This chapter presents information on specimen collection, common point-of-care (POC) tests and provider-performed microscopy (PPM), and other procedures.
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 typically involve specimens that are labile and not easily transportable, or for which delay in performing the test could compromise the accuracy of the test result.
POC testing is considered an integral 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 and competency assessments.
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 any test or procedure can be performed, 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 available.
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