4.6 Article

Educational intervention together with an on-line quality control program achieve recommended analytical goals for bedside blood glucose monitoring in a 1200-bed university hospital

Journal

CLINICAL CHEMISTRY AND LABORATORY MEDICINE
Volume 43, Issue 8, Pages 876-879

Publisher

WALTER DE GRUYTER GMBH
DOI: 10.1515/CCLM.2005.147

Keywords

educational intervention; glucose meter; glucose monitoring; on-line quality control; point-of-care testing

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Portable meters for blood glucose concentrations are used at the patients bedside, as well as by patients for self-monitoring of blood glucose. Even though most devices have important technological advances that decrease operator error, the analytical goals proposed for the performance of glucose meters have been recently changed by the American Diabetes Association (ADA) to reach < 5% analytical error and < 7.9% total e.rror. We studied 80 meters throughout the Virgen Macarena Hospital and We found most devices with performance error higher than 10%. The aim of the present study was to establish a new system to control portable glucose meters together with an educational program for nurses in a 1200-bed.University Hospital to achieve recommended analytical goals, so that we could improve the quality of diabetes care. We used portable glucose meters connected on-line to the laboratory after an educational program for nurses with responsibilities in point-ofcare testing. We evaluated the system by assessing total error of the glucometers using high- and lowlevel glucose control solutions. In a period of 6 months, we collected data from 5642 control samples obtained by 14 devices (Precision PCx) directly from the control program (QC manager). The average total error for the low-level glucose control (2.77 mmol/1) was 6.3% (range 5.5-7.6%), and even lower for the high-level glucose control (16.66 mmol/l), at 4.8% (range 4.1-6.5%). In conclusion, the performance of glucose meters used in our University Hospital with more than 1000 beds not only improved after the intervention, but the meters achieved the analytical goals of the suggested ADA/National Academy of Clinical Biochemistry criteria for total error (< 7.9% in the range 2.77-16.66 mmol/l glucose) and optimal total error for high glucose concentrations of < 5%, which will improve the quality of dare of our patients.

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