Estimated Risk for Insulin Dose Error Among Hospital Patients Due to Glucose Meter Hematocrit Bias in 2020.
Context.--Glycemic control requires accurate blood glucose testing. The extent of hematocrit interference is difficult to assess to assure quality patient care. Objective.--To predict the effect of patient hematocrit on the performance of a glucose meter and its corresponding impact on insulin-dosin...
| Publicado en: | Archives of Pathology & Laboratory Medicine Vol. 144; no. 10; pp. 1204 - 1209 |
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| Autores principales: | , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
College of American Pathologists
Oct2020
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=146256073&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 146256073 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00039985 1FS jtl: Archives of Pathology & Laboratory Medicine issn: 00039985 maglogo: N pubinfo: dt: Oct2020 vid: 144 iid: 10 pid: 2550 pub: College of American Pathologists place: Northfield, Illinois artinfo: ui: 146256073 146256073 146256073 10.5858/arpa.2020-0101-RA 146256073 ppf: 1204 ppct: 5 formats: fmt: @attributes: type: P tig: atl: Estimated Risk for Insulin Dose Error Among Hospital Patients Due to Glucose Meter Hematocrit Bias in 2020. aug: au: Inman, Mark Lyon, Andrew W. Lyon, Oliver A. S. Lyon, Martha E. affil: Department of Pediatrics, University of Saskatchewan, Saskatoon, Saskatchewan, Canada sug: subj: Insulin Administration and Dosage Medication Errors Inpatients Hematocrit Equipment and Supplies Blood Glucose Meters Equipment Failure Human Multiple Logistic Regression Regression United States Food and Drug Administration Descriptive Statistics ab: Context.--Glycemic control requires accurate blood glucose testing. The extent of hematocrit interference is difficult to assess to assure quality patient care. Objective.--To predict the effect of patient hematocrit on the performance of a glucose meter and its corresponding impact on insulin-dosing error. Design.--Multilevel mixed regression was conducted to assess the extent that patient hematocrit influences Roche Accu-Chek Inform II glucose meters, using the Radiometer ABL 837 as a reference method collected during validation of 35 new meters. Regression coefficients of fixed effects for reference glucose, hematocrit, an interaction term, and random error were applied to 4 months of patient reference method results extracted from the laboratory information system. A hospital inpatient insulin dose algorithm was used to determine the frequency of insulin dose error between reference glucose and meter glucose results. Results.--Fixed effects regression for method and hematocrit predicted biases to glucose meter results that met the "95% within ±12%" for the US Food and Drug Administration goal, but combinations of fixed and random effects exceeded that target in emergency and hospital inpatient units. Insulin dose errors were predicted from the meter results. Twenty-eight percent of intensive care unit, 20.8% of hospital inpatient, and 17.7% of emergency department results were predicted to trigger a ±1 insulin dose error by fixed and random effects. Conclusions.--The current extent of hematocrit interference on glucose meter performance is anticipated to cause insulin error by 1-dose category, which is likely associated with low patient risk. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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