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.

[alexis_xoxo]

At our facility, CNA's can do blood sugars. I started my first CNA job at a hospital yesterday and the CNA who trained me was VERY knowledgeable with blood sugars among alot of other things. I see no problem with it.

[JDZ344]

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?

In my place, that would get the aide into trouble, although the nurse would also be in trouble, because they are meant to check the paper charts every 2 hours and initial to acknowledge they have noted the vitals.

[JDZ344]

In my hospital, it depends what ward I work on, most places the nurses do them before they give the insulin, only on one is it 100% the assistants job.

[CrazyGoonRN]

Our UAPs were not allowed to do them when I worked in the hospital, either. It was RNs only. Honestly, our UAPs were known to make up blood pressures and temps or to ignore severely out of range vitals (like a temp of 39.2 C in an Onc patient) and not chart them for hours. We wouldn't have been able to trust them to do fingersticks.

RN's only? Were LPN's not allowed? Or were there just not any LPN's at your hospital?

[sapphire18]

Every place I've worked, the techs/aides did the blood sugars. Labs, too.

[KelRN215, BSN, RN]

RN's only? Were LPN's not allowed? Or were there just not any LPN's at your hospital?

Not one single LPN employed in any capacity in the entire hospital.

[HeartNursing3]

But the glucometer automatically uploads to the patient chart so it's not like the PCA can chart it wrong or tell the nurse wrong.... it's glucometer to chart. I don't see how this creates an issue? However, I always insist on doing the carb counts myself.

[KelRN215, BSN, RN]

But the glucometer automatically uploads to the patient chart so it's not like the PCA can chart it wrong or tell the nurse wrong.... it's glucometer to chart. I don't see how this creates an issue? However, I always insist on doing the carb counts myself.

Not all computer systems do this. Ours didn't.

[SoldierNurse22, BSN, RN]

But the glucometer automatically uploads to the patient chart so it's not like the PCA can chart it wrong or tell the nurse wrong.... it's glucometer to chart. I don't see how this creates an issue? However, I always insist on doing the carb counts myself.

The issue may be quality of collection. If you wipe a patient's finger, stick and collect a sample before allowing the alcohol to dry, the alcohol can cause a false low reading.

[thenightnurse456]

I don't live in a futuristic world where the glucometer charts for me! Sign me up sounds awesome.

[BWright81188]

The issue may be quality of collection. If you wipe a patient's finger, stick and collect a sample before allowing the alcohol to dry, the alcohol can cause a false low reading.

This should be avoided by wiping the first drop of blood before taking a sample. At least that is a pertinent step we are taught to take. Is this not universal?

[BWright81188]

The issue may be quality of collection. If you wipe a patient's finger, stick and collect a sample before allowing the alcohol to dry, the alcohol can cause a false low reading.

Oh wait I see your point regarding the automatic upload of the results. Another possibility might be if one doesn't clean the surface of the finger in the first place, the results are skewed!

These are certainly all possibilities, which is why I believe they require so many inservice hours/mandatory CE classes on how to properly take finger stick BGs and other POCs at my hospital. But a nurse could just as well make these mistakes too. I'm still not in favor of only allowing nurses to do these.