Extra-laboratory blood glucose measurement: a policy statement.

The introduction of test strips for measurement of blood glucose has led to their widespread use by medical and paramedical staff outside the central laboratory. While many users have developed ad hoc schemes of training and quality control, formal guidelines have not been presented. This paper makes recommendations on various aspects of extra-laboratory blood glucose measurement in hospitals, but not in the home, with the aim of improving the safety and reliability of results. It is recommended that: 1. a formal programme of training should be devised by staff in the laboratory together with those in the diabetes service and others as appropriate; 2. laboratory and diabetes staff should train, assess, and approve more senior users who would then take responsibility for the training and performance of more junior colleagues; 3. all users should demonstrate their competence at regular intervals; 4. there should be a quality assurance programme arranged by the laboratory which tests the performance of the operator and the equipment; 5. laboratory staff, in consultation with users, should be responsible for the selection and purchase of equipment; 6. equipment should be cleaned and maintained on a regular basis by users.