How do you check the patient's blood glucose??

I do the following:
Wipe the finger with alcohol, allow it to dry
Lancet the finger
Clean the first sample off with a 2x2
Apply the second sample to the test strip.

However, as I work on a rehab unit, I do a lot of diabetic teaching, so typically my patients do their fingersticks on their own with supervision.

In the almost 15 years of doing FSBG I have never seen anybody not use alcohol to clean the site. And when I have to do a lab the BS always correlates with the lab value.

That being said, I do what the others do, clean, swab the first drop of blood, take the sample, hold a cotton ball to site while I await the results.

Wash with a damp cloth (unless the finger's visibly contaminated), dry, use the lancet and use the first drop - lab and ward glucose approximate closely with specimens taken at the same time.

Alcohol not only alters the reading but also (over time) toughens the skin.

We have been taught 2 ways to do this (1 for use in the hospital setting and 1 for use in the hospital setting)

In the Hospital
1.We swab the finger (and then wait for the alcohol to dry, if the area is still wet with alcohol it can give a false high reading)
2.Lancet the finger
3. apply pressure to the are (or have the client do it if they are able), if they bleed more than just a bit a band-aid is applied

In the Community
1. The finger is not swabbed, but the client is asked if they have washed their hands recently, if they have then we go to number 2. if they have not we ask them to wash their hands. we also ask if they have eaten anything, applied lotion or hand sanitizer (as many people still consider their hands clean after doing this) if they have we ask them to was their hands
2. Lancet the finger
3. apply pressure, no band-aid is applied unless they continue to bleed

there are several resources out regarding best practice guidelines for glucose testing. I am not sure of where these American resources can be found but in Canada they can be found at www.rnao.org under best practice guidelines.

Goodluck on your study!

A 2x2 is a small sterile gauze (2in x 2 in).

I wipe the area with alcohol swab
Set up the glucometer as the alcohol is drying
squeeze the finger prior to and as I apply the lancet
then use the blood that comes out for my reading. I don't waste like you do with blood draws, but that's very interesting! I never thought of doing that.
Then I wipe the blood off with the alcohol swab and put some gauze on it, and if the patient is awake (I work nights a lot and do fingersticks in the wee hours of the night), then I ask them to hold pressure down on their finger.

Hope this helps!!

I am in a nursing home not a clinic, if that matters.
Start with clean gloves:
1. Look for finger with no or few marks from previous finger sticks or injury. Prepare glucometer.
2. Swab with alcohol wipe and let air dry.
3. Lancet to finger and throw away lancet.
4. Squeeze finger for blood.
5. Wipe away blood with cotton.
6. Squeeze finger again to obtain enough blood needed. It is sometimes necessary to massage entire finger to get enough blood.
7. Collect sample.
8. Cover area with cotton and apply pressure to site.
9. Dispose of cotton and sample strip.
10. Stay with pt until reading registers on glucometer.

My skills book in nursing school says alcohol swab is unnecessary but I always use it. I believe it is policy where I work.

Our hospital uses Lippincott's Nursing Procedures, 5th ed. According to Lippincott, an alcohol pad should be used to clean the puncture site and allowed to dry completely. Lippincott makes no mention of wasting the first blood.

1. I ask the patient to wash their hands if they are close to a sink.
2. Choose a finger and use an alcohol swab to wipe the finger that is going to be used.
3. Allow the alcohol to air dry while getting the glucometer ready.
4. Bend the finger slightly while squeezing and lancet the finger.
5. Use a 2 X 2 gauze to wipe off the first drop of blood which removes any excess alcohol.
6. Use the second drop of blood for the sample, putting the strip in the glucometer ASAP.
7. Apply the 2 X 2 to the finger to stop excess bleeding.

Sometimes in the hospital if we have to draw blood at the same time a blood glucose reading is due we will aspirate the blood using a syringe attached to a butterfly setup and we will take a drop of blood from the syringe (even syringes that look empty can make a drop big enough for a glucometer test strip.) It doesn't happen often but when the timing is right it works out very well (only have to bother the patient once and you get more out of the blood you took.)

!Chris

I am a phlebotomist and our lab rules state to do this:

Wipe the finger with alcohol, allow it to dry
Lancet the finger
Clean the first sample off with cotton ball
Apply the second sample to the test strip.

1)I assess which finger tip to prick
2) Clean and dry that finger with water using a cotton ball or paper towel
3) Use pressure and rub along the sides of the persons finger (especially if their hand is cold)
4) Wear disposable gloves and lancet the finger tip, using the first drops of blood
5) Apply a cotton ball to finger and wait with patient for the BGL result
6) Dispose of lancet and test strip in sharps bin