2.50
Hdl Handle:
http://hdl.handle.net/10755/164252
Category:
Abstract
Type:
Presentation
Title:
Point of Care Blood Glucose Testing: A System Improvement Project
Author(s):
Barnes, Deborah; Krall, Eva
Author Details:
Deborah Barnes, MSN, RN, CCNS, Palomar-Pomerado Health System, Poway, California, USA, email: nacnsorg@nacns.org; Eva Krall MSN, RN, CMSRN
Abstract:
Purpose: The purpose of the point of care testing (POCT) project was and continues to be accurate identification, treatment and documentation of patients with hyper or hypoglycemia. Significance: POCT to evaluate blood glucose levels and then provide treatment based on the results has become common nursing practice. Results between POCT and the clinical laboratory, with the laboratory considered gold standard, can vary +/- 15%. The variation in results is considered an acceptable risk for the ability to rapidly obtain test results and provide appropriate treatment. Because of the potential for variation that can put the patient at risk from inappropriate treatment manufacturers of POCT blood glucose meters issue warnings and guidelines delineating quality monitoring, substances and abnormal blood chemistry levels that compromise the accuracy of the test results, and high/low POCT results that should be confirmed by the clinical laboratory. Design: At our facility the warnings and guidelines available for the clinical staff were incomplete and this resulted in an adverse patient outcome. A root cause analysis was performed and many inconsistencies in practice and system wide processes were identified. An interdisciplinary team was brought together to address the issues that included conflicting procedures, initial and ongoing staff education, quality control issues for POCT, treatment of hypoglycemia, and education and referrals for newly diagnosed diabetic patient. Methods: Changes in practice were implemented across the health care system. Practice changes include development of a standardized hypoglycemic procedure, bar code scanning for employee and patient identification, update to POCT-Glucose standards to include identification of interfering substances, mandatory correlation testing for critically high and low POCT results, and automatic downloading of test results from the POCT meter to the clinical laboratory and to the patient's electronic medical record. Findings: The clinical laboratory now notifies the RN when a patient has blood chemistry level that interferes with the POCT results. The POCT is suspended until the chemistry values return to acceptable levels. Data shows improvement in accuracy of patient and employee identification numbers 65% to 99.9%, and correlation testing 0 to 75%. Quality control checks are at 100%. Conclusions: The improvement in correlation testing and identification of interfering substances decreases the chances that a patient will receive inappropriate treatment. Implications for Practice: Implications for practice are improved patient safety and outcomes.
Repository Posting Date:
27-Oct-2011
Date of Publication:
27-Oct-2011
Conference Date:
2008
Conference Name:
Clinical Nurse Specialists: Leaders in Clinical Excellence
Conference Host:
NACNS - National Association of Clinical Nurse Specialists
Conference Location:
Atlanta, Georgia, USA
Description:
Conference theme: Clinical Nurse Specialists: Leaders in Clinical Excellence, held March 5 - 8 at the Westin Peachtree Plaza in Atlanta, Georgia
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titlePoint of Care Blood Glucose Testing: A System Improvement Projecten_GB
dc.contributor.authorBarnes, Deborahen_US
dc.contributor.authorKrall, Evaen_US
dc.author.detailsDeborah Barnes, MSN, RN, CCNS, Palomar-Pomerado Health System, Poway, California, USA, email: nacnsorg@nacns.org; Eva Krall MSN, RN, CMSRNen_US
dc.identifier.urihttp://hdl.handle.net/10755/164252-
dc.description.abstractPurpose: The purpose of the point of care testing (POCT) project was and continues to be accurate identification, treatment and documentation of patients with hyper or hypoglycemia. Significance: POCT to evaluate blood glucose levels and then provide treatment based on the results has become common nursing practice. Results between POCT and the clinical laboratory, with the laboratory considered gold standard, can vary +/- 15%. The variation in results is considered an acceptable risk for the ability to rapidly obtain test results and provide appropriate treatment. Because of the potential for variation that can put the patient at risk from inappropriate treatment manufacturers of POCT blood glucose meters issue warnings and guidelines delineating quality monitoring, substances and abnormal blood chemistry levels that compromise the accuracy of the test results, and high/low POCT results that should be confirmed by the clinical laboratory. Design: At our facility the warnings and guidelines available for the clinical staff were incomplete and this resulted in an adverse patient outcome. A root cause analysis was performed and many inconsistencies in practice and system wide processes were identified. An interdisciplinary team was brought together to address the issues that included conflicting procedures, initial and ongoing staff education, quality control issues for POCT, treatment of hypoglycemia, and education and referrals for newly diagnosed diabetic patient. Methods: Changes in practice were implemented across the health care system. Practice changes include development of a standardized hypoglycemic procedure, bar code scanning for employee and patient identification, update to POCT-Glucose standards to include identification of interfering substances, mandatory correlation testing for critically high and low POCT results, and automatic downloading of test results from the POCT meter to the clinical laboratory and to the patient's electronic medical record. Findings: The clinical laboratory now notifies the RN when a patient has blood chemistry level that interferes with the POCT results. The POCT is suspended until the chemistry values return to acceptable levels. Data shows improvement in accuracy of patient and employee identification numbers 65% to 99.9%, and correlation testing 0 to 75%. Quality control checks are at 100%. Conclusions: The improvement in correlation testing and identification of interfering substances decreases the chances that a patient will receive inappropriate treatment. Implications for Practice: Implications for practice are improved patient safety and outcomes.en_GB
dc.date.available2011-10-27T11:44:52Z-
dc.date.issued2011-10-27en_GB
dc.date.accessioned2011-10-27T11:44:52Z-
dc.conference.date2008en_US
dc.conference.nameClinical Nurse Specialists: Leaders in Clinical Excellenceen_US
dc.conference.hostNACNS - National Association of Clinical Nurse Specialistsen_US
dc.conference.locationAtlanta, Georgia, USAen_US
dc.descriptionConference theme: Clinical Nurse Specialists: Leaders in Clinical Excellence, held March 5 - 8 at the Westin Peachtree Plaza in Atlanta, Georgiaen_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.en_US
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