Forms

Validation Tools Microscope Log QC Logs LabPad QC Data Tool

Roster Discontinue POCT Comparison Forms POCT Tracking tool Implementation Forms

Validation Tools
(Print as many Validation Tools (VT) as you need)

Inpatient and UTMB Clinics: 

Multiple POC Test Validation Tools

Validation Tool- Instrument POCT (Glucose, Hgb, Coaguchek, HgbA1C)

Validation Tool- Kits or Manual POCT (Guaiac, UA dip, Preg test, etc)

Validation Tool- Low Volume POCT (pH, Clinitest, CLOtest)

Single Device Validation Tools

Validation Tool- AVOX only

Validation Tool- CoaguchekXS Coaguchek, Coaguchek S (Protime/INR)

Validation Tool- Hemoglobin A1C

Validation Tool- Hemochron Response (ACT)

CBC Clinics

Validation Tool- Instrument POCT (Glucose, Hgb, Coaguchek, HgbA1C)

Validation Tool- Kits or Manual POCT (Guaiac, UA dip, Preg test, PH etc)

RMCHP Clinics

RMCHP Validation Tool- Complete

Residents & Medical Students

    UA dip Worksheets:

Chemstrip 10 UA Worksheet

Chemstrip 7 UA Worksheet

Multistix SG

Bedside Competency & Comparison Forms:

To be used for PT/INR lab comparisons

To be used for Bilicheck lab comparison

POCT Tracking Tools

UTMB inpatient and Outpatient Clinics POCT Tracking Tool

RMCHP Clinics POCT Tracking Tool

  Implementation Forms
  POCT Request Form - BST09I
  POCT Cost Analysis - BST09CA

Rosters

Attendance-Training

Guaiac

Glucose

pH Paper

CLOtest