title: Effect of Participating in a Quality Improvement System over Time for Point-of-Care C-Reactive Protein, Glucose, and Hemoglobin Testing.
abstract: BACKGROUND
  Users of point-of-care testing (POCT) in Norway participate in a quality improvement system that includes education and guidance in safe laboratory management along with participation in external quality assurance schemes (EQAS).The aim of this study was to identify the effect on the analytical performance of POCT C-reactive protein (CRP), glucose, and hemoglobin (Hb) with the use of a quality improvement system over time and to identify which factors are associated with good performance.
  
  
  METHODS
  Participants' results from 19 EQAS for CRP, glucose, and Hb from 2006 to 2015 along with information on the instruments used and different practice characteristics were analyzed. Logistic regression analysis was used to evaluate the factors associated with good laboratory performance. An instrument evaluation and comparison for CRP determination was performed by using commutable EQA material.
  
  
  RESULTS
  The mean number of participants in each EQAS was 2134, 2357, and 2271 for CRP, glucose, and Hb, respectively. The percentage of good participant performances increased gradually whereas that of poor performances decreased with participation in a quality improvement system over 9 years for all 3 analytes. Independent factors associated with good performance were type of instrument, the number of times performing EQA, performing internal QC weekly, performing 10 or more tests weekly, and having laboratory-qualified personnel perform the tests. Considering CRP instrument performance, Afinion and QuikRead exhibited the lowest systematic deviation.
  
  
  CONCLUSIONS
  The analytical quality of CRP, glucose, and Hb testing is improved by systematic participation in a quality improvement system over time.
authors: The Norwegian Quality Improvement of Primary Care Laboratories (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway; tone.bukve@noklus.no.
authors: Tone
authors: T
authors: Bukve
authors: The Norwegian Quality Improvement of Primary Care Laboratories (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway.
authors: Anne
authors: A
authors: Stavelin
authors: The Norwegian Quality Improvement of Primary Care Laboratories (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway.|Department of Global Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.|Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.
authors: Sverre
authors: S
authors: Sandberg
mesh_terms: D002097:C-Reactive Protein / Q000032:analysis*; D005947:Glucose / Q000032:analysis*; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D016015:Logistic Models; D009664:Norway; D019095:Point-of-Care Systems; D058996:Quality Improvement
chemical_list: D006454:Hemoglobins; D002097:C-Reactive Protein; D005947:Glucose