POC Critical Results
Hi everyone and Happy Thanksgiving.
CAP accredited and worried about documentation of POC critical results. I was cited for this during last inspection.
What is your process for operators to report and document critical results to treating personal, for example, anesthesia tech performs blood gas, anesthesia treats patient.
TIA,
COM.30000 Critical Result Notification Phase II
The laboratory has written procedures for immediate notification of a physician (or other clinical personnel responsible for the patient's care) when results of designated tests exceed established "critical" values that are important for prompt patient management decisions. Records of notification are maintained.
NOTE: Alert or critical results are those results that may require rapid clinical attention to avert significant patient morbidity or mortality. Each laboratory may define the critical values and critical results that pertain to its patient population. The laboratory may establish different critical results for specific patient subpopulations (for example, dialysis clinic patients). Critical results should be defined by the laboratory director, in consultation with the clinicians served. For changes to anatomic pathology and cytopathology reports, refer to ANP.12175 and CYP.06450 instead.
Allowing clinicians to "opt out" of receiving critical results is strongly discouraged.
Records must be maintained showing prompt notification of the appropriate clinical individual after obtaining results in the critical range. These records must include: date, time, responsible laboratory individual, person notified (the person's first name alone is not adequate documentation), and test results. Any problem encountered in accomplishing this task should be investigated to prevent recurrence.
Referral laboratories may report critical results directly to clinical personnel, or to the referring laboratory. The referral laboratory should have a written agreement with the referring laboratory that indicates to whom the referral laboratory reports critical results.
In the point-of-care setting, the identity of the testing individual and person notified need not be recorded when the individual performing the test is the same person who treats the patient. In this circumstance, however, there must be a record of the critical result, date, and time in the test report or elsewhere in the medical record.
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Since no one has responded to this question perhaps your critical result policy has "defined" that POC tests/results are exempt from critical result documentation?
Anyone???
Our policy for the ORs documentation is different then results performed on the unit.
In the ORs the documentation is in the procedural notes.
Our middleware allows for documentation of critical glucose result notification of everything but who was notified. Who was notified is documented in the HIS, EPIC by the testing personnel. This is a cumbersome process and difficult to track. We are looking for ways to improve this process.
Do folks have wireless glucose devices find this helps?
If it's the same person who treats the patient, so notification not needed.
In the point-of-care setting, the identity of the testing individual and person notified need not be recorded when the individual performing the test is the same person who treats the patient. In this circumstance, however, there must be a record of the critical result, date, and time in the test report or elsewhere in the medical record
The testing personnel at OSU are unlicensed personnel, patient care associates (PCAs) not the RN. We have not identified the PCAs as the person taking care of the patient, we have the RN or Licensed practitioner.
Who performs your testing?
For our Transport and Perfusion teams performing moderate complex iSTAT testing, we do not require that they notify since they are the individuals who are treating the patient. The critical results are defined and documented in the medical record.
We do have metrics for documenting critical results in Epic. We send out the compliance data monthly.