UHN nurses, lab managers and staff.jpg

Above, UHN nurses, lab managers and staff with the new glucose meter at Toronto Western Hospital, 8A/B Fell. In the back row, from left to right are Christine Cursio, Lori Taylor, Linneth Whitton, Sara Shafiey, April Mick, Sharel Faraon and Teri Arany. Sitting in front, from left to right are Sung Kim and Gillian Gilchrist. (Photo: UHN)

Nearly every Canadian knows someone with diabetes who needs blood glucose testing. For at-home testing, these small handheld glucose meters are available at local pharmacies and specifically designed for personal use.

But what about patients who can't be at home? For years, the Laboratory Medicine Program at University Health Network has been leading the way in the management, roll-out and expansion of glucose meters for patients staying in the hospital.

Right care, right time

This area of laboratory medicine is called Point-of-Care Testing (POCT) and it is all part of the laboratory's commitment to ensure that every patient receives the right care at the right time.

"There is always a collaborative laboratory team working behind the scenes to get results for our patients," said Tom Clancy, Director, Laboratory Medicine Program. "But, with Point-of-Care Testing and our in-house glucose meters, the clinicians receive their results almost on the spot, so decisions can be made immediately regarding their care."

Recently, LMP, along with collaborative clinical and technical partners, began the rollout of a new bedside glucose meter called the Nova StatStrip meter from Nova Biomedical.

Less blood required

This product was chosen for use at UHN because it is faster, requires less blood than our previous glucose meters and does not exhibit interference from other forms of glucose.

Other key components of the new meter program include scanning of the patient wristband for positive patient identification and that the results go electronically into the patient chart in EPR.

"Point-of-Care Testing has seen steady growth in the last decade, and we, in the labs, are seeking better solutions for an increasingly complex mix of patients," said Chris Cursio, Manager, POCT, Laboratory Medicine Program.

"We know how important it is to have all laboratory data available for clinical decision making, including bedside tests, to allow the clinicians to see the full picture when providing informed care for patients," he continued.

"Tracking point of care glucose results in EPR and providing the availability for electronic order entry is just the tip of the iceberg. We are excited for what this means for diabetes management down the road," said Lori Taylor, project manager for glucose testing. "For example, seeing how patient blood glucose levels trend alongside of medications received, provides insight into treatment plans and assists in seeing the bigger picture around diabetes management longer term."

Formal lab test

Although the meter provides the result in a few seconds and seems simple, it is a formal laboratory test and is subject to three different accrediting bodies (Ontario Laboratory Accreditation, Accreditation Canada and the College of American Pathologists).

In order to ensure that the highest standards are met with the roll-out of the Nova StatStrip meter, the POCT team is using a phased in approach across all four sites, ensuring that everyone who will use the meter is trained in the correct usage.

It's currently being used across Toronto Western Hospital, Toronto General Hospital and Princess Margaret Cancer Centre. Plans are underway for the Toronto Rehab sites throughout 2013.

Responsibilities of the Point-of-Care Testing team are not limited to handheld glucose meters. The LMP POCT team also monitors and manages POCT devices for a large POCT blood gas program, urinalysis and pregnancy screens and blood coagulation.

Each instrument provides the clinical team with accurate results that are of immediate benefit to the patient.

"The laboratory is an essential partner in patient care, alongside the nurses, clinicians and other health care providers at the bedside," said Dr. Sylvia Asa, Medical Director of Laboratory Medicine Program. "Nearly every patient at UHN is affected– one way or another – by the laboratory. Point-of-Care Testing is just one more example of how laboratory medicine actively contributes to the delivery of high-quality patient care."

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