Template

POCT Governance Checklist & QC Log Template (Interactive)

Structured, saveable POCT QC log and governance checklist for device inventory, QC schedules, operator competency, result verification, deviations, and regulatory readiness. Interactive form captures entries for later review, reporting, and regulatory evidence.

Interactive Tool

POCT QC Log & Governance Checklist

Use this interactive template at the point of care to record device QC events, operator competency sign‑offs, result verification checks, and any deviations or corrective actions. Each submission creates a saved QC record associated with the device. Fields include guidance for regulatory readiness. Use YYYY-MM-DD for dates. For multi‑device inventory updates or batch QC reporting, submit one entry per device/test event.

Why this helps: Structured entries reduce missing data, support audits, enable later analytics, and make handoffs and reviews faster.

Enter the date of this QC event. Use YYYY-MM-DD.
Unique device identifier or physical location (e.g., 'Glucometer-3 / Ward B').
Manufacturer and model.
Device serial number (if available).
Current operational status.
Reason or schedule for this QC event.
Pass or fail result for the QC material or check.
Optional numeric or textual result from the QC check (e.g., control value).
Person who performed the QC.
Employee ID, role, or initials.
Has the operator completed required competency for this device/test?
Reference to training record, date, or brief notes (if needed).
Was the patient/result verification step completed (per policy)?
How was verification performed?
Did any deviation from expected QC or procedure occur?
Describe the deviation or nonconformance (what happened, when, who noticed).
Actions taken on discovery (e.g., device taken out of service, repeat tests, notify supervisor).
Does this event require further investigation, CAPA, or reporting?
Describe required follow‑up (who, what, by when).
Select documents that are maintained for this device.
Person who reviewed the entry (if applicable).
Optional supervisory comments or approval note.
Note attached evidence (photo filename, scanned QC card, or storage location). Use the platform's attachment features if available.
Any other relevant observations.
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