Point of Care Services  

Point of Care Testing:

POCT is relatively new section of the department of pathology and laboratory medicine (DPLM) in King Abdulaziz Medical City, National Guard Health Affairs. POCT section has started on April 2000 and the POCT committee was formed on Jul 2000 with 10 members represent physicians, nursing, laboratory, LIS, ISD, Purchasing, Logistic and Quality Improvement departments.

POCT is defined as diagnostic testing performed at or near the site of patient care. It may be also called as: bedside testing or near patient testing. POCT describes a delivery option rather than a particular test. Most of the laboratory tests can be conducted close to the patient by locating an analyzer on the medical unit.

POCT can provide faster laboratory result by utilizing whole blood and eliminating the need for samples blood extraction tubes, Phlebotomy and transportation. Faster results allow the potential for quicker therapeutic action and improved patient outcome and satisfaction.

As laboratory testing devices become increasingly smaller and easier to use, lab tests can now be performed more frequently at the point of care (patient's bedside). Familiar POCT tests are whole blood glucose, pregnancy test, Coagulation Prothrombin time and International Normalized Ratio, D-Dimer, Troponin, CK-MB, Hepatitis C and urine for Urinalysis or Drug Abuse plus fecal occult blood.

The POCT section is responsible for developing all the required policies and procedures to maintain JCIA and CAP standards requirements and to govern the establishment, implementation, operation and proper utilization of POCT.

The section also provides the required training and certification for the POCT operators and the required maintenance and troubleshooting for all the POCT instruments throughout the hospital.

King Abdulaziz Medical City was the first hospital in the Middle East had established the Ethernet connectivity for the POC Glucometers. The server Cobas IT 1000 is used to ensure regulatory compliance; allows to retrieve the information facilitate and can be access in any location Ability to import and export data in various formats; Automated as well as manual patient and quality control result entry; Multi-site capability within a hospital network; Web based technology; Connectivity to Roche and non-Roche instruments; Uni-directional and bi-directional interfacing to Laboratory Information Systems and Hospital Information Systems User-defined system generated warnings and alerts. The arterial blood gas analyzers can be connected too.

The Point Of Care Testing section in KAMC is taking care of the following Point Of Care Tests:

1. Glucose Test by Accu-check Inform System Glucometers (Roche):

There are 231 Glucometers in different sites of KAMC to monitor the blood glucose using whole blood sample. The equipment sips automatically the blood into the external strip. The test provides a quick, accurate, quantitative blood glucose result at the patient’s bedside. The device is based on a dock station to ensure re-charging and download data all the time.

2. Urinalysis (Roche Urisyus):

The urinalysis Point of Care Test is performed in some wards and units as needed where the results of the test are mainly used as screening tool to guides the physician treatment. The Combur 10 test strip is inserted in the Urisys for Immediate automated documentation of results as a printout or online The handy Urisys 1100 Urine Analyzer provides standardized results and virtually eliminates possible sources of visual evaluation errors. Even easier to operate - Simply place the test strip on the test strip tray and - just press one button! Incubation, evaluation and printout occur automatically, quickly and quietly. Versatile computer interface Efficient in every respect which can detect Glucose, Bilirubin, Ketone, Specific gravity, Blood, pH, Protein, Urobilinogen, Nitrite and Leukocytes within 70 seconds all the results can be downloaded to the POC sever. Urisys 1100 is suitable for rapid screening of diseases of the kidney and the urogenital tract, carbohydrate metabolism disorders (diabetes mellitus), liver diseases and hemolytic disorders. Early recognition of diseases like urinary tract infections or diabetes enables the physician to start treatment early in order to prevent or delay serious complications.

3. Coagulation PT/INR (CoaguChek XS Plus system):

The CoaguChek XS plus is used for Coagulation Monitoring system, the CoaguChek XS Plus system: it is the first Coagulation Monitoring system from Roche which has been specifically developed to meet the requirements of healthcare professionals including quality control and connectivity features.

It produces results equivalent to those obtained with reference laboratory methods and also compare very closely to the patients device,

Through several innovations e.g. easy portability, top and side blood dosing options, extensive data management options and safety features, e.g. onboard quality control (QC) for strip integrity check, QC lockout to meet potential regulatory requirements and much more, the CoaguChek XS Plus system will help you to provide on the spot high quality PT/INR results, allowing patients more quality faster therapeutic turn around time.

4. Cardiac Marker CK-MB and Troponin:

The Cardiac Marker Cobas h 232 is used for CK-MB and Troponin and can be sued for D-Dimer and Myoglobin & N-terminal proBNP (NT-proBNP) as well; It is Portable, self-contained, and easy to use. All the results and quality controls are transmitted to the POC Server Cobas IT 1000. 

5. Manual tests Pregnancy Test urine, Urine for Drug Abuse and Fecal Occult blood:

The urine pregnancy test is performed in specific wards and units only; The Urine for Drug Abuse is designated for Emergency department and fecal occult blood is designated for Primary Health Care Clinics all the manual tests quality controls and patient results can be entered in the Accu-check Inform.

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