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...

Descripción completa

Detalles Bibliográficos
Publicado en:Archives of Pathology & Laboratory Medicine Vol. 144; no. 10; pp. 1204 - 1209
Autores principales: Inman, Mark, Lyon, Andrew W., Lyon, Oliver A. S., Lyon, Martha E.
Formato: research tables/charts Journal Article
Publicado: College of American Pathologists Oct2020
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