Capillary blood glucose monitoring: a comparison of two hospital quality control programs.

Abstract

Clinical utility of capillary blood glucose (CBG) values rests on timeliness and accuracy. Reflec tance meters permit bedside glucose monitoring with accuracy and precision. Given an appro priate monitoring system, relia bility of CBG values depends on the personnel performing the test. We compared two hospital CBG programs: Hospital I, where monitoring occurred on four general nursing units; and Hospital II, where monitoring occurred on a diabetes-focused unit. CBG readings were com pared with clinical laboratory glucose values. At Hospital I the absolute error was 7. 23 % ± 1. 08 %; the directional error was 0.63% ±1.38 %. At Hospital II the absolute error was 9.31 % ± 0.38%; the directional error was -5.28 % ± 0.52 %. The larger directional error at Hospital II was monitor generated. We conclude that (1) one monitor brand should be used hospitalwide; (2) quality control systems can accommodate practical hospital settings; and (3) general nurse CBG reliability can be equivalent to that of specialized nurses.