Glucometer critical value reporting
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I was wondering what other facilities do in regards to documentation for critical POC glucose results. Do you have somewhere that clinical staff must chart that the provider was notified? Do you monitor these values and ensure notification was made? I'm struggling with finding a process for this that works well. We have in our policy that documentation is made in the EMR on a critical value notification record. There would be documentation of notifying the provider charted in this location. If there is a protocol in place as far as giving insulin or dextrose for example, they would still document as to indicate why no notification was made protocol in place. This is difficult for nursing staff to keep up with since a lot of times glucometer checks occur frequently on the same patient. Do you even document notification of critical values for POC glucose testing? I'm just looking to see what others have in place for their facility, any input is appreciated! Thanks!
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If critical low result- treat and re-test 15 minutes post treatment.
If critical (>400) high result- first time, confirm with a lab draw, consequent critical BGMs are repeated bey not confirmed. If they go below 400 and then back over 400, it's a new episode and needs another lab confirmation.
For neonates, critical is 39 and less or 180 and up, not repeated, but confirmed every time, as established by the house pediatrician.
Do you all require documentation in the medical record that the results were reported to the provider or caregiver? Or just proceed with treatment? We have NAs that perform POC glucose testing along with RNs and the NAs would not be able to start treatment as it is not within their scope of practice, they would have to notify a RN or MD of the critical. I'm trying to see if the notification of the critical is documented in the EMR at other facilities.