we're (halic university school of nursing, in turkey) planning a research about the differences between checking blood glucose level techniques. we wonder that which techniques do you use in clinics?
- which solution do you use to clean the area? (alcohol, iodine etc.)
- do you check the first blood sample or do you clean the first sample and take the second? or do you want your patient to clean his/her hand?
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.
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.
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.
I ask the patient to wash their hands if they are close to a sink.
Choose a finger and use an alcohol swab to wipe the finger that is going to be used.
Allow the alcohol to air dry while getting the glucometer ready.
Bend the finger slightly while squeezing and lancet the finger.
Use a 2 X 2 gauze to wipe off the first drop of blood which removes any excess alcohol.
Use the second drop of blood for the sample, putting the strip in the glucometer ASAP.
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.)
I'm sure on how to post a question and I ran across this questions so I will just post mine here.
At the nursing home where I work the nurses check the patient's cbgs and give them their insulin in the dining room while they eating. In school we were always taught to take our cbgs before meals and never do anything invasive in the dining area. I'm not comprehending this. If they have already started eating wouldn't their cbg level be high by the time they got their insulin. Someone please explain this to me. I am a new grad and I feel like what I learned in school is totally opposite of what I do and see at the nursing home.
go with what you have been taught, that is one thing that was drummed into our heads from day one, and to NEVER pick up bad habits from other nurses. You are absolutely right in what you have said and bgl's are supposed to be done before meals NOT during.
the things that i have witnessed on placement and the way i was treated for doing things the way i was taught almost turned me off being a nurse!
talaxandra
3,037 Posts
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.