February 2022

Regulatory change expands patient access to point-of-care tests

Starting Friday, July 1, 2022, all nurses will be able to perform point-of-care tests. Regulation changes, which the Ministry of Health announced on Feb. 19, 2022, will make nurses’ authority to perform point-of-care tests clear.

This regulatory change grants all nurses an explicit exemption under the Laboratory and Specimen Collection Centre Licensing Act to perform point-of-care tests without receiving an order or directive to do so.

Registered Nurses (RNs) and Registered Practical Nurses (RPNs) currently perform point-of-care tests, and the regulation makes clear they can continue to do so. The regulatory change also represents an expansion for Nurse Practitioners (NPs), who currently don’t have the authority to perform point-of-care tests.

Conducting point-of-care tests and collecting specimens can be part of the patient’s plan of care, and can help diagnose and formulate treatment plans for patients in a timely manner. Point-of-care tests (which include but are not limited to glucose blood tests, urine dipstick analysis and pregnancy tests) are performed at the patient’s bedside or at a clinic.

Performing point-of-care tests safely includes assessing the patient’s condition, evaluating the accompanying benefits and risks of the test, and ensuring that you have the adequate resources available to perform the activity safely. While many patients won’t notice any difference in the care they receive, the change means that some won’t need to go to a different facility, lab or to the emergency room to have a simple test done. For some patients, it could mean that they don’t have to wait for diagnostic testing. It also can mean that individuals with mobility difficulties can receive more direct care.

Because nurses may already perform point-of-care tests under authorizing mechanisms, like direct orders or directives, CNO has practice standards and guidelines to support safe nursing practice and uphold patient safety. These include the Decisions About Procedures and Authority practice standard, which says you must possess the knowledge, skill and judgment to perform any given point-of-care test safely.

Depending on your individual learning needs you could also choose to include point-of-care tests as part of your annual goal-setting and ongoing learning for this year's Quality Assurance (QA) Program. (See the article in this issue about QA for more information.)

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