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Patient safety in point-of-care testing

      The probable connection between patient safety and point-of-care testing appears at the intersection of technical limitations, rapid availability, and the therapeutic implications of this genre of tests [
      • Price C.P.
      Point-of-care testing: impact on medical outcomes.
      ]. In the absence of a systematic evidence base, a series of definitions may be used to approach the topic. (These include definitions of patient safety, medical error, and preventable adverse event, as well as definitions of point-of-care testing itself and point-of-care test operator; and the stipulations of three regulatory categories: waived testing, provider–performed microscopy testing, and moderate complexity testing.) The eight definitions collide with actual point-of-care testing practice to reveal latent conditions that predispose point-of-care test systems to active medical errors [
      ,
      • Price C.P.
      • Hicks J.M.
      Point of care testing: an overview.
      ,
      • Demers L.M.
      Regulatory issues in point-of-care testing.
      ]. These latent conditions appear with special prominence among tests in the regulatory category of waived point-of-care testing [
      • Szabo J.
      Quality concerns uncovered at laboratories doing waived tests.
      ]. The medical consequences of these limitations require more attention, both to detect point-of-care testing errors and to prevent the adverse events that flow from them [
      • Terry L.M.
      Point-of-care testing and recognizing and preventing errors.
      ,
      • Bonini P.
      • Plebani M.
      • Ceriotti F.
      • Rubboli T.
      Errors in laboratory medicine.
      ,
      • Ioannides J.P.A.
      • Lau J.
      Evidence on interventions to reduce medical errors.
      ,
      • Bion J.F.
      • Heffner J.E.
      Challenges in the care of the acutely ill.
      ,
      • Pronovost P.J.
      • Nolan T.
      • Zeger S.
      • Miller M.
      • Rabin H.
      How can clinicians measure safety and quality in acute care?.
      ].
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