Establishing indicators to monitor the utilization of POC glucose meters in glycemic control

Abstract

Objectives

The use of point-of-care (POC) glucose meters and effectiveness of glycemic control should be monitored as part of quality assurance practices. This study is the first to establish indicators to evaluate the utilization of glucose meters in our academic hospital.

Methods

Patient results from glucose meters located in emergency department (ED), intensive care units (ICUs), general wards, and neonatal units were extracted from the data management system for the months of October to December from 2021 to 2023. Six indicators were developed and compared across clinical units, including: glucose test number per meter, daily frequency of patient glucose testing 1–4 times (%), ratio of POC to core lab glucose testing, and percentages of patient glucose results within target ranges, below critical level 2.5 mmol/L, or above 25.0 mmol/L.

Results

The six indicators varied greatly between clinical units due to the differences in patient populations, clinical scenarios, and clinical guidelines. About 90 % of patients in general wards, ED and neonatal units were tested glucose 1–4 times/day, while 27.1 % patients in ICUs were tested glucose 5–10 times/day or more. The average POC/core lab glucose testing ratio in neonatal units, general wards, ICUs, and ED was 17.6, 14.9, 2.2, and 0.3, respectively. Overall, 69.6 % of patient glucose results in all clinical units fell within the target ranges. Percentages of patient glucose results below 2.5 mmol/L or above 25.0 mmol/L were both under 0.6 % across clinical units.

Conclusions

In this study, the indicators were able to assess the use of POC glucose meters and the effectiveness of glycemic control and to identify opportunities for quality improvement. The approach can be readily applied in other hospitals.