Glucometer controls

CAP only requires Expiration date, so that's what we use.

We have hot pink labels that we place on the controls and the strips with open and discard dates. We use the Nova Statstrip meters. I was understanding that this is required by The Joint Commission. 

We use a small date opened and exp date label. We were using exp date only, but had a staff using incorrect date range, this way it's covered.

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My nursing units are not responsible for labeling glucometer QC.  In order to maintain compliance, I date and distribute all QC material.  I use Avery labels # 5418 to print the labels that I attach to the QC bottles.  Because this is done printed I can fit both the open date and the expiration date.

The floors cannot order any of these ‘controlled' items. (Yes, I am a control freak and with these type of things you have to control just about every step of the process).

While distributing QC, I make sure all old QC is replaced. This will require confiscating any items in storage on the floors.

If a department ‘looses' their allotted vials - I do not issue more vials, they have to borrow from a neighboring unit (the exception to this is an offsite location).  Exceptions have been made on a case by case basis, but it's rare. 

If any QC is issued mid-cycle I use the same open/discard date to keep everyone on the same schedule.

Lastly, I keep the ‘old' lot number temporarily stored in RALS for a couple of days that way I can monitor if any of those vials got passed me and are still being used.  If they do use the old lot number I'll call them up and instruct them to discard the old QC.  After a couple of days, I'll remove the lot number in RALS that way if anyone attempts to use the old lot number, from vials that did not get discarded when I swapped out QC, the system will notify the end user that the lot is not available for testing.

I implemented this system shortly after being hired in this role as it was one of those hot topics and frequently cited items.  Almost 10 years later, no issues, no deficiencies. 

We require only the expiration date.  The nursing staff are responsible for this, we have about a 70% compliance rate at any given time.

I put the open and exp date on the controls with a  label from a label maker.  I found other stickers that were small enough would not stick to the bottle or they would get control on them and you wouldn't be able to see it.  I label enough sets for all of the floors.  Then, I personally remove the old controls and replace with the new ones.

This has helped with old controls not being used or failure to label them properly.

Love the idea of removing the old lot from RALS. I too am a control freak and do the same as you, but had not thought of removing the old lot to prevent them from using a wayward bottle that someone stuck in their pocket.

This does not solve the problem discussed. But I do see slightly better understanding from medical assistants and nurses when I refer to the 3 month re-dating as 'discard date'. Seems like discard is indeed translated to 'throw it out'. When I show dating the controls during training, I use 'O 2/25/20' and D 5/25/30'.

But I no longer work inpatient and I have quite a bit of contact with end users within clinics due to all the other WT POC we perform.

I also retrain if I see the printed expiration date on the control vial circled, unless it's within 3 month of their open date. I'm ok if they circle the printed expiration date on the box the controls come in since that's the usual behavior for nursing for all things that have expiration dates (items that then sit on the shelves of storage or in drawers). 

There is no way in our system that the controls can be distributed via POCCs.

Per a recent meeting with CAP, I add a label with the expiration date only.  I distribute QC and throw away the expired at the same time.

We recently got "dinged" for this on our JC inspection.

One of our units had the date on the vial, but it was smudged, so illegible.

We had to create a plan of action and submit it to TJC and audit it for 3 months with 100% compliance.

We issued fine tip sharpies to each unit and yellow small labels. They were instructed to write the open date and the new expiration date on the label (we have Roche Accuchek II Meters). They were also instructed not to cover the barcode or the lot number with the label.

RN Managers 2x a week for 3 months have been auditing the compliance, and I have been doing spot checks when I have been out doing linearity studies.

We write just the open date on the vials (Roche Accu-chek meters) with sharpies. No expiration date is used since we follow the manufacturer's 3 month expiration.

To monitor this our hospital implemented last year a system where every 3 months we discard ALL controls in the hopsital and start with new ones. Even if the most recent controls were only opened lets say 2 weeks prior they are still discarded and everyone starts fresh on the assigned date. Myself and one of the quality officers then does an audit of the hospital to make sure everyone has opened new vials. Then 3 months later we send another notice to the nurse directors to do the same process again. This has been working really well for us.

Thank you all for your responses!

a little tip that helps, I write the 3 month expiration date directly on the bottle and overlay it with clear scotch tape to prevent smudging which is likely to happen. Also we do the same here, every floor gets a fresh batch of controls at the same time and we throw away all the previous ones. that way we do not have multiple expiration dates on the floor. its easier to track that way.

I put out new QC every 3 months with the date opened and the expiration date. Everyone has the same outdates.  The only difference is our Express Care Units (2) which get QC sent when it's needed.  They always record expiration! We have 12 units so I would rather have this correct then get cited.  I have a hard enough time getting staff to record the 6 month expiration on strips!

NOVA StatStrips