title: Development of a protocol for capillary blood glucose testing in nursing home and rehabilitation settings.
abstract: OBJECTIVE
  To develop an algorithm to standardize capillary blood glucose (CBG) testing in nursing home and rehabilitation patients.
  
  
  METHODS
  Descriptive study in which an interdisciplinary team from a nursing home, a rehabilitation center, and a diabetes mellitus care program developed and tested a protocol to standardize diabetes management parameters and CBG testing frequency.
  
  
  METHODS
  Department of Veterans Affairs nursing home and rehabilitation unit.
  
  
  METHODS
  One hundred one patients admitted to the units during the 6-month study period who had orders for CBG testing.
  
  
  METHODS
  Use of a standardized CBG testing protocol.
  
  
  METHODS
  Use of management goal, use of CBG testing protocol, total CBG tests/month.
  
  
  RESULTS
  One hundred one subjects received orders for CBG testing; 72 (72%) received orders for a management goal, and 69 (69%) received orders to use the CBG protocol. Of these 69 patients, 22 met their CBG goals and were advanced to less-frequent CBG testing using the protocol, and 15 did not meet their CBG goals and were not advanced. An additional 15 patients were advanced to less-frequent CBG testing but not using the protocol. In all, 54 of 69 patients (78%) were advanced or could have been advanced by protocol to less-frequent CBG testing. Total CBG testing per month did not change before, during, or after the study period.
  
  
  CONCLUSIONS
  This protocol would be useful in long-term care facilities and in other congregate living settings where patients with diabetes mellitus have staff assisting with their diabetes management. Barriers to successful implementation are discussed.
authors.affiliation: Portland Department of Veterans Affairs Medical Center, Portland, Oregon, USA. scott.mader@med.va.gov
authors.forename: Scott L
authors.initials: SL
authors.lastname: Mader
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Fuglee
authors.forename: Deanna S
authors.initials: DS
authors.lastname: Allen
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Werner
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Wanlass
authors.forename: Keith J
authors.initials: KJ
authors.lastname: Pagel
authors.forename: Kay L
authors.initials: KL
authors.lastname: Beliel
authors.forename: Judy A
authors.initials: JA
authors.lastname: McEuen
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Stephens
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Allison
authors.forename: Karen A
authors.initials: KA
authors.lastname: McWhorter
authors.forename: Julie E
authors.initials: JE
authors.lastname: Vandling
mesh_terms: D000368:Aged; D000465:Algorithms; D001786:Blood Glucose / Q000032:analysis*; D002196:Capillaries; D002985:Clinical Protocols; D003920:Diabetes Mellitus / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods / Q000592:standards*; D009735:Nursing Homes / Q000458:organization & administration; D009922:Oregon; D012047:Rehabilitation Centers / Q000458:organization & administration; D014481:United States; D014493:United States Department of Veterans Affairs
chemical_list: D001786:Blood Glucose