No more glucose checks by CNAs/PCTs

[Paws2people]

Let me start off by saying I live in NY. My hospital just told everyone that CNA's/PCT's can no longer do fingersticks. They say that it came from the Board of Health rather than the hospital itself. They didn't explain why it is being enforced, so I was wondering if anyone had any insight as to the reasoning. I asked management, but they themselves didn't know. Thanks to anyone who can shed some light.

[turnforthenurse, MSN, NP]

UAPs are able to able to check FSBG in all of the places I have been.

[Caffeine_IV]

PCTs can do the fingersticks at my current employer but at a previous hospital, they could not. It has been helpful to me when I have 2 or 3 diabetic patients. That said, we rarely have a PCT so I'm used to doing my own.

Along with that I do my own vitals 98% of the time and I try to time it close the med admin time.

[Nurse Kyles, BSN, RN]

At my place of work, we scan the patient's wristband and when we dock the blood sugar, it automatically loads up into the patient's lab values.

This is how it works at my hospital. The aids do the blood sugars most of the time. We use the Precision XceedPro. We always treat blood glucose based on POC glucose listed in the labs in EMR.

[angelabLPN]

I worked in Fla as a CNA and now an LPN, At the local area hospitals the CNAs could take the blood sugars as long as they had the training through the hospital, but in the local area nursing homes, NO CNAs were allowed to do finger sticks at all and it was the same for all of them in my county that I am aware of :)

[mmc51264, BSN, MSN, RN]

Here we have two levels of aides. I was a CNAII which means I took an extra skills course, and was checked off on fingersticks, inserting and removing Foley catheters, removing PIV, PEG tube feeding (established) and basic trach care (again, established) with no deep suctioning. In some of the the EDs, we have aides that insert PIV and draw labs. I do my own FBS if aide is busy and I want to get one before breakfast and I will do Bps if giving BP meds.

Most of the skills I learned as a CNAII were the same that were learned in nursing school other than inserting PIVs.

Where I work, aides do the FSBS and the IIs can remove PIVs. We remove Foleys. Our aides are great there and are pretty insightful, but there are some things that I just like doing to make sure pt is ok.

Other than a timing issue, and the fact that they are certified to take blood sugars, I don't understand not letting them do the sticks makes sense

[cassie77775]

Our NA's aren't able to do them either. For us, it's similar as mentioned, they can't interpret it and since the nurse is dosing insulin, the nurse has to do it. We have to do them very infrequently so it's not an issue for us.

[RunnerRN2015, ASN, RN]

I'm an aide, and I think that is just stupid. At my place of work, we scan the patient's wristband and when we dock the blood sugar, it automatically loads up into the patient's lab values. We immediately inform the nurse of blood sugars and if it is low, unless the patient is NPO, we are allowed to give them something.

By that same logic, aides shouldn't be allowed to do any vitals either. More work for the nurses!

Same here. I let the RN know what the BS is so she can plan accordingly. When I dock the accucheck it automatically uploads the info.

[martymoose, BSN, RN]

We have to do them very infrequently so it's not an issue for us.

Gee you're lucky- sometimes my whole assignment is all diabetics- 6 pts x 3 fsbg in 12 hour shift- no wonder I never get anything done.......

[thenightnurse456]

Where I'm from our aides don't take VS or finger sticks. I don't know if I would feel comfortable giving someone medication/insulin based on a number someone else got.

Out of curiosity; what happens when an aide doesn't tell you something eg: a low BP or a low sugar and a patient has a negative outcome? Does it all fall back on the RN for not checking the aides work? Would the aide get any disciplinary action?

[BWright81188]

I'm an ER tech in CA and we do check BGs, creats, hematocrits, PT INRs, Na, K, and a few others via finger sticks. The only Point Of Care test that we never do via finger stick is Lactic Acid (we use the blood drawn by the nurses/phlebotomists). If we get a critical result, blood must be drawn and sent to lab (which is 9/10 times done anyway) to confirm the critical result. The nice thing about these tests is we can get the results in less than 3 minutes instead of waiting on lab to call in the results. We have to do classes twice a year on how to perform these tests, which are a waste of my time since I do a POC/BG test at least a dozen times a night, but I understand why it's necessary. Despite these classes, the nurses very rarely do these tests. In fact, I just had to teach a nurse how to do one of the POC tests! The nurses just don't do them often enough, I guess. It would be a real inconvenience to our nurses if the hospital took this ability from the techs, and as a tech I'd probably feel a bit degraded. Checking BGs is one of the simplest skills to learn, IMO.

[Guest219794]

I was told it was because nurses are basing insulin dosing on this , so UP cant do the fsbgs. We've had to do our own bgs for a few years nowIt stinks, esp. when every one of your pt';s is diabetic.

But if one's using that same reasoning, I guess we shouldn't be basing b/p meds on vs obtained by UP also.

Obviously there was some big mistakes made re" insulin.hence the nurse only checking and dual sign offs.

Faulty logic here. How is a UAP cna/tech or what have you any different from a phlebotomist? Though phlebotomy lisences are required in some states, in most cases they are certified. I think.

[cassie77775]

Gee you're lucky- sometimes my whole assignment is all diabetics- 6 pts x 3 fsbg in 12 hour shift- no wonder I never get anything done.......

Yea I work mother baby so we do a baby when it is first admitted and more if necessary and only on moms that are ordered which is rare :)