more on glucose monitoring

[debRN0417]

Blood Glucose Monitoring Practices - Recent Published Alerts from CDC and FDA

The Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) released alerts in late August and early October in response to an increase in the number of reported outbreaks of hepatitis B transmission associated with blood glucose monitoring. The announcement is intended to inform healthcare providers of the risks associated with using shared blood glucose monitoring equipment and reinforce current recommended practices.

Long-term care facilities, where multiple persons receive assistance with blood glucose monitoring, have been identified as settings in which sharing of reusable lancets is commonly practiced. However, these devices may also be shared in other settings such as hospitals, residential care facilities, clinics, health fairs, shelters, schools, senior centers, detention centers, and camps. Although reusable devices are readily available, they are difficult to clean and disinfect appropriately. Therefore, they should only be used by individuals who perform self-monitoring of blood glucose and be limited only to the use of one person per device.

In summary:

Fingerstick devices should never be used for more than one person.

Auto-disabling single-use devices, also known as disposable lancets, should be used for assisted monitoring of blood glucose levels.

[Sun0408, ASN, RN]

Wow, I thought that was common sense. All facilities I have ever been in have single us disposable lancets.

[Forever Sunshine, ASN, RN]

We use the single use safety lancets( purple ones). I have no issue with them. A couple of times we've had these purple and white lancets that the residents didn't feel and it got a good drop of blood.

We were out of safety lancets for a bit and they gave us these little lancets to use. The kind you get at CVS. They hurt the patients and one resident refused her finger sticks if she saw us coming with one of those wretched things.

We had the multiuse lancet once but I didn't like the idea of it. So I found a fresh one and used it for the resident that refused to let us use the CVS lancets

I got tired of using those so I bought a box of one time safety lancets from amazon and I keep it in my car just in case I go into work and they are out of the lancets I like.

[Butterfliesnroses]

We only have the one time use lancets...I can't imagine using a multiple use lancet! Talk about SCARY! The nursing home I did clinical in have multi-use lancets (but we didn't use them on multiple ppl or even on the same person more than once). The only thing we used them for was poking the liquid doss to drain in for ppl w/crushed meds. The nursing home I work in now has crushable doss.

[Talino]

The findings were not attributed to the type of lancets used alone ...

Unsafe practices during assisted monitoring of blood glucose and insulin administration that have contributed to transmission of HBV or have put persons at risk for infection include:

• Using fingerstick devices for more than one person
  
• Using a blood glucose meter for more than one person without cleaning and disinfecting it in between uses
  
• Using insulin pens for more than one person
  
• Failing to change gloves and perform hand hygiene between fingerstick procedures
  

CDC - Blood Glucose Monitoring - Injection Safety

[tyvin, BSN, RN]

I can't believe there are actually lancets that indicate reusable. I have never seen anyone do it or even suggest such a thing. Where is this coming from?

[merlee]

I personally reuse my lancets, frequently using one for 3-4 sticks. But it is my personal device for my use only. I can't imagine using anything but disposables in a facility.

[simboka]

Our hospital just told us we have to start wiping down our glucometers between patients, it's a pain in the butt when you have 10 min before shift change and three sticks to get. But if there's that serious of a risk...

[country mom]

I can't believe there are actually lancets that indicate reusable. I have never seen anyone do it or even suggest such a thing. Where is this coming from?

It is not the lancet itself that is at issue here in regards to being reused, it is the lancing device. It has been the practice of some that a new lancet is loaded into a lancing device that is used on multiple people. The end cap can become contaminated, causing an infection control problem, even if the lancet is new.

[classicdame, MSN, EdD]

Don't forget, if you fail to clean the equipment you are exposing YOURSELF to disease.

[debRN0417]

It is not the lancet itself that is at issue here in regards to being reused, it is the lancing device. It has been the practice of some that a new lancet is loaded into a lancing device that is used on multiple people. The end cap can become contaminated, causing an infection control problem, even if the lancet is new.

you're correct. They are referencing the "pens" that can be reloaded with the lancets.

[tyvin, BSN, RN]

It is not the lancet itself that is at issue here in regards to being reused, it is the lancing device. It has been the practice of some that a new lancet is loaded into a lancing device that is used on multiple people. The end cap can become contaminated, causing an infection control problem, even if the lancet is new.

Thanks for clearing that up for me. I was really horrified when I thought it related to the actual lancet. I had visions of people wiping off the blood to do the next person; yuck........

Over here in Hawaii where ever I've worked that has always been the procedure; one stick tool per lancet;