Training of nurses in point-of-care testing: a systematic review of the literature.

AIMS AND OBJECTIVES: To review and describe the training of nurses in point-of care testing. BACKGROUND: Point-of-care tests are usually carried out by nurses. They are used in many healthcare units. Through training, nurses are able to improve their competence in performing point-of-care testing. DESIGN: Systematic review. METHOD: A literature search of electronic data was undertaken in autumn 2011 using CINAHL, The Cochrane Library, Medline (Ovid) and Scopus databases. RESULTS: From the available literature, six specific initiatives were analysed. The studies were performed on three continents and in five healthcare settings. The three interventions were related to glucose point-of-care testing. The training approaches involved seven aspects. The interventions were diverse, broad and multifaceted, but they appeared to be successful. The strength of the interventions lay in the involvement of laboratory staff. Quantitative synthesis of the data was not undertaken because of different designs for the studies. CONCLUSION: Training can improve nurses' competence, and many methods are available. There are very few studies of training nurses in point-of-care testing, although in-depth descriptions of interventions in different settings would be valuable. RELEVANCE TO CLINICAL PRACTICE: Nurses can be trained using a variety of methods in different healthcare settings. To save resources, especially in large hospitals and sparsely populated areas, distance learning is worth considering. However if training is delivered with the support of laboratory professionals, nurses subsequently perform good-quality point-of-care testing.

The Accu-Chek Mobile blood glucose monitoring system used under controlled conditions meets ISO 15197 standards in the hands of diabetes patients.

BACKGROUND: Self-monitoring of blood glucose is a cornerstone of diabetes management. The aim of this study was to evaluate the analytical quality and the ease of use of the Accu-Chek Mobile, a new glucose monitoring system designed for capillary blood testing by diabetic patients. MATERIALS AND METHODS: The performance of the Accu-Chek Mobile was evaluated both in the hands of a scientist and of diabetes patients. The designated comparative method was a hexokinase-based laboratory method (Architect ci8200). Diabetics (N = 88) with previous experience of self-testing were recruited for the study. Patient samples, containing glucose in concentrations mainly between ˜4 and ˜20 mmol/L, were analyzed in duplicates both on the Accu-Chek Mobile and with the comparative method. The patients answered a questionnaire about the ease of use of the meter. RESULTS: The meter yields reproducible readings, with an imprecision CV <5% as required by the American Diabetes Association (ADA). Of the glucose concentrations obtained by both the scientist and the patients, more than 95% of the individual results were within ± 20% of the comparative method, meeting the ISO 15197 accuracy goal, but not the stricter ± 10% ADA goal. CONCLUSION: Accu-Chek Mobile is a user-friendly glucometer that in a normo- and hyperglycemic range fulfils the ISO 15197 accuracy requirement, also in the hands of diabetes patients.

An interactive two-step training and management model of point-of-care glucose testing in northern Finland.

OBJECTIVES: To assess an interactive 2-step training and management model for nurses in glucose point-of-care testing (POCT). STUDY DESIGN: The training of the nursing staff by the point-of-care coordinator of the laboratory started with interactive sessions with contact persons who subsequently trained their nursing colleagues at the Oulu University Hospital in northern Finland. The 2-step training model was applied in blood glucose testing as a pilot study. METHODS: Functional quality was assessed through interviews with clinical contact persons and a questionnaire was given to the trained nurses. Technical quality was assessed through control measurements by laboratory and nursing staff. RESULTS: Training succeeded because of basic resources (trainers' knowledge and skills, organized contents of training and place), interpersonal communication and high-quality interactions. Nurses were especially satisfied with the prerequisite training of the contact persons (mean score 1.58, Likert scale from -2 to +2, strongly disagree - strongly agree). Day-to-day repeatabilities of less than 3% were achieved in control measurements by both nursing and laboratory staff. CONCLUSIONS: The interactive 2-step training and management model could be implemented in the clinical units using a reasonable amount of laboratory resources. The goal of good functional and technical quality in point-of-care testing in the clinical units was achieved. Despite successful implementation, POCT needs continuous support from the laboratory.