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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. ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are 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/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are 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/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are 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/ ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are 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/