Hi Helen

All of our patients GDM, and pre-existing have their blood glucose checked using our hospital point of care meter. It is within our guideline for this to happen. Our reasons are 

1) quality control

2) Audit trail of blood glucose readings automatically downloaded onto our laboratory system,

3) staff awareness of readings and able to manage appropriately, 4) staff take responsibility for inpatients,

5) contemporaneous documentation.

There has been lots of litigation cases in the media reporting nurses and GPs being struck off for failing to monitor blood glucose levels as an inpatient or mismanagement of diabetes. The ultimate responsibility for their diabetes is on the staff caring for them during their inpatient stay rather than the patient. In our trust the diabetes nurses are developing a self-management of diabetes and a self-medication of diabetes medication guideline, but due to pregnancy being such a destabilising event maternity patients are not being included in the guideline and will continue to be managed by midwives. If you look at the national guidance around self-management of diabetes, self-medication of diabetes, and consent to self-medicate or self-manage, only patients who have been stable on a particular regime for a length of time can be included, and due to the pregnancy, and increasing insulin resistance, increasing insulin requirements, they aren't deemed to be stable. What does everyone else think? 

Hi Helen,

I agree with Heather Davis, like she has written we also advise that CBG's are monitored using the POCT meter for all inpatients.  The readings upload to our online patient information system under the patients name (on our Concerto database).  

This can be viewed by Staff regardless of where they are in the Trust.  An added advantage is that the team can review inpatients by speaking to staff over the phone after reviewing their CBG's online.

Regards,

Jenni