POC glucose controls 90 days vs. 3 Months

Hello Ruth,

We have three steps into play on our Glucometers ( STAT STRIP):

besides the nurses being trained and documented yearly.

1st we have labels on all the boxes which are located at there working stations

2nd they must put a little label on that states date open and date expires and intial

3rd  I document every week with a form that I have when I do my rounds and tally up their number with a compliance %.  Every month I email the nurse manager and let them what I am  noticing.  Every month I review the previous month and if they are consistent I let them know about it and issues my first verbal at them.  2nd verbal results in re-training for the whole staff 3rd warning warrants a suspension of running that test on the floor.  ( I have never had to hit 2nd warning)  

If you like to see my forms then i will show you.

Joseph Rudic

joseph.rudic@tuhs.temple.edu

Hello,

Our POC department distributes and dates glucose QC every 90 days which has helped improve compliance tremendously.

Tierra Cuff

Regional POCC

Hello,

Tierra - How many locations do you date and distribute the QC ?  What product are you using?

Joe - I would not mind seeing those forms.

Thank you

Gina Martinelli-Painter POCC

I too would like to see your review documentation forms.

TIA

I maintain the stock of control solutions. (Fortunately we are small enough that can take a hike every 3 months.) They are labeled and distribute by me. It is a lot of added work, but prevents incorrect expiration dates. I also went to this method because the controls were being pocketed or "lost". Just allowed too much variance in expiration dates.

There is no good way to change the manufacturer's expiration dates. Inspectors want to see the insert says "XX Days" or "3 months". If it is XX days you must count out that number of days until expiration. If you don't, you are opening yourself to non-compliance and in the back of my mind someone may try to argue that you are throwing it into off label testing (high complexity).

I just had a DOH inspector check the manufacturer's insert to check the wording of the expiration date.

We do the same as Tierra. I started this process almost 8 years ago when I first started in my POC role. Historically the institution had always been cited for expired controls during every CAP and JC inspection.

Since we transitioned to this system in 2010 we have had zero deficiencies or findings.

We have around 140 meters at about 120 different sites across two hospitals, an ambulatory surgery center and several clinics. 

The whole process IS time consuming but the peace of mind is priceless. 

I just contacted our vendor to get in writing that 90 days and 3 months are interchangeable because of the same issue you are facing. Same with 180 days and 6 months.

When our vendor came out 5+ years ago to train us on our new meters, he stated the QC open stability is 90 days or "3 months minus 3 days" and the strips are 180 days or "6 months minus 6 days" (or the actual expiration date, which ever comes first ). This has worked out well for us. Of course the issue arises on documentation compliance. I have taken to writing on the bottom of the control vials the date I place them on the "grab and go" cabinet, this way when I do my monthly rounds I can either date the out date calculated from the shelf date or remove them altogether due to lack of compliance. Of course, I only have 7 meters scattered here (we are a pediatric hospital so most diabetic patients are located in the same unit).

We have a designated user on each unit that labels a new vial of QC with the exp date sticker. This helped to improve our compliance and lessen the work on the POCC. We haven't had any citations from TJC and CAP since.

We also include POCT during the annual review day for nurses, which is created by nursing educators and all nurses must attend, so I go over with them the exp. dating of controls, it is also a good way to assess annual competency. Also, it is nice to get familiar with the staff and to have them familiarize your face as the face of the lab.

Melissa- Our region consist of 5 150+ bed facilities and 3 stand alone EDs. We use Roche Accuchek inform II. We order an average of 70 vial sets per hospital and my team of 3 dates each a couple of days prior to distribution. It is a tedious task but it is worth it.

Tierra

We use MediSense controls with our FSPP's.  The package insert mentions 90 days AND 3 months.  But it gives the example of 3 months.  We use 3 months.

Hi Joseph. This is a great idea. I would love to see the forms you use.

Thank you!

Hi Jody,

If you can just send me an email so that I have your email I will send you those forms:

my email is Joseph.Rudic@tuhs.temple.edu