Implementation of capillary blood glucose monitoring in a teaching hospital and determination of program requirements to maintain quality testing

Kent Lewandrowski, Robert Cheek, David M. Nathan, John E. Godine, Katherine Hurxthal, Karen Eschenbach, Michael Laposata

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

purpose: To study the implementation of bedside capillary glucose monitoring using a hospital-wide quality control (QC) program. methods: A prospective study of QC performance in 7 outpatient and 39 inpatient treatment units was performed in a large teaching hospital over a 2-year period. Approximately 800 nurses were trained to perform bedside capillary glucose monitoring (Accu-Chek II, Boehringer-Mannheim, Indianapolis, IN). An eight-point QC program was instituted including proficiency testing, instrument maintenance, performance of daily controls, storage of reagent strips and supplies, instrument calibration, and documentation procedures. results: Comparison of laboratory and bedside test results (split-sample proficiency testing) revealed Y = 1.004X + 7.26, r = 0.95, with a mean percent difference of -4.2% (p <0.001). Less than 7% of results fell outside ± 20% of the laboratory results. QC scores (0 = worst to 4 = best), based on adherence to the QC program, improved from 0 on the first inspection to 3.7 ± 0.17 by the 11th inspection. The most common QC deficiencies were failure to perform split-sample testing (41.4%) and failure to perform instrument maintenance (30.2%). Significant differences were noted in the QC performance of different types of medical services. During the 2-year study period, the total number of glucose assays performed in the clinical laboratories decreased by 22.2% concurrent with initiation of bedside testing. The number of instruments in the hospital increased from 10 to 46. conclusions: Bedside capillary glucose assays can be widely implemented in large hospitals with an acceptable degree of accuracy. QC programs with frequent inspections are necessary to identify units that function inadequately, and a formal disciplinary policy is required to ensure compliance with the program.

Original languageEnglish (US)
Pages (from-to)419-426
Number of pages8
JournalThe American Journal of Medicine
Volume93
Issue number4
StatePublished - Oct 1992
Externally publishedYes

Fingerprint

Teaching Hospitals
Quality Control
Blood Glucose
Glucose
Reagent Strips
Maintenance
Documentation
Calibration
Inpatients
Outpatients
Nurses
Prospective Studies

ASJC Scopus subject areas

  • Nursing(all)

Cite this

Implementation of capillary blood glucose monitoring in a teaching hospital and determination of program requirements to maintain quality testing. / Lewandrowski, Kent; Cheek, Robert; Nathan, David M.; Godine, John E.; Hurxthal, Katherine; Eschenbach, Karen; Laposata, Michael.

In: The American Journal of Medicine, Vol. 93, No. 4, 10.1992, p. 419-426.

Research output: Contribution to journalArticle

Lewandrowski, Kent ; Cheek, Robert ; Nathan, David M. ; Godine, John E. ; Hurxthal, Katherine ; Eschenbach, Karen ; Laposata, Michael. / Implementation of capillary blood glucose monitoring in a teaching hospital and determination of program requirements to maintain quality testing. In: The American Journal of Medicine. 1992 ; Vol. 93, No. 4. pp. 419-426.
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