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Convincing Hospitals That

Glucose Management Matters
By Dan Fleshler | Published on 23 October 2017
 

Patients' blood glucose (BG) levels in many American hospitals run dangerously high, but hospitals aren’t doing nearly enough to address the problem.

Between 70% and 80% of patients with diabetes experience hyperglycemia when they’re hospitalized for critical illnesses or have cardiac surgery. And about 30% of all inpatients experience high blood sugars (>180 mg/dL). Even if you stay in the hospital for just a few days, rising glucose levels increase the mortality risk and the risk of eventual kidney failure, poor healing, dehydration and other problems. Meanwhile about 6% of hospital inpatients experience potentially dangerous hypoglycemia (low blood sugar) as well!

It doesn’t have to be this way. In this day and age of continuous glucose monitoring (CGM) and closed loop technology, hospital diabetes management has the potential for a seismic shift -- if they choose to adopt these newer innovations.

For example, recently on Oct. 18, the FDA approved a first-of-its-kind CGM for surgical ICUs that can monitor glucose levels and alert physicians and hospital staff of any highs or lows. It's a sign of the times, as this type of tech to monitor glucose and dose insulin promises to improve patient health, reduce hospital readmissions and cut health care costs.

Yet only about 10% of Americans hospitals now use these “e-Glycemic solutions,” says Linda Beneze, CEO of Monarch Medical Technologies, which provides high-tech glucose management systems to hospitals. Read more >

How to Choose a Quality Improvement Project
Q&A with Michael Astion, MD, PhD, Editor-in-Chief, CLN Patient Safety Focus

In the October issue of CLN, a reader asked...

 

'I took a new job as a supervisor in a medium-sized hospital lab. The lab is in reasonably good shape with no emergent problems, but my co-workers and I agree that certain areas need improvement. I am confident I can do a quality improvement (QI) project and have worked in organizations that used different approaches—like Lean, Six Sigma, and homegrown strategies—and feel I will be able to fit into any system.

 

I know how to choose metrics and incremental goals. But how do I know which problems to work on first? It is important to me that these first QI projects succeed and are meaningful to the staff.'

 

For Dr. Michael Astion's answer, click here...

Keeping Up with POCT Regulatory Compliance
MLO, October 2017, By Connie Mardis

Today, hundreds of tests once considered too complex for point-of-care testing (POCT) are routinely performed outside the laboratory. Due to hospitals’ decentralized structure, laboratory testing is performed on a multitude of POCT devices from various manufacturers in many hospital wards, critical care departments, clinics, and physician offices. Typically, POC devices in a hospital can include dozens of blood gas analyzers, urine chemistry and cardiac marker systems, and handheld coagulation instruments, as well as hundreds of glucose devices.

 

Perceived barriers to implementing POCT have been attributed to accountability factors such as quality control, adequate staff training, and oversight for accreditation purposes. This article will review accreditation requirements and advances in open, vendor-neutral POCT data management to facilitate billing capture, regulatory compliance, and inspection preparedness.


... the challenge of maintaining separate POCT data management systems

for each manufacturer’s products to interface with the hospital and laboratory information systems (HIS and LIS) has added complexity and increased software licensing costs.

Today, hospitals can utilize an open-access data management system to connect more than 160 POC devices from all manufacturers to the hospital’s IT system.

A manufacturer-independent solution helps ensure IT investment protection

in the event a hospital changes POC equipment vendors.


Why POCT? Because of its convenience, timeliness, and potential to improve patient outcomes, POCT’s popularity continues to rise.1 Near-patient testing increases the likelihood that healthcare professionals and the patient will receive test results faster, which may facilitate faster diagnoses, more timely treatment interventions, and improved patient compliance. For example... Read more >

Urinalysis Quality Control at the Point-of-Care
MLO, October 2017, By Brian Fernandez

The goal of any clinical diagnostic test procedure is to provide critical information in a timely manner so that appropriate actions may be taken, ultimately improving patient outcomes. Point-of-care testing (POCT) is a term that has come to describe a multitude of rapid medical tests that can be performed at or near the site of patient care. The most compelling benefit of these tests is that, as opposed to having to wait hours or days for results to arrive from an outside laboratory, clinicians can obtain the results immediately, allowing for clinical management decisions to be made while the patient is still at the care facility. While the implementation of rapid diagnostic tests dates back to ancient history (sweet-tasting urine was once commonly used to diagnose diabetes mellitus), it was not until the 1950s that these rapid diagnostic methods gained any real predictive value.

Today, the popularity and demand for POCT are increasing rapidly. TriMark Publications estimates that the global market for POCT was $14.5 billion in 2016, and is expected to grow by seven percent over the next five years.

Urinalysis dipsticks at the point-of-care Urinalysis using multi-analyte dipsticks is a point-of-care test performed at any hospital, clinical laboratory, doctor’s office, health clinic, and nursing facility. Various iterations of these tests have existed for decades, and they continue to be among the most commonly performed tests of any kind. Urinalysis dipsticks contain... Read more >

FDA Raises the Bar for Flu Tests, Aiming for Better Testing and Better Outcomes
Clinical Lab Products, October 2017, By K.C. McGrath
 

FDA’s recent regulatory reclassification of antigen-based rapid influenza diagnostic tests (RIDTs) from Class I to Class II was prompted by concerns about the tests’ performance during severe flu seasons, most notably during the H1N1 influenza pandemic of 2009. The goal of the reclassification is to improve point-of-care influenza testing, in order to reduce misdiagnoses and accelerate linkage to appropriate treatment.


The Rationale for Reclassification
FDA’s device classification system reflects the regulatory controls needed to ensure that devices are safe and effective for human use.

 

There are three device classifications based on risk: Class I, Class II, and Class III. All three classes of devices must satisfy basic requirements specified by FDA (‘general controls’), such as proper packaging and labeling. Read more >

The Journey to 100% Point-of-Care Connectivity
Clinical Laboratory News, October 2017, By Christiane Nooney, MHA/MBA, MT(AMT)

At first glance, the need for centralized connectivity of point-of-care (POC) instruments may seem conceptually at odds with the primary benefit these devices provide. Indeed, caregivers generate results and may well have acted on them by the time POC staff can view test data on their middleware server.

Nonetheless, the value of POC connectivity has risen steadily in concert with the growing importance of informatics in care delivery. Connectivity not only facilitates dissemination of clinical data to caregivers across the house but also provides numerous advantages to laboratorians under the broad heading of compliance management.

 

Unlike hospital laboratories...  Read more >

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Last updated: 11/14/2017 Questions or corrections: editor@pointofcare.net. © 2016  BACK TO TOP