glucose reflex testing

I have worked in 2 different systems and removed the lab reflex order for POCT in both systems.
This was for numerous reasons. 
One: the patient is in front of the operator and (usually) can be asked follow-up questions. If it is a baby... and it is low....they feed it. 
Two: Based on audits, the end users were not doing the reflux testing. Why require something that the end users will not perform- And then get a citation because the operators are not following procedure? 
Three: patients do not appreciate getting "stuck" to "check a result". Daily lab work might be the norm for these patients.....
Lastly, we require a repeat for any critical results. This they do perform by audits. 

Below is how Glucoses are handled on our facility.  

“HI” (>600 or an error)

          -repeat the test 

          -order LAB 2811 Glucose confirm; nursing a to verify with the lab instrument 

 

 Results between 400-600

 

- repeat the test-if the two results are within 10% of each other, you can accept the results and treat the patient.

 - if the difference is >10%, you must order a LAB 2811 Glucose confirm; nursing only to verify          

 

The ONLY exception is a patient on Glucomander protocol.  If the glucose is between 400 and 600, the glucose does not need to be repeated.

  

Result <53

          -repeat the test

          -treat patient for hypoglycemia following nursing protocol

 

“LO” (<40 or procedure error)

          -repeat the test

          - treat patient for hypoglycemia following nursing protocol

Results within between 53-400 

 

          - if you repeat the test- the two results are within 10% of each other, you can accept the results and treat the patient.

           - if the difference is >10%, you must order a LAB 2811 Glucose confirm; nursing to verify