Importance of periodic reeducation of hospital-based nurses in capillary blood glucose monitoring and an evaluation of the usefulness of reflectance meters.

Precision and accuracy of capillary blood glucose measurements performed by general staff nurses were assessed before and after a modest reeducation program both with and without the use of reflectance meters. A total of 380 capillary glucose determinations were performed by nurses and the hospital laboratory on the same samples. Prior to reeducation, nurses using meters were more accurate than those reading visually, but no difference was found in precision. Reeducation improved precision equally in both groups while improving accuracy only in the group using meters. While glucose readings with the use of reflectance meters were statistically more accurate than those read visually, the percentage of readings within 10% and 20% of the laboratory readings was the same. Thus, the increased accuracy observed with meters may have little practical significance, suggesting that their use might better be based on other considerations, such as user confidence, convenience, cost, and quality control. Periodic education is, however, an essential component of any quality assurance program.