title: Point-of-care urine albumin in general practice offices: effect of participation in an external quality assurance scheme.
abstract: BACKGROUND
  The Norwegian Quality Improvement of Primary Care Laboratories (Noklus) offers external quality assurance (EQA) schemes (EQASs) for urine albumin (UA) annually. This study analyzed the EQA results to determine how the analytical quality of UA analysis in general practice (GP) offices developed between 1998 (n=473) and 2012 (n=1160).
  
  
  METHODS
  Two EQA urine samples were distributed yearly to the participants by mail. The participants measured the UA of each sample and returned the results together with information about their instrument, the profession and number of employees at the office, frequency of internal quality control (IQC), and number of analyses per month. In the feedback report, they received an assessment of their analytical performance.
  
  
  RESULTS
  The number of years that the GP office had participated in Noklus was inversely related to the percentage of "poor" results for quantitative but not semiquantitative instruments. The analytical quality improved for participants using quantitative instruments who received an initial assessment of "poor" and who subsequently changed their instrument. Participants using reagents that had expired or were within 3 months of the expiration date performed worse than those using reagents that were expiring in more than 3 months.
  
  
  CONCLUSIONS
  Continuous participation in the Noklus program improved the performance of quantitative UA analyses at GP offices. This is probably in part attributable to the complete Noklus quality system, whereby in addition to participating in EQAS, participants are visited by laboratory consultants who examine their procedures and provide practical advice and education regarding the use of different instruments.
authors.forename: Tone
authors.initials: T
authors.lastname: Bukve
authors.forename: Thomas
authors.initials: T
authors.lastname: Røraas
authors.forename: Berit Oddny
authors.initials: BO
authors.lastname: Riksheim
authors.forename: Nina Gade
authors.initials: NG
authors.lastname: Christensen
authors.forename: Sverre
authors.initials: S
authors.lastname: Sandberg
mesh_terms: D000419:Albuminuria; D058006:General Practice / Q000706:statistics & numerical data*; D006801:Humans; D007202:Indicators and Reagents; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data*; D013997:Time Factors
chemical_list: D007202:Indicators and Reagents