Blood Glucose Monitoring- What is your workflow?

[janeybirdRN]

Dear Nurses,

I need your help. I am looking for feedback from your personal experience. It would be most helpful if you can describe the work flow of the blood glucose result obtaining and reporting. What do you like and dislike about the way facilities record and report blood glucose results?

Here is an example:

At my work, when a blood glucose is checked, the tech/aid gets the blood glucose result and it is first recorded in the accu-check machine, then goes on the aide's blood glucose paper, then onto the assigned nurse's report sheet, into the patient's MAR, onto the charge nurse's report sheet, and sometime during the shift, it is recorded on a graphics page in the individual patient's chart.

[AngelRN27]

What setting do you work in? I work in a LTACH (long story short- ICU step down) and the nurse does the finger stick, the result is visible in 20 seconds on the glucometer, it is entered on-the-spot into the eMAR, and any SS insulin is given at that moment as applicable.

The system you described above seems like it may take too long and also with so many places to records the BS, it may be recorded incorrectly (in the wrong patient's record, the wrong time, or simply transcribing the wrong value).

[Kay28]

On my unit the RNs are responsible for the blood sugars. The glucometers are all interfaced with the computers so the results are automatically uploaded onto the computer. Never had any problems.

[ChristineN, BSN, RN]

I agree the OP's method sounds like it is risky for errors if transcribed one place incorrectly. Also sounds like a time consuming process

[MendedHeart]

I work on CV stepdown, CNA take BGMs and record directly in eMAR. They also call us or tell us if they are way high or low. We usually use SSI formula based on MD ordered per sensitivity factor and desired BG. We cover carbohydrate grams on some surgical patients and do Insulin drips.

[classicdame, MSN, EdD]

we have electronic medical records. Once the glucose monitor is docked, the results are automatically documented in the patient's medical record. Nurses also indicate in MAR to justify why they did or did not give an insulin dose if on a sliding scale.

[janeybirdRN]

Thank you all for your responses. I have found very few places that do it the way described in the example which is from a Rehab facility. The places that are similar are usually LTC/nursing homes. I think with the HITECH act and facilities transitioning to electronic health records, this method will finally be put to rest. It is awful and has room for so many errors. Reporting off to the charge nurse and the nurse for the next shift are steps that I don't think can be streamlined. However, I am finding a lot of facilities only allow the RN/licensed nurse to get the blood glucose. Also, of the facilities already using electronic health records either the machine transmits results wirelessly or it transmits when it is docked. This is definitely ideal and hopefully facilities that have this capacity are using it to the best of its abilities. One nice thing about having it recorded in so many places is that it is easily accessible but EHRs can be designed so the that BG result goes into the MAR as well as the patient's trend or graphics page. I would love to see more people respond to the survey! Thanks for your input!