title: Documentation of quality control and operator training at point-of-care testing: a College of American Pathologists Q-Probes study of 106 institutions.
abstract: BACKGROUND
  Operator training, quality control, and proper follow-up for out-of-range quality control (QC) events are crucial steps that must be adequately performed and documented to ensure excellent patient care and regulatory compliance.
  
  
  OBJECTIVE
  To examine point-of-care testing (POCT) personnel training and QC documentation/compliance.
  
  
  METHODS
  Participants in a POCT documentation study of the College of American Pathologists Q-Probes program collected data retrospectively for glucose and urine dipstick testing regarding test operators, operator competency assessment, and QC documentation. Documentation was assessed for participant adherence to 4 quality indicators: (1) whether test operator training was up to date, (2) whether the test operator names were noted in the test records, (3) whether QC was performed, and (4) whether out-of-range QC events were followed up. Data were analyzed for associations with institutional demographic and practice variables.
  
  
  RESULTS
  The institutional median number of POCT personnel was 648 for blood glucose and 76 for urine dipstick testing, with a median number of 105 948 glucose tests and 9113 urine tests performed. Ninety-four percent (3830 of 4074) of the test operators completed training or competency assessment within the prior 12 months, 96.8% (21 603 of 22 317) of the test records documented the operator, and 95.7% (19 632 of 20 514) of the expected QC events (per institutional regulations) were documented. Approximately 3% (659 of 20 514) of the QC events were outside the designated range (an average of 6 out-of-range QC events were identified per institution [n = 106]). Of the out-of-range QC events, 92.6% (610 of 659) had documentation of appropriate follow-up. Most laboratories (176 of 179; 98.3%) violated specimen requirements by storing POCT urine specimens for less than 24 hours.
  
  
  CONCLUSIONS
  There was greater than 90% compliance for POCT documentation and nearly 96% of expected QC events were properly documented.
authors.affiliation: From the Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio (Dr Dyhdalo); the Department of Pathology, SUNY Downstate Medical Center, Brooklyn, New York (Dr Howanitz); the Department of Pathology, Virginia Commonwealth University, Richmond (Dr Wilkinson); the Department of Biostatistics, College of American Pathologists, Northfield, Illinois (Ms Souers); and the Department of Pathology, Henry Ford West Bloomfield Hospital, Detroit, Michigan (Dr Jones).
authors.forename: Kathryn S
authors.initials: KS
authors.lastname: Dyhdalo
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Howanitz
authors.forename: David S
authors.initials: DS
authors.lastname: Wilkinson
authors.forename: Rhona J
authors.initials: RJ
authors.lastname: Souers
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Jones
mesh_terms: D001786:Blood Glucose / Q000032:analysis; D006801:Humans; D007318:Inservice Training; D010338:Pathology, Clinical / Q000193:education* / Q000592:standards*; D019095:Point-of-Care Systems / Q000592:standards*; D011786:Quality Control; D012016:Reference Values; D012189:Retrospective Studies; D012955:Societies, Medical; D014481:United States; D016482:Urinalysis / Q000592:standards
chemical_list: D001786:Blood Glucose