Responsibilities in point-of-care testing. An institutional perspective.

The development of "user-friendly" laboratory analyzers, combined with the need for rapid assessment of critical care patients, has led to the performance of in vitro diagnostic testing at the point of care. This strategy has been well received by most physicians who desire rapid turnaround times for laboratory tests, especially in the critical care areas. Since the primary care-giver in most critical care units is the registered nurse, much point-of-care testing has been delegated to nursing personnel. This has resulted in questions of authority, responsibility, regulation, and conflict resolution. These areas are discussed along with alternative strategies, such as vacuum transport, stat and/or satellite laboratories, unit-based phelebotomists, or "super techs," designed to achieve the goals of bedside or near-bedside testing in the critical care setting.