Nova Glucose strip vial dating

17 followers
0 Likes

This is an age-old problem and I'm wondering if anyone has come up with any kind of solution.  The Nova Glucose strip vials need an opened date and an expiration date when they are put into use, preferably with an indelible marker and covered with scotch tape.  Our Supply Chain stocks nursing's par bins.  How do you get compliance on nursing doing this?  This s not an education issue; it's purely compliance.  We perform audits all the time and nursing admin does not appear to take it seriously.  Sure enough, got cited last week during our CAP inspection because the inspector found one un-dated vial out of the two she looked at. I know; there should've been a more thorough look, but I didn't feel it was my place to suggest that, and truth be told, I'm sure there were more out and about with the 70 meters in use. My director asked what the resolution will be in our CAP response, and I told her that I have nothing!  I honestly don't know what more the POC Dept. can do.  I asked her to request a meeting with nursing admin and ask them how we should respond. I feel it comes down to accountability and the charge or lead should be ultimately responsible, include this as part of report between shifts, and start writing them up when they're found.  You would think that after a few write-ups they would give it attention.  This would never be a continuous problem in the Lab, at least not in ours. I appreciate any wisdom you may have!

10 Replies

I feel your pain. While our compliance is not the gold standard as we are still working on it, we did get some traction by collaborating with our Nursing Education Department. A Knowledge Sharing Document was created using nursing language that meant more to the target audience. The RN Educators did the rounding at the morning huddles and the document had been sent out to all. I did hear something on one of the POC networks about Joint Commission Tracing but didn't look into that any further. Good Luck! 

to all,

When the Nova was used here, we finally resorted to sending all strips up in the tube system-dated by the lab. They received one vial per meter on each unit. 
We would round every two weeks-knowing exactly how many bottles were on each unit. 
This was a small hospital (36 meters).
With this process, the lab was the hardest to educate as to the process, especially the off shifts. 


You may have already tried making signs placed near the reagents as a reminder. This is not a popular solution and may be severe for labeling but have you considered removing the device if labeling is not performed properly? I have done this at the direction of my director when cleaning documentation was not performed on the glucometers. You could give the units a warning and do a monthly audit. If delinquent 3 months in a row then device removal is required. The unit will then need to submit an action plan on how they will not fail to do this in the future. I had to implement this in one unit and word spread fast through out the institution. Many units came up to the benchmark and it is still talked about (this occurred in 2017). 

Hi, we had the same issue, until we decided to implement a green label system. Once they open a new vial, they are required to use a green label, supplied by the lab, to record the opened and expiration dates. It worked! they are very much in compliance with the label system, and we audit them every time we go to the units and when doing periodic checks.  Maybe you can try that. Good luck.

One comment about the removal of the instrument......I have a procedure that allows it approved by the pathologist and the head of TJC compliance.
 
I removed an ISTAT from an ER using the procedure once with all of the appropriate documentation that it required. The ER nurse manager was almost fired. 

I have never been close to that with a meter due to the fact that one mention of the procedure to the unit......and they start to pay attention. 

I pre-date the labels with expirations dates before they are sent to central supply for distribution to the campus. It does short date the vials a bit because they will set on the shelves before opening for a couple of weeks, but it does ensure they are labeled. Joint Commission grumbles about it but I'm meeting the requirements technically. 

Age old issue here as well.  Only idea I have is to attach the endlible marker to the bin where supplies are stored - make it as easy as possible. (this helped with dating iSTAT cartrdiges here). Then create a simple audit tool for continued compliance.  Could you do % of units each month -  "a random subset of units are included in the audit monthly with all included at least once on an annual basis"  - so don't set self up to go to each one each month.  Also nursing would not know which one you are going to?   Submit a photo of the attached marker, documentation of discussion with nursing leadership and at least one completed audit.  OR we did have at one time an audit tool that the unit had to do monthly - worked for some units but i just ended up begging for them and would have been easier myself.  Good Luck.  

Like Jake mentioned above, we also prelabel our vials before distribution. Our central supply labels them all when they come in. We have never been sited for a vial not being labeled since. 

I'm kinda surprised at the pre-dating and I'm not sure how we would handle that at our facility.  We perform about 9,000 tests/month and there is quite a variance of usage on the floors.  Plus, it irks me to give nursing a pass! 

Patsy Gunn, we did try some of your suggestions; we supplied a marker with velcro by the par bin and that fell by the wayside, there is signage near the meters "If YOU open it, YOU date it!".  We perform a random audit of our whole house at different times each month and send out a report to all of the managers and educators of who was 100% compliant, partially compliant, and not compliant at all.  I like the idea of them performing the audit, however I feel like they will cover for each other and slap a date on the vial, but at least the vial will be dated.  Sad to have to think that way. The very morning of the CAP inspection, rounding was performed and a mass email went out to all of the managers and assistant managers to especially check the vials.  In the morning, I'm sure everything was as it should be, however when the inspector was checking at 1:30, a vial was put in use and not dated because it is not habit for them.

I would love to threaten pulling the meters, but I know I would not get any support because it is too much of a risk to patient care.  I was able to pull UAs from the ER, but that certainly is not as impactful as a BGL.  But I will definitely mention this during our meeting!

Not the answer you want to hear, but we solved our strip dating issue by moving to Abbott meters where the strips are individually wrapped and therefore have no container to label.  When we did have canister-based storage for strips, we did use these labels; compliance was never more than so-so, however.
Attachment.
image.png

Reply
Subgroup Membership is required to post Replies
Join POCT Listserv now
Anita Belanger
over 2 years ago
10
Replies
0
Likes
17
Followers
850
Views
Liked By:
Suggested Posts
TopicRepliesLikesViewsParticipantsLast Reply
Roche Chemstrip specific gravity
Laura Ball
1 day ago
1089
Michael Bishop
1 day ago
Anybody have experience with the Actalyke?
Edith Synnefakis
2 days ago
00131
Edith Synnefakis
2 days ago
Cal/Ver Istat pCO2
Autilia Sisti
2 days ago
20249
Autilia Sisti
1 day ago