nurse's aides doing accuchecks

[panurse101]

I am wondering what everyone else is doing in their ltc facility. We used to educate our cna's and supervise them doing accuchecks. Recently however, this has become an issue at our facility with the staff. What is correct? Where do I find an answer? I am from Pa. What are the rest of you doing?

thank you, Tracy

[anndoodle]

I can see two sides to this: first, if I'm the one giving the insulin, you better believe I'm going to be the one to check that sugar for the sliding scale. When I worked LTC, many diabetics got their morning insulin depending on their sliding scale results. Secondly, many diabetics who are non-insulin dependant still get accuchecks every other morning/twice a week/ or weekly. I can see the CNA doing these, as there isn't a dependant insulin dosage resulting. I have no problem with CNA's being trained as med-techs, provided they are educated properly and are held accountable for their med errors, and not the nurse. Like it was mentioned before about the "nurse aware" of accucheck results when the cna didn't even tell the nurse....that's all too common. Where I used to work, we had one lpn who was fired partly because she had the habit of writing her accucheck results in the MAR, but the accucheck results never showed up in the memory on the accucheck machines. What does that tell you? I wouldn't be too sure that same woman would take the time to change the "sharp" in the accucheck pen she used, either. Really makes you wonder just how many corners some nurses cut....

[NancyJo]

I agree, it depends on whether you have reliable staff. Our CNA's do the accuchecks, they record the number on a dry erase board and call me with any high or low values immediately, I happen to think we have exceptional CNA's on our floor. I do however take time to check behind when I have pulled help or someone I am unfamiliar with. At our hospital all of our CNA's attend mandatory inservices twice a year that discuss technique, glucose values and the importance of reporting abnormal results immediately. Alot of times I think they do there part in a more timely manner that some of the licensed staff they are reporting to.

[NeuroICURN]

At my hospital (in Pgh. PA) in an intensive care unit, our NAs do our accuchecks. No problem at all with it.

[panurse101]

I appreciate everyone opinion and advice.. I did recieve two seperate emails from pa dept of health.. both emails stated that in ltc the cna's cannot do accuchecks on the residents. It is an invasive procedure. So, that ended my option of training them. Thank you

[PHTLS]

I appreciate everyone opinion and advice.. I did recieve two seperate emails from pa dept of health.. both emails stated that in ltc the cna's cannot do accuchecks on the residents. It is an invasive procedure. So, that ended my option of training them. Thank you

Cool.

When I was a CNA, you could trust me...well, because I was good :rotfl:

[Antikigirl, ASN, RN]

IN my facility only nurses can, but I find it kind of funny since I work in assisted living and CNA's and unlicensed care staff can administer medications (they are delegated). Seems odd, but most of my CBG's need insulin, and that they can not administer.

I know, this assisted living thing is very odd...I to this day am still very nervous about them giving meds! But since they will do it despite me being there or not...I just try to educate them all as much as I can...they are very good at it so far, very cautious, always ask the nurse if they are concerned with anything! That is very helpful!

[Antikigirl, ASN, RN]

IN my facility only nurses can, but I find it kind of funny since I work in assisted living and CNA's and unlicensed care staff can administer medications (they are delegated). Seems odd, but most of my CBG's need insulin, and that they can not administer.

I know, this assisted living thing is very odd...I to this day am still very nervous about them giving meds! But since they will do it despite me being there or not...I just try to educate them all as much as I can...they are very good at it so far, very cautious, always ask the nurse if they are concerned with anything! That is very helpful!