EFFICACY OF FEEDBACK FROM QUARTERLY LABORATORY COMPARISON IN MAINTAINING QUALITY OF A HOSPITAL CAPILLARY BLOOD-GLUCOSE MONITORING PROGRAM

OBJECTIVE - A 1-year randomized prospective study was conducted to inv estigate the efficacy of feedback from split-sample testing as part of a capillary blood glucose quality assurance program. RESEARCH DESIGN AND METHODS - A total of 124 nurses were randomized to either group A (quarterly comparisons with feedback) or group B (no feedback). The me asure of nurse accuracy against the laboratory at 0, 6, and 12 months was determined by an additional five to seven split-sample tests witho ut giving feedback to either group. Mean accuracy was determined in te rms of percent absolute deviation from the laboratory result and a cli nical consensus limit of +/-20% deviation from the laboratory. RESULTS - By 12 months, there was a significant effect of feedback on nurse a greement with the laboratory method (P = 0.022 when agreement was scor ed as the mean percent absolute difference and P = 0.002 when agreemen t was scored in terms of the +/-20% clinical consensus limit). Nurses in the group who had received no quarterly feedback from split-sample testing produced a 3.5% greater mean percent absolute deviation from t he laboratory method and 12% fewer comparisons within the acceptable /-20% range. CONCLUSIONS - Feedback received from split-sample testing has a significant effect in maintaining accuracy in capillary blood g lucose monitoring.