This paper describes the process of implementing a successful bedside capillary blood glucose monitoring (CBGM) program in an acute care, universityaffiliated, general hospital. A quality-assurance program was established that included simultaneous laboratory analysis and bedside analysis of the same specimen. Results were correlated over a 12-month period (r = . 92). The findings suggest that sustained positive results are possible in a well-planned bedside CBGM program by registered nurses if the nursing staff receives adequate preparation and participates in an ongoing qualityassurance program. While many agencies continue to monitor blood glucose by the indirect method of testing urine glucose levels, the value of this form of clinical assessment has been criticized for nearly 50 years. 1.2 By contrast, capillary sampling to assess circulating glucose levels is an effective and desirable approach to blood glucose monitoring.&dquo; Acute care facilities are finding the potential of rapid bedside estimation with subsequent adjustments to insulin dosage to be a valuable adjunct to diabetes care.&dquo; Unlike laboratory sampling and analysis, which involves a time interval between the decision to sample and the acquisition of the results-a time interval that may be clinically significant in some situations-bedside capillary blood glucose monitoring (CBGM) provides almost immediate results. Other benefits include decreased patient trauma, smaller blood volume required for analysis, and conservation of veins for other access needs.The increasing demand for bedside CBGM in acute care facilities presents the problem of how best to implement such a program. Concern has been expressed about the accuracy of such testing by large numbers of registered nurses.&dquo;'&dquo; Laboratory staff, subject to stringent quality-assurance programs, 11).11 are concerned about how accuracy of results can be measured and assured and who will be responsible for the quality of such a program. Physicians are eager for the benefits of rapid bedside estimation of blood glucose for the clinical management of their diabetic patients; nursing administration and staff are concerned about adding tasks to already stretched resources. Everybody is concerned about the cost and how it will be distributed. It is in this environment that an agency's diabetes educator is usually asked to oversee the planning and implementation of such a program.
