Glucometer- Holding them responsible?

At our facility, we lock them out if they don't respond in a timely manner( a few days). We do email their managers too and enter a patient safety report. Hope this helps!

We give temporary patient barcodes.  We have a team that does emergency response for our families, staff, and non-inpatients.  They often check blood glucose during these calls.  We allow transport team, emergency response team, and code teams to all have these barcodes that we make.  It holds in our middleware and we can change ID if it needs to go to the chart.  This way we MUST get a response in order for you to get a result.

We have begun to explore locking folks out until retraining happens if they are repeat offenders.  We always file a safety report though as well (just as we would for scanning a wrong label) for no positive patient ID.  When your patient safety team gets wind of how often it really happens, I'm sure you'll see changes :)

We have a very similar process at our facilities. At one hospital we decided to turn off the ability to manually enter patient MRN's. Instead, we included a barcode on an "emergency testing form" that the operator would scan for emergency testing. This allowed us to identify all instances of deviation from standard PPID practices (i.e. we would see 9999999999 as the MRN in our middleware). This pilot drastically reduced pseudo-MRN events, and increased proper documentation.

Hypoglycemic and Rapid Response situations are difficult to manage. You're often stuck choosing between patient safety and adherence to well intentioned policies and procedures. Admittedly, our program has a ways to go in terms of developing a formal response and process for handling deviations from SOP, but we're getting there.

For wat it's worth, I would suggest building relationships with your senior leaders in lab and risk management. Getting support and building communication channels will often give you better results than punitive actions. I'm not saying restricting access won't help your cause, but it's a lot to manage if you have a large institution with hundreds of operators.

Good luck with everything.

We would give the device operator 72 hours to return the completed form and expire their device certification for the same 72 hours. We also emailed them w/their supervisor copied to ensure they were aware. 

Hi
I think this is a universal issue for point of care.  We have crashcart911 barcodes on all the crashcarts in the hospital. Use of this barcode holds the results in the middleware for reconciliation.
We are very specific about when and where they can be used:
1. Emergency Room - unresponsive
2. Labor and Delivery- Newborn
3. Code blue for nonhospital patients- staff, visitors etc. (also allow for alternate numbers such as all numbers)

Currently, give them 4 weeks to supply demographics.  Each week they are sent the same email with the notice number...similar to getting a bill!  I've attached a copy of the form that is sent to the operator and unit manager/clinical leader.

Patient ID Correction Form.docx

After 4 weeks if the information is not supplied an incident report is submitted.

Note: Identifying these types of results is a QA/QI monitor for Point of Care.  The annual competency exam lists a question regarding the proper use of the alternative patient ID policy.
Firmly agree with other colleagues concerning getting risk, nursing education, and department managers involved.
Good Luck

We have placeholder MRNs for emergency use.  If used, we send an email to the user and manager the next day.  The department has five business days from the time of notice to provide patient demographics, or if the situation itself did not allow for correct patient ID, a description of the event and why no resolution took place.  Those who do not provide appropriate follow-up within five business days receive an incident report.

We don't see this situation happen too often, but when it does, I have found that email communication is the least likely to get a response. Many CNAs/RNs are just too busy to log into their email everyday. The Nova StatStrip meters have a function that allows me to send a message to the operator on the meter the next time they log in. I usually just say "call POCC". This sometimes works. I've also found that using the Secure Chat messaging function in EPIC seems to work the best, since they are all in EPIC at one point. I also have them trained to use a meter comment such as STAFF, VISITOR or TEST if it is truly not a result that needs to be charted. 

This is such a tough situation. We do allow use of fake MRNs on our iSTATs and glucose meters. We have to for codes, transports and L&D. They are allowed to make up their own number and then follow up with an email. Compliance is pretty good. Used to be better before the onslaught of tons of travelers in both nursing and RT. Based on the responses here, I may try to start keeping track of repeat offenders and then putting a rule in place that an SLR will get filed after X number of days. 

Our users can enter generic numbers as the patients CSN in the event they don't have a wristband and we follow up on these daily. First we check the log in the ED (that they never use) then email the user and CC the manager. If they can't identify within a week, we suspend access and force them to go through POC retraining. 

We have a 10 day / 3 email policy.  If operators do not respond within those parameters, we remove testing access to the devices and they must return to an initial training class for additional training and counseling documentation.  Supervisors also receive the email communications for notification purposes and so they can assist the operator in finding the correct information.