scope:

Who Should Use This Guideline?

This guideline has been developed for authorized personnel directly involved in the establishment, management, and implementation of a blood glucose monitoring program at sites without support from hospital laboratories. For the purposes of this document, these authorized personnel will be referred to as "Operators." In settings where there is more than one Operator, one individual should be designated to coordinate the testing program; and for the purposes of this document, this individual will be referred to as the "Coordinator."

Where Should This Guideline Be Used?

This guideline should be used in settings where there is no laboratory support, such as those mentioned below, to be defined by each institution. All areas of use shall be staffed with personnel who are authorized by the institution to use blood glucose testing meters.

This guideline is not intended for use in acute and chronic care facilities with on-site laboratory support. Operators monitoring glucose levels in these types of settings should refer to the most current edition of CLSI/NCCLS document C30-Point-of-Care Blood Glucose Testing in Acute and Chronic Care Facilities.

This guideline for glucose monitoring may be used in a variety of locations which include, but are not limited to:

• physicians' offices;
• camps attended by people with diabetes;
• mobile emergency medical facilities;
• free-standing dialysis and surgical centers;
• home healthcare settings (not applicable to individuals with diabetes who do their own testing);
• visiting nursing programs;
• public health facilities;
• mobile or free-standing clinics (e.g., migrant worker clinics, other clinics in remote locations);
• occupational health facilities;
• pharmacies;
• prisons;
• residential care communities;
• schools and student health facilities;
• urgent care centers; and
• day care centers.

What Is Included in This Guideline?

This guideline provides information related to specimen collection, use of the blood glucose test strips and meters, and the necessary actions to be taken when finding abnormally high or abnormally low blood glucose concentrations.

It is intended to help Coordinators:

• select a glucose monitoring system;
• develop a procedure manual;
• implement a QA program;
• implement a program for maintenance of glucose monitoring systems;
• develop a documentation system for recording test and QC results; and
• train and authorize Operators.

It is intended to help Operators:

• understand the qualifications for operation of glucose monitoring devices;
• understand the need for and performance of quality control;
• perform maintenance procedures for the blood glucose meter;
• properly collect and safely handle blood specimens;
• properly calibrate or code the meters;
• perform blood glucose tests;
• understand the technique needed for obtaining accurate test results; and 
• understand the appropriate use of the blood glucose test results.

How Is This Guideline Organized?

This guideline is organized into nine sections:

• Scope;
• Introduction;
• Standard Precautions;
• Definitions;
• Information for Coordinators;
• Information for Operators: If you are the only Operator at a testing location, you should be familiar with the information in both the Operator and the Coordinator sections, because you will fill both roles;
• Procedure Manual: This section provides an outline for developing a procedure manual that is specific for the blood glucose measuring system being used;
• Sample Forms for Recordkeeping: This section provides sample forms for recording blood glucose results, QC testing, and meter maintenance activities; and
• Appendixes.