Dear all,
We have Nova Biomedical meters- dual purpose in some areas. Meters are intelligent so they know if you've scanned a ketone strip container and tried to insert a glucose and vice versa.
Both colour coded and also display KET or GLU next to the result generated on screen.
Results are then electronically transferred to EPIC (patient record) via Bioviewer .
We have not experienced any major issues with the implementation of whole blood ketone testing using these meter, only really wastage of strips due to expiry in low usage areas.
We train staff clearly on the differing display of results and the DSN's also deliver the background knowledge training where needed in terms of interpretation. I think it is clear that there are issues and benefits to both but it the management of the training and implementation that is key to their appropriate use as per any other POC device/instrument.
Rhys
Rhys Tassell
Team Leader
Senior BMS
Point of Care Testing
Tel: 01223 348890 |Extn: 58890 (ANSWEPHONE AVAILABLE)| [log in to unmask]
Direct: 01223 348634 |Extn: 58634|NO ANSWERPHONE
NOTE: Usual office hours are Monday to Friday 07:30- 15:30. Occassionally my hours and availability vary with service demands.
Department of Pathology Clinical Services |Box 282| Cambridge University Hospitals NHS Foundation Trust| Cambridge Biomedical Campus | Hills Road| Cambridge| CB2 2QQ
The Trust is part of the National Institute for Health Research - Cambridge Biomedical Research Centre and a member of Cambridge University Health Partners
This email is confidential, see www.cuh.org.uk/email_disclaimer.html
-----Original Message-----
From: Brown Stephen (THE PATHOLOGY PARTNERSHIP) [mailto:[log in to unmask]]
Sent: 11 May 2016 09:28
To: [log in to unmask]; Church Sarah (EAST AND NORTH HERTFORDSHIRE NHS TRUST); Helen Lyons ; Sadiq Mohammed (THE PATHOLOGY PARTNERSHIP); Sinclair Rodney (THE PATHOLOGY PARTNERSHIP); Tassell, Rhys; Vaid Jay (EAST AND NORTH HERTFORDSHIRE NHS TRUST)
Subject: FW: ACB-POCT Digest - 6 May 2016 to 10 May 2016 (#2016-64)
Hi
You might already subscribe to the ACB point of care testing email group so you will have seen this already, but those who haven't had the pleasure. I forward to you a thread about the misinterpretation of results when using POCT devices that can give multiple results.
An interesting incident; one which proves once again the value of training and competency assessment.
Stephen
Stephen Brown CSci FIBMS
POCT Manager, The Pathology Partnership Iconix One | Iconix Park | London Road | Pampisford |CAMBRIDGE CB22 3EG
M: +44 7487 777259
E: [log in to unmask]
http://thepathologypartnership.info/
An NHS Pathology provider
-----Original Message-----
From: ACB Point-of-Care Testing [mailto:[log in to unmask]] On Behalf Of ACB-POCT automatic digest system
Sent: 11 May 2016 00:12
To: [log in to unmask]
Subject: ACB-POCT Digest - 6 May 2016 to 10 May 2016 (#2016-64)
There are 3 messages totaling 700 lines in this issue.
Topics of the day:
1. Ketones
2. Self-administration of insulin (2)
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Date: Tue, 10 May 2016 11:19:35 +0000
From: "Ryder David (UHMB)" <[log in to unmask]>
Subject: Re: Ketones
Hi,
I had an incident in my trust where the staff mixed two machines up. This involved multiple staff of all grades from staff nurse to Consultant. All viewed the instrument and the result thinking it was Hb when actually it was glucose. If they are going to make the mistake they'll make it whether you have separate machines or not. What is important is good quality training, which I think is more achievable with one device.
We have blood gas machines which provide lots of different parameters and no one would advocate having separate meters for each of those parameters.
David Ryder, Point of Care Testing Coordinator
University Hospitals of Morecambe Bay NHS Foundation Trust Furness General Hospital Dalton Lane Barrow-in-Furness, Cumbria, LA14 4LF
External: 01229 491171 | Extension: 51171 | Mobile: 07580 818900
-----Original Message-----
From: ACB Point-of-Care Testing [mailto:[log in to unmask]] On Behalf Of Cambridge Anthony (PLYMOUTH HOSPITALS NHS TRUST)
Sent: 05 May 2016 16:26
To: [log in to unmask]
Subject: Re: Ketones
Hi Nicky
I've heard of many incidents where staff have mixed up the results at multiple Trusts, even when colour coding is in place. Maybe one of the issues is reviewing results on the meter, but the screen does show 'ketones' or 'glucose' when displayed. I do ask myself how staff make these errors but regardless of how or why, they have still occurred. Something for everyone to be aware of and hammer home the message during training.
Regards
Tony Cambridge
Lead Biomedical Scientist
Tel Ext- 01752 430050
Tel Int- 30050
E- [log in to unmask]
-----Original Message-----
From: ACB Point-of-Care Testing [mailto:[log in to unmask]] On Behalf Of HOLLOWOOD NICKY (RCD) PATHOLOGY
Sent: 05 May 2016 16:17
To: [log in to unmask]
Subject: Re: Ketones
We have the abbott meter and have ketones activated on about 2/3 of our meters. We are a small hospital so our type one diabetic patients are located throughout the hospital. We much prefer having on one meter as it reduces training time, documentation, management, less equiepment, connectivity operator lockout etc is all on one device etc. The strips are labelled and coloured differently so getting tests mixed up is not a problem for us. We can spilt packs and share between low usage wards as the strips are individually wrapped. We can keept our DKA management protocol in one place-with the meter. Costs are offset by reduced bed days/time though we had to do some audits and troubleshooting when we first introduced ketone testing as a lot of type 2 patients were tested........These meters work well for us in this trust.
Nicky Hollowood
POCT Manager
Pathology Department
Lancaster Park Road
Harrogate
HG2 7SX
01423 555858
________________________________________
From: ACB Point-of-Care Testing [[log in to unmask]] on behalf of David James [[log in to unmask]]
Sent: Thursday, May 05, 2016 2:20 PM
To: [log in to unmask]
Subject: Re: Ketones
We use Nova - single meter for both
No issues - have only activated ketones in locations where DM patients managed - has kept costs under control
dj
-----Original Message-----
From: ACB Point-of-Care Testing [mailto:[log in to unmask]] On Behalf Of Cambridge Anthony (PLYMOUTH HOSPITALS NHS TRUST)
Sent: 05 May 2016 13:57
To: [log in to unmask]
Subject: Re: Ketones
Hi Theresa
Currently with Roche for glucose and Abbott for ketones. Always been a bit reluctant to have a combined meter due to the reports of staff interpreting ketones as glucose and vice versa. Will be going to tender next year for glucose and will likely incorporate ketones at that point so I'll never say never!
Took a look at the Roche meter but didn't evaluate it as we were not ready for a tender and other ongoing procurement prevented it. I have a similar opinion to other responses posted.
Regards
Tony Cambridge
Lead Biomedical Scientist
Tel Ext- 01752 430050
Tel Int- 30050
E- [log in to unmask]
-----Original Message-----
From: ACB Point-of-Care Testing [mailto:[log in to unmask]] On Behalf Of Theresa Hornsby
Sent: 05 May 2016 07:30
To: [log in to unmask]
Subject: Ketones
Can I ask if anybody is using the ketone meter that Roche provide? If so, what do you think of it? If you don't use it but have looked at it I would appreciate any feedback.
Also if you have Roche glucose meters and don't use that device, what ketone meters do you use?
We currently use a combined meter but are about to go to Tender and aren't sure whether to stick to a dual meter or not. The reasoning behind your choice would be appreciated.
Many thanks.
Theresa
POCT Coordinator
Norfolk & Norwich University Hospital
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Date: Tue, 10 May 2016 14:35:13 +0000
From: "Bennett Michelle (BFWH)" <[log in to unmask]>
Subject: Self-administration of insulin
Hi All
A query has come up with our diabetes team regarding patients who self-administer insulin during their time as an inpatient. I was wondering what policies other Trusts have in place regarding the testing side for patients who self-administer, as our pharmacy team is currently in the process of producing such a policy in our Trust and I am keen to know how this will fit in with POCT. Any feedback regarding practices elsewhere would be greatly appreciated.
Best wishes
Michelle
Michelle Bennett
Point of Care Testing Lead
Blackpool Teaching Hospitals NHS Foundation Trust Pathology Department | Blackpool Victoria Hospital
* 01253 (95) 7511
* [log in to unmask]<mailto:[log in to unmask]>
[Dot_not_touch[1]]Stop and think - are you trained on a medical device? If not, don't touch!
------------------------------
Date: Tue, 10 May 2016 18:32:16 +0000
From: Helen Peat <[log in to unmask]>
Subject: Re: Self-administration of insulin
In line with DoH guidance our patients are encouraged to monitor their own glucose using their own meters but any changes to medication or dosage has to be confirmed using a glucose from either a Trust meter, blood gas analyser or a lab generated result (as they have evidence of IQC etc)
From: Bennett Michelle (BFWH) [mailto:[log in to unmask]]
Sent: Tuesday, May 10, 2016 03:35 PM
To: [log in to unmask] <[log in to unmask]>
Subject: Self-administration of insulin
Hi All
A query has come up with our diabetes team regarding patients who self-administer insulin during their time as an inpatient. I was wondering what policies other Trusts have in place regarding the testing side for patients who self-administer, as our pharmacy team is currently in the process of producing such a policy in our Trust and I am keen to know how this will fit in with POCT. Any feedback regarding practices elsewhere would be greatly appreciated.
Best wishes
Michelle
Michelle Bennett
Point of Care Testing Lead
Blackpool Teaching Hospitals NHS Foundation Trust Pathology Department | Blackpool Victoria Hospital • 01253 (95) 7511 • [log in to unmask]<mailto:[log in to unmask]>
[Dot_not_touch[1]]Stop and think – are you trained on a medical device? If not, don’t touch!
------------------------------
End of ACB-POCT Digest - 6 May 2016 to 10 May 2016 (#2016-64)
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This message may contain confidential information. If you are not the intended recipient please inform the sender that you have received the message in error before deleting it.
Please do not disclose, copy or distribute information in this e-mail or take any action in reliance on its contents:
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Thank you for your co-operation.
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