Objectives Point-of-care testing (POCT) is testing performed outside the traditional laboratory, often at the patient bedside. In hospital settings, blood glucose is the most common POCT. Staff performing POCT are not usually laboratory trained; they are clinical staff with a primary focus on treating patients. Clinical staff find POCT quality assurance (QA) practices burdensome and are often non-compliant. In hospitals within EORLA (Eastern Ontario Regional Laboratories Association), all critically high POCT glucose results must be repeated prior to acting, according to policy. Compliance with this policy is audited regularly. Design and methods: All POCT glucose tests performed in participating sites between January and June 2018 and June and December 2019 were audited for compliance with the critical repeat policy. The discordant repeat rate was also determined for each audit period. Between January and May 2019, there were interventions aimed at improving compliance with the repeat policy. Results Compliance with the critical repeat policy increased from 30 to 57% in 2019 compared to 2018, following nursing education and implementation of notifications on the glucose meters themselves. The rate of discordant repeat results (>20% different from initial) also improved at most sites in 2019 compared to 2018. Nurses cited insufficient cleaning of patient hands prior to initial testing as the primary reason for discordant repeats. Conclusions Operator compliance with POCT QA policies is an ongoing challenge requiring continual audit, feedback and education. A strong POCT multi-disciplinary committee with supports from senior and clinical leadership in an organization are key to improving compliance.
Background: Impaired gut barrier function has been reported in some functional gastrointestinal (GI) disorders. Evidences suggest that gut microbiota affects GI motility in particular Lactobacillus species elicits anti-inflammatory activity and exerts protective effects on damage induced by pathogen Gram negative-derived lipopolysaccharide (LPS). LPS produced an oxidative imbalance in human colonic smooth muscle cells (SMC) that persists after LPS-washout and contributes to SMC morphofunctional alterations. The aim was to evaluate if supernatants harvested from LGG cultures protect SMC from LPS-induced myogenic damage. Methods: L. rhamnosus GG (ATCC 53103 strain) was grown in MRS medium and samples were collected from bacterial cultures in middle exponential phase, in early, in middle and late stationary phase (overnight). Supernatants were recovered, filtered and stored at -20 8C. Highly pure human SMC culture was then exposed for 24 h to highly purified LPS (1 mg/ml) of E. coli (O111:B4) in the absence and presence of the supernatants. Their effects were evaluated on LPS-induced SMC morphofunctional alterations and pro-inflammatory IL-6 production. Data are expressed as mean AE SE (P < 0.05 significant). Results: LPS induced persistent significant 20.7% AE 1.2 cell shortening and 35.2% AE 2.6 decrease in contraction of human colonic SMC. These alterations were paralleled to a 238.5% AE 82.5% increase in IL-6 production. These effects disappeared in the presence of LGG-supernatants, following a progression related to LGG growth curve phases. Supernatants collected in the middle exponential phase already significantly partially restored LPS-induced cell shortening by 43.4% AE 10.2% and IL-6 increase by 47.6% AE 13.1%, but had no effect on LPS-induced inhibition of contraction. Supernatants collected later, in the early and middle stationary phase, further counteract LPS-induced damage, including inhibition of contraction. Maximal protective effects were observed with supernatants of the late stationary phase where LPS-induced cell shortening was reversed by 86% AE 4.7%, inhibition of contraction by 98.2% AE 1.8%, and IL-6 basal production by 91.3% AE 0.6%. Conclusions: LGG-secreted products are substances/byproducts able to directly protect human SMC from LPS-induced myogenic damage. Novel insights are then provided about the possibility that LGG-derived products could reduce the risk of progression to a post-infective motor disorder.
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