Abstract
Background and Objectives: Point of care test (POCT) is generally performed by non-laboratory staff who often lack an understanding on the quality control and quality assurance programs. The purpose of this study was to understand the current status of quality management of point of care (POC) blood glucose testing in a single institution where non-laboratory staff perform the tests. Materials and Methods: From July to August 2020, management status of glucometer, test strips, quality control (QC) materials, quality assurance program, and operators’ response to processing of displayed results was monitored in all Soonchunhyang University Bucheon hospital departments that performed POC blood glucose test. Results of the POC blood glucose test conducted from January 2019 to May 2020 were analyzed retrospectively. Results: A total 124 glucometers were monitored in 47 departments. Insufficient management of approximately 50% of blood sugar, test strips, and QC materials was observed. Although daily QC was conducted by 95.7% of the departments, the QC records were inaccurate. The method of recording test results varied with departments and operators. Various judgments and troubleshooting were performed on the unexpected or out of measurable range results, including some inappropriate processes. In POC blood glucose test results review, 4568 atypical results were identified from a total of 572,207 results. Conclusions: Sufficient training of the non-laboratory staff and ongoing assessment of competency through recertification is needed to maintain acceptable levels of POCT quality. In this study, various problems were identified in glucometer and reagent management, QC and post-analytic phase. We believe that these results provide meaningful basal information for planning effective operators’ training and competency evaluation, and the development of an efficient POCT quality management system.
Highlights
Point of care testing (POCT) is a diagnostic test conducted at a place where care is conducted, not at the central laboratory
Dental outpatient clinic, and angiography departments were excluded from monitoring, because there was no point of care (POC) blood glucose test prescription in these departments during the monitoring period
Operators were found to be non-compliant with maintenance and quality control (QC) measures, and POC blood glucose test was non-compliant with the laboratory standards institute (CLSI) guideline or manufacturer’s manual
Summary
Point of care testing (POCT) is a diagnostic test conducted at a place where care is conducted, not at the central laboratory. While central laboratory testing of plasma glucose remains the standard reference, POC blood glucose test is used widely at the patient bedside because of its reliable quantitative result, portable size, low cost and simple operation [2,3]; it enables immediate determination of glucose levels, and fast treatment decisions in response to glycemic fluctuations in hospitalized patients. The purpose of this study was to understand the current status of quality management of point of care (POC) blood glucose testing in a single institution where non-laboratory staff perform the tests. Materials and Methods: From July to August 2020, management status of glucometer, test strips, quality control (QC) materials, quality assurance program, and operators’ response to processing of displayed results was monitored in all Soonchunhyang University Bucheon hospital departments that performed POC blood glucose test. We believe that these results provide meaningful basal information for planning effective operators’ training and competency evaluation, and the development of an efficient POCT quality management system
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