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The point I was making was that whilst we
put lots of effort into ensuring our hospital glucose meters are well looked
after and testing procedures are robust we generally do little to help patients;
which then raises the question as to where our POCT responsibilities stop.
In other words if we are encouraging
patients to use their own meters, as we probably should, shouldn’t we then
provide them with appropriate laboratory support This is probably unachievable
in reality but as a principle I think it is something that we should aspire to.
Ian
From:
Clinical biochemistry discussion list [mailto:[log in to unmask]]
On Behalf Of Jonathan Kay
Sent: 05 August 2009 17:39
To:
[log in to unmask]
Subject: Re: Connected meters in
Paediatric departments
Thanks.
I'm not sure if you're being ironic about current approaches to risk
reduction in laboratory management.
IQC and EQA aren't objectives, they're just means of reducing one risk:
someone (clinician or patient) acting on a result that is invalid.
But there are risks and benefits in View A and in View B. What we need
to do is carry out the option appraisal and balance all of them for each
option.
Jonathan
On 5 Aug 2009, at 15:27, Ian Barlow wrote:
View B-Governance problem?
Who ensures that the glucose meter the
patient uses has had regular QC done? Who provides EQA support? Is the patient
given an SOP (document controlled and reviewed annually of course)?
Regards
Ian
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On
Behalf Of Jonathan Kay
Sent: 05 August 2009 14:55
To: [log in to unmask]
Subject: Re: Connected meters in Paediatric
departments
Haven't come across this with children but
have with adults who have diabetes.
it's rather like the question of
"allowing" patients to keep their own medicines with them in hospital.
View A
The healthcare provider needs to know
what's going on, therefore we'll take the patient's device (drugs) from them,
and document what's going on our way.
And we'll know our staff understand the
devices that are being used etc.
View B
If the patient's able to safely measure
their own blood glucose (take their own drugs) when at home they can safely do
it while they are in hospital. (And not unconscious etc.)
Furthermore they won't need to be
restabilised, retrained etc when they go home.
And the healthcare provider might learn
more from the patient about their disease.
Is there a governance problem with View B?
I don't think so if you've done an option appraisal including costs, benefits
and risks, and documented it. And, of course, included some patients in that
option appraisal.
Jonathan
On 5 Aug 2009, at 14:00, Ford Clare wrote:
Dear All,
Has anyone experienced opposition to the
introduction of connected glucose meters in Paediatric departments because of
the way children are trained to monitor their own blood glucose?
I am told that it is standard procedure
for children to remain in hospital after diagnosis of diabetes to be
taught to check their own blood glucose and that consequently, once stabilised,
all glucose measurements are performed by the child, under supervision, on the
meter that they will be taking home and not by the nursing staff on the ward
meter. Therefore, even if connected meters were available most of
the glucose measurements would not be performed on them. I am alarmed by
the Governance issues with this approach and would like some indication of
whether it is common or not.
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clinical community working in clinical biochemistry. Please note, archived
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those of the individual and they are responsible for all message content. ACB
Web Site http://www.acb.org.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/