Blood glucose and insulin

[adclay]

Just wanted to to see if any hospitals or facilities that everyone works at have policies about how old a blood glucose reading can be to give insulin. Does the reading need to be no more than say an hour before or is there no difference where you work? Trying to find information to put together a policy for the techs taking glucose on patients and time frames . I appreciate any help you can offer.

[Sour Lemon]

We just look at trends, use our brains, etc. There's no specific policy that I know of.

[adclay]

Thanks for the response I appreciate it. We have a lot of new nurses and the problem I'm running into is the techs are taking blood sugars right after the patient eats dinner and nurses are covering that value up to four and a half hours later.

[beekee]

Then you have a huge knowledge deficit that needs to be address, not necessarily a policy issue. I typically won't use a blood glucose more than about a half hour old. If it's stable and not too high or too low, I might use one that's an hour old. I definitely wouldn't use one taken after dinner or drinking juice/soda. And no way would I give insulin based on a four hour old reading taken after dinner. I hope someone is checking on them overnight!

[MunoRN, RN]

This is an education issue and not a policy issue, a proper understanding of the basis of insulin and BG management can be substituted with policy.

[JKL33]

I mean no disrespect when I say that it sure is too darn bad that all (current types of) efforts to try to prevent the difficulties that arise when novices are supposed to function independently with weak/no support can't be channeled into helping people become excellent nurses.

The particular issue/problem you've described is very unlikely outside of a situation where way too few people understand what the H they're doing.

[adclay]

The overnight drops is what is prompting me to look into writing a policy because it is a problem.The wall I am hitting is some nurses and techs telling me well it's not written anywhere and I want them to understand they will be held accountable. The education portion is ongoing it just seems some people are harder to get through than others.

[BlueShoes12, BSN, RN]

Yikes. People, use your brain! I usually won't use one more than half an hour old, but if they've had a very stable blood sugar and it's less than an hour old, I might use that one.

I was precepting once and had to remind the nurse I was precepting to check a patient's blood glucose prior to giving them their scheduled HS insulin. IIRC, it was Lantus, but it was a huge dose and still...