinical Scientist who can be contacted via switchboard.
Alternatively, if you do not need help urgently, you can contact us by email (POCT at alderhey.nhs.uk).

Quality

Each POCT device must be regularly checked to ensure that the results are accurate and that it is safe to use. Most maintenance can be performed by the normal users of the analyser, and we can advise on this. Part of this is the running of Quality Control, which comes in two forms. 

Internal Quality Control (IQC), commonly known just as QC, consists of two or three ‘levels’ of a known solution and is used to ensure that POCT equipment is performing correctly. IQC samples should be analysed at regular intervals, depending on the piece of equipment being used, and is routinely analysed by the users of the equipment. The analyser will tell you if it has passed or failed, or you may have to consult a spreadsheet.

If your analyser has failed Quality Control, this means that patient results may be unreliable and further samples should not be tested until all levels of QC give acceptable results. Please contact the POCT team for advice and assistance. 
External Quality Assurance, or EQA, is sent to us as unknown samples by an external organisation. These are analysed by either the POCT team or the ward staff and the results are returned to the EQA scheme organisers, who tell us how accurate they are by comparing our performance with other centres. 

All new devices must be enrolled onto an EQA scheme (if available) so that performance can be monitored. The POCT will monitor EQA performance and will take action to correct performance issues if necessary.

Ordering new POCT equipment

Please contact the laboratory if you are considering purchase of a new piece of POCT equipment so that we can advise on its selection. We can ensure that you to choose the most appropriate equipment for your clinical requirements, ensure that it is cost-effective and fulfils all regulatory requirements. We have good relationships with both the company reps and with other hospitals and may be able to negotiate a better deal by adding it to an existing contract, or can ask around to find out which manufacturers devices are preferred in similar settings.

Please note there can also be disadvantages to POCT compared with laboratory testing. For many POCT tests, the equipment used to perform the analysis is not as sophisticated as laboratory equipment. Also the cost of POCT is usually higher than hospital laboratory testing. 

When your new equipment arrives, we will technically and clinically validate it for you to check that it works as expected, arrange for both types of Quality Control to be implemented, and will ensure that operator training is provided to your users at a time that suits you.

The Biomedical Engineering (BME) department must also be contacted if any new piece of equipment is to be introduced; if a device comes under the Point of Care Testing umbrella you should also contact the team using the methods above. If you are unsure whether the equipment you are ordering is a POCT device, feel free to ask us and we can advise.