Glucometer / Infection Control

[ktwlpn, LPN]

Have you all heard that this is a major issue this year with the DOH? We have 1 glucometer on each unit -6 finger sticks before breakfast and our trays arrive at 7:00. We now have glucometer wipoes that contain bleach. Our QI told me that the solution is supposed to sit for 5 mins to completely disinfect the unit. So we are supposed to hold the trays and do one finger stick every 5 mins? No one wants a glucometer for each resident "Who wants to run all of those controls?' O-please-night shift nurse sits at the desk and eats chips while she runs them now. The residents want breakfast fresh and hot. Our meter (I forget the brand-even through I use it every day) never touches the resident.The strip sticks out of the unit. I take the med cart to the bedside and use it's surface so the meter touches NOTHING but the top of the med cart.So what's the problem here? If I take the equipment to the bedside I have to lay out a clean field on the over bed table (a paper towel per our policy )and then wipe down the unit first with an alcohol wipe and then the bleach wipe. BUT THE UNIT NEVER TOUCHES THE RESIDENT. I can see using th bleach if you have visible blood on the unit but shouldn't alcohol be sufficient between each poke in this case?

[pielęgniarka, RN]

I know ........ argh yes we were cited for this. Thing is, next year the DOH will find something else to nitpick and won't even care about the glucometers. We also had to revise our policy. Alcohol doesn't kill everything so the wipe must contain something else, I think benz chloride. The manufactorer said it dries in 2 min so that is our policy. Wipe down, dry on paper towel, use for next res. Think of the superbugs we are breeding! But if it helps our residents stay healthy I'm all for it. Really... Why stop with glucometers? Why aren't we disinfecting all the other stuff after each use that we bring into different resident's room like BP cuffs, tymp. thermometers, stethoscopes, hoyer lifts, transfer belts etc!

[nursinger]

It's getting crazier by the day! Thank God we haven't heard anything about this, but I'm sure it's not far off into the future. I don't know about you all, but the chlorine is killing me! Between houskeeping using bleach for everything and nursing wiping everything down with wipes containing chlorine so much is absorbed into your body. My eyes water and everything I eat or drink tastes like chlorine. I don't know if it's overkill or what, but I'm really concerned about longterm inhalation of chlorine fumes everyday on healthcare workers.

[NotFlo]

Yup, we have to wipe down between each patient now too. However, our policy is only that, to wipe it down between each patient. It says nothing about how long to wait for it to dry and be ready to use again, etc. So we'll probably get cited for something like not letting it dry for a full five minutes or some other crap anyway.

And it does blow my mind that they're going to focus on one item...the glucometers, and apparently no one is monitoring that all the other equipment that contacts patients is wiped between each one. BP cuffs...sure it would be great if each pt had their own but as it stands we have one for each cart and if we're really good at begging we get a separate one for precaution rooms. I don't even think wipes are effective on the velcro part of the cuff anyway. And the cloth gait belts that are issued to CNAs and PT/OTs...I don't think wiping down that cloth material sufficiently sanitizes them at all.

[Muffy5]

They didn't stop with glucometers for us! We have to disinfect everything, including lifts, BP cuffs, etc...We were only told 2 minutes to let it dry though. Everyone has their own glucometer now thank goodness, so a little less time consuming..

[pistolchick]

My current workplace has no policy about disinfecting between patients (scary)... my previous workplace had a wipe down/no waiting policy. The person who mentioned chlorine inhalation - I recently became concerned not about chlorine inhalation, but inhalation of crushed medications. I worked on a unit where about 20 people needed to have their medications crushed, and I could smell and taste it, even when strategically breathing out when pouring the crushed meds back into the med cup and holding it far away from me. I wonder how a study could be done to find the trace medications inhaled by nurses, especially in LTC.

[ktwlpn, LPN]

pistolchick said:

I wonder how a study could be done to find the trace medications inhaled by nurses, especially in LTC.

I have wondered about that,too. We'll probably get some funky superbug pneumonias in record numbers someday. Only then will anyone care. Our quality assurance nurse is a bit highstrung and she freaks out annually when the DOH is due. I have a pretty good routine going now. I grab my cart, do the finger sticks ,eye drops, inhalers,nasal sprays and early meds and then come back around and give the insulins ,then the g-tube meds. I figure I can get that all out of the way before a surveyor ever hits the floor. I actually have a more efficient pass that way and really can follow the proper protocol without cutting corners. During a mock survey recently a nurse dropped a pill on the floor,picked it up and BLEW ON IT then proceeded to administer it to the res. With co-workers like that my facility may be in trouble this year

[Jeni31]

Quote

I know ........ argh yes we were cited for this. Thing is next year the DOH will find something else to nitpick and won't even care about the glucometers. We also had to revise our policy. Alcohol doesn't kill everything so the wipe must contain something else, I think benz chloride. The manufactorer said it dries in 2 min so that is our policy. Wipe down, dry on paper towel, use for next res. Think of the superbugs we are breeding! But if it helps our residents stay healthy I'm all for it. Really... Why stop with glucometers? Why aren't we disinfecting all the other stuff after each use that we bring into different resident's room like BP cuffs, tymp. thermometers, stethoscopes, hoyer lifts, transfer belts etc!

The place that I work at we have sanitizer wipes that are pretty potent and we keep them in the med cart, and we have to wipe down everything as in blood pressure cufsf thermometers etc... its pretty handy but we are getting ready for the DOH but personaly I feel we should have been doing this since the begining

[Jeni31]

ktwlpn said:

I have wondered about that,too. We'll probably get some funky superbug pneumonias in record numbers someday. Only then will anyone care. Our quality assurance nurse is a bit highstrung and she freaks out annually when the DOH is due. I have a pretty good routine going now. I grab my cart, do the finger sticks ,eye drops, inhalers,nasal sprays and early meds and then come back around and give the insulins ,then the g-tube meds. I figure I can get that all out of the way before a surveyor ever hits the floor. I actually have a more efficient pass that way and really can follow the proper protocol without cutting corners. During a mock survey recently a nurse dropped a pill on the floor,picked it up and BLEW ON IT then proceeded to administer it to the res. With co-workers like that my facility may be in trouble this year

Thats gross! That person should have have used the spare!

[scoochy]

ktwlpn said:

I have wondered about that,too. We'll probably get some funky superbug pneumonias in record numbers someday. Only then will anyone care. Our quality assurance nurse is a bit highstrung and she freaks out annually when the DOH is due. I have a pretty good routine going now. I grab my cart, do the finger sticks ,eye drops, inhalers,nasal sprays and early meds and then come back around and give the insulins ,then the g-tube meds. I figure I can get that all out of the way before a surveyor ever hits the floor. I actually have a more efficient pass that way and really can follow the proper protocol without cutting corners. During a mock survey recently a nurse dropped a pill on the floor,picked it up and BLEW ON IT then proceeded to administer it to the res. With co-workers like that my facility may be in trouble this year

A nurse at the LTC where I am employed picked the med (a narcotic) off the floor and did the same thing; what's worse, she did it in the presence of a family member!! End result: bye, bye, nurse...she followed "the five second rule" in the wrong place, to say the least! Geishhhh, use your head for more than a hat rack!!

[kmarie724]

Muffy5 said:

They didn't stop with glucometers for us! We have to disinfect everything, including lifts, BP cuffs, etc...We were only told 2 minutes to let it dry though. Everyone has their own glucometer now thank goodness, so a little less time consuming..

Us too! Pretty soon we'll have to shower and change clothes in between every resident we come in contact with. We have 2 glucometers for each hallway now, so we can use one while the other is drying. I think it's crazy that they're so worried about the BP cuffs but things like doorknobs and hand rails aren't disenfected on any kind of regular schedule that I'm aware of. But I don't want to bring it up for fear that will be next!

[CapeCodMermaid, RN]

We just finished survey. Infection control wasn't even mentioned and I know they knew we used a glucometer because they were all over our sliding scale insulin documentation. We never use bleach in long term care here. I called the company that makes the glucometers and had them send me a sheet on the proper way to disinfect...NO alcohol on the machine. It ruins the sensor. I was ready but the DPH had other priorities.