iSTAT Error Thresholds

I set my overall Quality Error Rate at <5% and for individuals, the Staff Error Rate goal is <10%. These were recommended by Abbott.  It has taken some time, but our departments are now doing better than the beginning. 
For those staff that are making error rates >10%, I get the technical consultants to get with them.  If they are consistently making errors that should be avoidable (overfilled, underfilled, etc.), we recommend that they get remediated by POC. We send these reports out monthly and have even gotten departments to no longer use the i-STAT's based on testing numbers and error numbers, which basically is a waste of money.

Individual error rate is set at < 5% and assessed during our recertification event. If > 5%, remediation by our clinical educators must be documented before the operator can be recertified. Dept error rate is also at 5% and if greater than that, investigated further with remediation for those who need extra training.

Thanks all! Looks like we might’ve set our threshold a bit too tight. Interestingly, I couldn’t find any paperwork from Abbott on the 5% threshold. My rep didn’t have any solid recommendations either 

I just happened to ask the Technical Specialist onsite when we were validating the instruments.

The 5% threshold was in place before I came to POC at our hospital. I never found any information on why 5% was the lucky number, but I ran it by our medical director, and he hasn't disputed it. Overall, our issues occur with individuals and not units. If the situation doesn't improve, the operator comes to us directly for remediation...if there are still errors, their access is removed. So far, we haven't had to deal with that issue.

When I monitored this it depended on usage.  Units that only did a few tests per month had a higher threshold, whereas the high usage units were lower. (Think if you did only 3 tests and one failed you had a 33% failure rate).  Higher usage units were more experienced and better at it so their rates were much lower.  Plus, much depended on how samples were collected.  Our Peds ICU's for example were almost all line draws so less chance of clotting and errors related to sample quality.  The ones that had to do capillary and venipunctures always had a higher failure rate.  I had low use units targeted to <15 and higher use <10.  

Ivy Douglas, we take those scenarios into consideration too...especially when you're dealing with new certs.

This is something that we monitor monthly as well. We have never really set thresholds but looked at ways to improve- was the issue for the entire unit, same operator every time or even the same iSTAT each time. We have used the errors to watch for iSTATs that are having issues and there is an intervention (usually conditioning the pins) to prevent the errors from reoccurring and increasing. 
It's nice to see what others are doing and possibilities to add to our own program.

We do >3 errors/per month/per operator on our official Quality Reports.  But we also look at if it's the same operators every month or the same ISTAT in case it needs to be looked at.