Near patient blood glucose monitoring

This report describes the quality control and quality assurance programs for bedside glucometry at our institution. From our 3-year experience, a regular schedule of inspections is necessary for maintenance of high-quality bedside glucose testing. The most common violation of quality control/quality assurance in bedside glucometry in our institution was the failure to perform regular proficiency testing, in which one random patient's bedside capillary blood glucose value during each inspection period was compared to his or her venous plasma or serum glucose value obtained from the central laboratory. Failure to perform instrument maintenance and document operator certification were the next most common violations of quality control/quality assurance in our bedside glucometry program. Regarding the cost analysis for bedside glucometry, we conclude that bedside glucose testing is not inherently more expensive than testing performed within the clinical laboratory. The increased cost of bedside glucometry over laboratory testing can be significantly minimized by involvement of a limited number of health care workers and performance of bedside glucometry only on clinical units where testing is required more than five times per day.