What We Should Consider in Point of Care Blood Glucose Test; Current Quality Management Status of a Single Institution

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.

Real-World Evidence of Point-of-Care Glucometers: Enhanced Passive Surveillance and Adverse Event Reporting Status in Korea and the United States

“…Dear Editor, The accuracy of a point-of-care (POC) glucometer is closely related to the quality of insulin dosing decisions [1,2]. The performance of a POC glucometer should be sufficient for a pre-market study.…”

Effectiveness of Unified Computerized Reporting of Point-of-Care Glucose Meter Test

“…Most laboratory test results are uniformly reported through laboratory information systems (LISs), which leads to standardized data [2]. However, data of point-ofcare (POC) tests, like point-of-care glucose meter tests (PGMTs), are not standardized [3]. Although many Korean and global medical institutions have adopted computerized reporting to ensure the reliability of PGMT results [4], the extent and scope of this implementation differ substantially depending on the acceptance of data integration and standardization among medical staff.…”