Blood glucose monitoring at triage

To examine the use of a blood glucose monitor (BGM) on nursing and medical care, treatment time, and disposition time for patients in an ED triage.

Experimental design. Individuals assigned to the experimental group had their blood glucose tested by finger stick in the triage area. The blood glucose level was made known to the triage nurse and/or the nurse caring for the patient in the emergency department proper. The investigator observed the nursing care, nursing and medical interventions and times. The control group underwent triage as usual, with no finger stick.

Individuals with a history of diabetes and at least 18 years old were randomly assigned to the experimental or control group. The participants were 30 men and 38 women.

Early knowledge of the patient's blood glucose level as determined by BGM affected time and implementation of nursing care. Three nursing interventions were significantly different between the groups: assessment, chi 2(1,N = 68) = 10.15, p < 0.001; consult a physician, chi 2(1,N = 68) = 17.58, p < 0.001; and order stat laboratory tests, chi 2(1,N = 68) = 13.09 = p < 0.001. The time the nurse intervened was significantly less for the experimental (24 minutes) than for the control (164.3 minutes) group (t[65] = -7.05, p < 0.001). Medical treatment time was significantly less for the experimental group (89.2 minutes) than for the control group (165.5 minutes) t[64] = -2.07, p = 0.05). Disposition time did not differ between groups.

Data support the use of a BGM as a fast, accurate means of obtaining blood glucose levels. The nurses consulted with a physician, ordered stat laboratory tests for verification, and assessed the experimental patients more frequently than the control patients. Medical treatment time was also shorter for the experimental group. A BGM is an important source of data with which emergency nurses initiate care, at a fraction (3%) of conventional laboratory cost.