Alcohol use with insulin injections and BG sticks

[CrazierThanYou]

i work in an assisted living facility as a cna. we have a resident who is diabetic, she gets her bg checked once a day and 1 insulin injection a day. i always use alcohol pads when checking her sugar or injecting her. the last time i worked, there were no pads so i used alcohol on a cotton ball (the administrator isn't very conscientious or organized when it comes to keeping us in supplies).

yesterday, i was at the facility and observed the cna who was working check the resident's sugar and give her the insulin with nothing. no alcohol or anything. i asked her why she didn't use any alcohol and she said "no one ever does, its no big deal".

isn't that an infection risk?

[JulieCVICURN, BSN, RN]

At a hospital, I would always use an alcohol pad. As a diabetic, I can tell you that at home I usually do not. But that's a different setting, and at home I'm not risking exposure to other peoples nasty bugs.

[ayla2004, ASN, RN]

Its standard in the UK not to use alcohol but to ensure the area has been washed prior to getting a blood sugar, or injecting insulin.

[ArizonaMark]

First a caveat, I DO use alcohol wipes prior to every FSBS with my patients. Having said that, there was a study recently regarding the efficacy of using alcohol wipes vs not. The study demonstrated no difference in rates of infection r/t wipes or no wipes.

Now, tell that to your patient and watch them hit the roof. I tried it for a bit, but gave up as patients are accustomed to the wipes. So be it.

Nonetheless, wipe or not. It doesn't matter.

Kindly,

Mark

[CrazierThanYou]

Okay, that makes me feel a little better. I am a diabetic and I usually don't use alcohol when I check my bs... (I confess I also use the lancets more than once)

I feel like I have the choice not to bother with alcohol when its me, but I feel better using alcohol on my residents.

[jackierocks]

I work in LTC and always use alcohol to clean the skin before all injections whether it be to check glucose levels or inject insulin. I believe there is EBP to confirm infection control issues. I do also realize there is question as to whether any alcohol residue may alter BS values. I dry the alcohol with a few swift hand waves before puncturing the skin and if the pt. has enough blood I wipe the first drop away and use the second. Also, I always wipe the top the insulin bottle before puncturing it as well.

At home, my husband does this all without alcohol but as mentioned before the only 'bugs' at home are our own and the environment is more controlled as far as infection is concerned.

I say wipe everything at work, it may take a bit longer but in the end it is about pt. safety and quality care.

[ArizonaMark]

(i confess i also use the lancets more than once)

hmm, i would suggest this is not a good idea. not using alcohol wipes is one thing, but driving a dirty needle through your skin into your bloodstream is probably not a good idea.

remember, little buggies like to grow on those dirty needles. don't give them a free pass through your body's initial line of defense, your skin.

just my two cents,

kindly,

mark

[turnforthenurse, MSN, NP]

I always use alcohol when checking BS or giving insulin. When checking a BS, I also always wipe the first drop of blood with a clean cotton ball THEN collect the sample on the test strip. Even though the alcohol is dry before you stick the finger with a lancet, it can still cause a false elevation in the patient's BS.

[Flare, ASN, BSN]

i work as a school nurse. Sometimes, i will just have the kids wash their hands with soap and water as i notice some of them use the alcohol and either don't let it dry - which can alter the results or blow it dry (which in my mind spreads germs back onto hands) or even worse, wipe it dry on their filthy pants. If the students can use the alcohol wipes to "my" standards, then they are permitted to do so.

[mamamerlee, LPN]

For myself, I wash my hands well prior to sticking my fingers. I don't bother w/alcohol swabs for bottles of injection sites. If I am concerned about the top of my bottle, I wipe it off with a hand wipe, and let it dry. Fingers still look good, no s/s of any problems anywhere.

If I am in a facility, I ask the pt what they prefer - usually handing them a warm wet washcloth to wipe their hands with, and a dry one, as well.

I use alch pads to wipe off the top of bottles, and the area I am going to inject.

[pers]

I use the wipes because that's my hospital's protocol. Ever taken a look at the wipe after using it on some folks though? Not everyone washes their hands as well as others.

[lovemydeano]

:redbeathe Personally, if the patients hand is washed, that should be good enough. If they don't want to wash their hand, I would then use an alcohol pad. :redbeathe