Kathryn S Dyhdalo1, Peter J Howanitz, David S Wilkinson, Rhona J Souers, Bruce A Jones. 1. From the Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio (Dr Dyhdalo); the Department of Pathology, SUNY Downstate Medical Center, Brooklyn, New York (Dr Howanitz); the Department of Pathology, Virginia Commonwealth University, Richmond (Dr Wilkinson); the Department of Biostatistics, College of American Pathologists, Northfield, Illinois (Ms Souers); and the Department of Pathology, Henry Ford West Bloomfield Hospital, Detroit, Michigan (Dr Jones).
Abstract
CONTEXT: Operator training, quality control, and proper follow-up for out-of-range quality control (QC) events are crucial steps that must be adequately performed and documented to ensure excellent patient care and regulatory compliance. OBJECTIVE: To examine point-of-care testing (POCT) personnel training and QC documentation/compliance. DESIGN: Participants in a POCT documentation study of the College of American Pathologists Q-Probes program collected data retrospectively for glucose and urine dipstick testing regarding test operators, operator competency assessment, and QC documentation. Documentation was assessed for participant adherence to 4 quality indicators: (1) whether test operator training was up to date, (2) whether the test operator names were noted in the test records, (3) whether QC was performed, and (4) whether out-of-range QC events were followed up. Data were analyzed for associations with institutional demographic and practice variables. RESULTS: The institutional median number of POCT personnel was 648 for blood glucose and 76 for urine dipstick testing, with a median number of 105 948 glucose tests and 9113 urine tests performed. Ninety-four percent (3830 of 4074) of the test operators completed training or competency assessment within the prior 12 months, 96.8% (21 603 of 22 317) of the test records documented the operator, and 95.7% (19 632 of 20 514) of the expected QC events (per institutional regulations) were documented. Approximately 3% (659 of 20 514) of the QC events were outside the designated range (an average of 6 out-of-range QC events were identified per institution [n = 106]). Of the out-of-range QC events, 92.6% (610 of 659) had documentation of appropriate follow-up. Most laboratories (176 of 179; 98.3%) violated specimen requirements by storing POCT urine specimens for less than 24 hours. CONCLUSIONS: There was greater than 90% compliance for POCT documentation and nearly 96% of expected QC events were properly documented.
CONTEXT: Operator training, quality control, and proper follow-up for out-of-range quality control (QC) events are crucial steps that must be adequately performed and documented to ensure excellent patient care and regulatory compliance. OBJECTIVE: To examine point-of-care testing (POCT) personnel training and QC documentation/compliance. DESIGN:Participants in a POCT documentation study of the College of American Pathologists Q-Probes program collected data retrospectively for glucose and urine dipstick testing regarding test operators, operator competency assessment, and QC documentation. Documentation was assessed for participant adherence to 4 quality indicators: (1) whether test operator training was up to date, (2) whether the test operator names were noted in the test records, (3) whether QC was performed, and (4) whether out-of-range QC events were followed up. Data were analyzed for associations with institutional demographic and practice variables. RESULTS: The institutional median number of POCT personnel was 648 for blood glucose and 76 for urine dipstick testing, with a median number of 105 948 glucose tests and 9113 urine tests performed. Ninety-four percent (3830 of 4074) of the test operators completed training or competency assessment within the prior 12 months, 96.8% (21 603 of 22 317) of the test records documented the operator, and 95.7% (19 632 of 20 514) of the expected QC events (per institutional regulations) were documented. Approximately 3% (659 of 20 514) of the QC events were outside the designated range (an average of 6 out-of-range QC events were identified per institution [n = 106]). Of the out-of-range QC events, 92.6% (610 of 659) had documentation of appropriate follow-up. Most laboratories (176 of 179; 98.3%) violated specimen requirements by storing POCT urine specimens for less than 24 hours. CONCLUSIONS: There was greater than 90% compliance for POCT documentation and nearly 96% of expected QC events were properly documented.