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This chapter presents information on common point-of-care (POC) tests and provider-performed microscopy (PPM) procedures.
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POC testing is defined as medical testing at or near the site of patient care. POC tests are performed outside a central clinical laboratory using portable and hand-held devices and test kits or cartridges. PPM procedures are microscopic examinations performed by a healthcare provider during the course of a patient visit. PPM procedures involve using specimens that are labile and not easily transportable, or for which delay in performing the test could compromise the accuracy of the test result.
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POC testing is considered as an integrated part of clinical laboratory service and is under the direction of the central laboratory. Physician interpretation of PPM findings (eg, direct wet mount preparation and KOH preparation) requires appropriate clinical privileges.
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In the United States, test results can be used for patient care only when the tests are performed according to the requirements of the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88). These include personnel training and competence assessment before performing any test or procedure, following standard operating procedures and/or manufacturer instructions, performance and documentation of quality control for all tests, and participation in a proficiency testing program, if applicable.
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Specimens should be collected and handled according to the institution's policies and procedures.
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Safety Considerations
General Safety Considerations
Because all patient specimens are potentially infectious, the following precautions should be observed:
Universal body fluid and needle stick precautions must be observed at all times. Safety needle devices should be used.
Disposable medical gloves, gown, and sometimes mask, goggle, and face shield should be worn when collecting specimens.
Gloves must be changed and hands washed after contact with each patient. Dispose of gloves in an appropriate ...