Bedside glucose monitoring: in compliance with regulatory standards

When accurately performed, bedside glucose monitoring (BGM) is a prompt, reliable, and cost-effective method of managing patients who require a high degree of glucose control. However, regulatory agencies have criticized the quality-control deficiencies of most existing BGM programs. A new generation of multi-user reflectance meters enables the various regulatory directives to be more easily satisfied. These meters provide computer-assisted quality control analysis and facilitate operator feedback for each control test. New York State Department of Health regulations state that the ultimate responsibility for BGM belongs to the chemistry laboratory director. We believe that nursing personnel should retain their patient care prerogative to perform glucose monitoring. Implementation of our successful BGM program required the collaboration of nursing, medical, laboratory, and administrative personnel. These departments combined theoretical and practical expertise with material and financial management. During the first 5 months of operation, our program has shown a steady increase from 78% to 89% of control tests performed correctly. This model can be used by other hospitals to achieve a successful BGM program.