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

2005 ◽  
Vol 43 (8) ◽  
Author(s):  
Víctor Sánchez-Margalet ◽  
Manuel Rodriguez-Oliva ◽  
Cristina Sánchez-Pozo ◽  
María Francisca Fernández-Gallardo ◽  
Raimundo Goberna
Keyword(s):  
Blood Glucose ◽  
Glucose Control ◽  
Educational Program ◽  
Total Error ◽  
Control Program ◽  
University Hospital ◽  
Low Level ◽  
Analytical Goals ◽  
On Line

AbstractPortable 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 error. We studied 80meters 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-of-care testing. We evaluated the system by assessing total error of the glucometers using high- and low-level glucose control solutions. In a period of 6months, 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 (2.77mmol/l) was 6.3% (range 5.5–7.6%), and even lower for the high-level glucose control (16.66mmol/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 2.77–16.66mmol/l glucose) and optimal total error for high glucose concentrations of <5%, which will improve the quality of care of our patients.

scholarly journals Institutional Blood Glucose Monitoring System for Hospitalized Patients: An Integral Component of the Inpatient Glucose Control Program

2009 ◽  
Vol 3 (5) ◽  
pp. 1168-1174 ◽  
Author(s):  
Mona Boaz ◽  
Zohar Landau ◽  
Zipora Matas ◽  
Julio Wainstein
Keyword(s):  
Blood Glucose ◽  
Diabetic Patient ◽  
Glucose Control ◽  
Medical Center ◽  
Control Program ◽  
Hospitalized Patients ◽  
Blood Glucose Monitoring ◽  
Diabetic Patients ◽  
Integral Component

Background: The ability to measure patient blood glucose levels at bedside in hospitalized patients and to transmit those values to a central database enables and facilitates glucose control and follow-up and is an integral component in the care of the hospitalized diabetic patient. Objective: The goal of this study was to evaluate the performance of an institutional glucometer employed in the framework of the Program for the Treatment of the Hospitalized Diabetic Patient (PTHDP) at E. Wolfson Medical Center, Holon, Israel. Methods: As part of the program to facilitate glucose control in hospitalized diabetic patients, an institutional glucometer was employed that permits uploading of data from stands located in each inpatient department and downloading of that data to a central hospital-wide database. Blood glucose values from hospitalized diabetic patients were collected from August 2007 to October 2008. The inpatient glucose control program was introduced gradually beginning January 2008. Results: During the follow-up period, more than 150,000 blood glucose measures were taken. Mean glucose was 195.7 ± 99.12 mg/dl during the follow-up period. Blood glucose values declined from 206 ± 105 prior to PTHDP (August 2007–December 2007) to 186 ± 92 after its inception (January 2008–October 2008). The decline was associated significantly with time ( r = 0.11, p < 0.0001). The prevalence of blood glucose values lower than 60 mg/dl was 1.48% [95% confidence interval (CI) 0.36%] prior to vs 1.55% (95% CI 0.37%) following implementation of the PTHDP. Concomitantly, a significant increase in the proportion of blood glucose values between 80 and 200 mg/dl was observed, from 55.5% prior to program initiation vs 61.6% after program initiation ( p < 0.0001). Conclusions: The present study was designed to observe changes in institution-wide glucose values following implementation of the PTHDP. Information was extracted from the glucometer system itself. Because the aforementioned study was not a clinical trial, we cannot rule out that factors other than introduction of the program could explain some of the variability observed. With these limitations in mind, it nevertheless appears that the PTHDP, of which the institutional glucometer is an integral, essential component, was associated with improved blood glucose values in the hospitalized diabetic patient.

scholarly journals Comparing effects of continuous glucose monitoring systems (CGMs) and self monitoring of blood glucose (SMBG) among adults with type 2 diabetes mellitus: A systematic review protocol

2020 ◽  
Author(s):  
Mingyue Zheng ◽  
Yunting Luo ◽  
Wei Lin ◽  
Adeel Khoja ◽  
Qian He ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Type 2 Diabetes ◽  
Blood Glucose ◽  
Glucose Control ◽  
Diabetes Management ◽  
Self Monitoring ◽  
Glucose Levels

Abstract Background: Continuous glucose monitors (CGMs) have been used to manage diabetes with reasonable glucose control among patients with type 2 diabetes (T2D) in recent decades. CGM systems measure interstitial fluid glucose levels to provide information about glucose levels, which identifies fluctuation that would not have been identified with conventional self-monitoring. Self-monitoring of blood glucose (SMBG) is a classical tool to achieve glycaemic control. However, the effectiveness of glucose control, costs, and quality of life are needed to evaluate and compare CGM and SMBG among adults with T2D.Methods: The review will compare the various forms of CGM systems (i.e flash-CGM, real-time-CGM, retrospective-CGM) versus SMBG/usual intervention regarding diabetes management among adults with T2D. The following databases will be searched: Cochrane Library, Science Direct, PubMed, EMBASE, CINAHL, PsycINFO, Scopus and grey literature for the identification of studies. The studies involving adults (aged ≥ 18 years old) will be included. We will include and summararize randomised clinical trials (RCTs) with respect to authors, publication type, year, status, and type of devices. Studies published in English between February 2010 and March 2020 will be included as the field of CGMs among T2D patients has emerged over the last decade. Primary outcomes that will be measured will be; HbA1c, body weight, time spent with hypoglycaemia or hyperglycaemia, blood pressure, quality of life. Secondary outcome measured will be morbidity, all-cause mortality, user satisfaction, and barriers. Study selection, data extraction, and risk of bias assessment will be conducted independently by at least two authors. A third author will determine and resolve discrepancies. Moreover, the quality of the evidence of the review will be assessed according to the Grading of Recommendations Assessment, Development and Evaluation Tool (GRADE).Discussion: The systematic review will synthesise evidence on the comparison between using CGMs and SMBG. The results will support researchers and health care professionals to determine the most effective methods/technologies in the overall diabetes management. Moreover, this review will provide more detailed information about the barriers of using CGMs to improve implementation.Systematic review registration: PROSPERO CRD42020149212

scholarly journals External Evaluation of the Quality of the Seven Biochemical Parameters in Antananarivo in 2020

2020 ◽  
Vol 1 (1) ◽  
pp. 01-06
Author(s):  
Miora Koloina Ranaivosoa ◽  
Annick Anjatiana Raherinaivo ◽  
Andriamiarimbola Irène Rakotoniaina ◽  
Rasoamialy-Soa Razanakolona ◽  
Olivat Rakoto Alson ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Biochemical Parameters ◽  
Accreditation Process ◽  
University Hospital ◽  
External Evaluation ◽  
Evaluative Study ◽  
Quality Program ◽  
Clinical Biology ◽  
Hospital Center

The aim of the present study is to assess the performance of the biochemistry laboratory of Joseph Ravoahangy Andrianavalona by the dosage of the most prescribed 7 biochemical parameters. It is a retrospective evaluative study of the performance of the biochemistry laboratory of Joseph Ravoahangy Andrianavalona University Hospital Center on a period of 6 months from January 2020 to June 2020 involving 12 samples of External Evaluation of the Quality provided by the Quality Insurance Association of the clinical Biology Laboratories in France. Uremia, Serum creatinine, blood glucose, natremia, kaliemia, chlorure and were dosed on the 12 samples which carried out 84 dosages. During a period of 6 months the accuracy was 97.61%. The precision had been 100% if the Variation Coefficient Ratio (VCR) was below 1.50. This participation in the External Evaluation of the Quality program can then improve the quality of the laboratory. It is a step towards the accreditation process.

Cinderella – A Clinical Nuclear Medicine Retrieval and Filing On-Line Stand-Alone System for Patient Data

1980 ◽  
Vol 19 (02) ◽  
pp. 80-84
Author(s):  
E. Ben Ezra ◽  
N. Back ◽  
Y. Steiff ◽  
H. Atlan ◽  
Jean Salomon
Keyword(s):  
Nuclear Medicine ◽  
Data Entry ◽  
Clinical Diagnostics ◽  
University Hospital ◽  
Base System ◽  
Patient Status ◽  
Interactive Retrieval ◽  
Medical Biophysics ◽  
On Line

SummaryWe describe a microcomputer-based, stand-alone, on-line scheduling data entry and retrieval clinical data base system, specially tailored for a nuclear medicine department. It includes provision for free format clinical diagnostics text answers to each radioisotope scan. Such a system is currently installed at the Department of Medical Biophysics and Nuclear Medicine at the Hadassah University Hospital, and handles all the patient tests performed in this department. We feel that the design of an independent microprocessor-based system customized for one’s department needs has indeed improved the quality of the clinical services, both in ensuring that the patient records are kept up-to-date and complete, and in providing, through fast interactive retrieval transactions, immediate answers for a given patient status.

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