Table 10—

Characteristics of an effective bedside glucose monitoring (BGM) quality-control program

• A specifically designated responsible individual, preferably a laboratory professional, is involved in the administration and quality assurance of the BGM program.
• A written procedure for the BGM program.
• An organized training program that involves laboratory personnel and nursing staff.
• Defined frequencies and requirements for maintenance and cleaning of BGM instruments.
• Regular performance of quality control testing on each instrument (daily or by shift), depending on the frequency of patient testing.
• A policy to regularly compare the BGM results from each operator and instrument with results from a corresponding sample tested in the clinical laboratory. Suggest that all BGM results are, at least, within ±15% variation from the clinical laboratory results.
• Participation in an external proficiency testing program.
• Acknowledgment of the limitations of BGM and requirement of a clinical laboratory glucose determination when a BGM result is outside a defined range.
• Acknowledgment of the effect of hematocrit value variation on BGM results and establishment of hematocrit value limitations for the instrument in use.
• Determination of the bias of the instrument in use and communication of this information to the physicians and the institutional quality assurance program.
  • Adapted from Jones et al. (443).