Problems of the guided POC-glucometry and experience with the net of glucometers in two University hospitals: Part I. - Review and intial state [Problematika řízené POC glukometrie a zkušenosti se sítěmi glukometrů ve dvou fakultních nemocnicích: Část I. - Přehled a výchozí stav]
Schneiderka P.,OKB Fakultni Nemocnice |
Kajabova M.,OKB Fakultni Nemocnice |
Stern P.,Ustav Klinicke Biochemie A Laboratorni Diagnostiky 1 Lf Uk A Vfn V Praze |
Dohnal L.,Ustav Klinicke Biochemie A Laboratorni Diagnostiky 1 Lf Uk A Vfn V Praze |
And 4 more authors.
Klinicka Biochemie a Metabolismus | Year: 2010
Introduction: Guided point-of-care glucometry system into the clinical wards and medical offices began to start in General University Hospital (GUH) in Prague at the year 2004, and in the University Hospital Olomouc (UHO) at 2007. In this work we explain processes used to put our intention into practice, describe testing of analytical characters of glucometers, and discuss our experience with the log-term performance. Materials and methods: The aim was an extensive introduction of uniform technology in a whole hospital which is guided from one laboratory center and enables reliable control, documentation, archivation and listing of all tests performed. The system Accu-Chek Inform & Accu-Chek Sensor Comfort Pro was chosen along with the software Cobas IT 1000 (Roche) based on the evaluation of analytical principles, technical solutions and with respect to current recommendations. Results: Comparisons among glucometers, current routine methods, and reference method ID/GC/MS are only partly acceptable. We briefly describe the actual state of the art at the beginning of our work. Further we present our organizational and technical experience with installation of glucometers and emphasize crucial importance of introductory and runnig staff education. Actually there are 73 glucometers working in GUH and 65 glucometers in UHO. They are connected to the net at both hospitals by software Cobas IT 1000, cooperating with hospital information system Medea and laboratory information system OpenLIMS (Stapro Ltd.). Glucometers are managed and controlled by a competent person from one laboratory center each. This design generally fulfils the requirements of EN ISO 15189 for POC-technique and technology supervision, and especially according to running check-up, full, direct and exact documentation, and permanent storage of test results. Conclusion: The goal has been achieved by introducing guided POC-glucometry and elimination of heterogeneous, analytically doubtful, uncontrolled, non-coordinated and thriftless use of many types of personal glucometers in clinical practice. New system was generally accepted and technology applied proved as a sufficiently robust. Described course of POC-glucometry introduction and assurance could be a suitable performance pattern in the other POCT, eg. ABB, INR, CRP etc.