Flatland Bente, Freeman Kathleen P, Vap Linda M, Harr Kendal E
Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA.
Vet Clin Pathol. 2013 Dec;42(4):405-23. doi: 10.1111/vcp.12099.
Point-of-care testing (POCT) refers to any laboratory testing performed outside the conventional reference laboratory and implies close proximity to patients. Instrumental POCT systems consist of small, handheld or benchtop analyzers. These have potential utility in many veterinary settings, including private clinics, academic veterinary medical centers, the community (eg, remote area veterinary medical teams), and for research applications in academia, government, and industry. Concern about the quality of veterinary in-clinic testing has been expressed in published veterinary literature; however, little guidance focusing on POCT is available. Recognizing this void, the ASVCP formed a subcommittee in 2009 charged with developing quality assurance (QA) guidelines for veterinary POCT. Guidelines were developed through literature review and a consensus process. Major recommendations include (1) taking a formalized approach to POCT within the facility, (2) use of written policies, standard operating procedures, forms, and logs, (3) operator training, including periodic assessment of skills, (4) assessment of instrument analytical performance and use of both statistical quality control and external quality assessment programs, (5) use of properly established or validated reference intervals, (6) and ensuring accurate patient results reporting. Where possible, given instrument analytical performance, use of a validated 13s control rule for interpretation of control data is recommended. These guidelines are aimed at veterinarians and veterinary technicians seeking to improve management of POCT in their clinical or research setting, and address QA of small chemistry and hematology instruments. These guidelines are not intended to be all-inclusive; rather, they provide a minimum standard for maintenance of POCT instruments in the veterinary setting.
即时检验（POCT）是指在传统参考实验室之外进行的任何实验室检测，意味着与患者密切接近。仪器化即时检验系统由小型手持式或台式分析仪组成。这些在许多兽医环境中具有潜在用途，包括私人诊所、学术兽医医疗中心、社区（如偏远地区兽医医疗团队），以及在学术界、政府和工业界的研究应用。已发表的兽医文献中表达了对兽医临床检测质量的担忧；然而，针对即时检验的指导却很少。认识到这一空白，美国兽医临床病理学家协会（ASVCP）于2009年成立了一个小组委员会，负责制定兽医即时检验的质量保证（QA）指南。指南通过文献综述和共识过程制定。主要建议包括：（1）在机构内对即时检验采取正式方法；（2）使用书面政策、标准操作程序、表格和日志；（3）操作人员培训，包括定期技能评估；（4）评估仪器分析性能，并使用统计质量控制和外部质量评估计划；（5）使用正确建立或验证的参考区间；（6）确保准确报告患者结果。在可能的情况下，根据仪器分析性能，建议使用经过验证的13s控制规则来解释控制数据。这些指南旨在帮助寻求改善其临床或研究环境中即时检验管理的兽医和兽医技术人员，并涉及小型化学和血液学仪器的质量保证。这些指南并非旨在涵盖所有方面；相反，它们为兽医环境中即时检验仪器的维护提供了最低标准。
