RNs to do glucose checks on patients without DM

[sistrmoon, BSN, RN]

PCAs have done our fingersticks since I came to this hospital 6 years ago. Now they are saying that if a patient is critically ill(defined as a 1:1 ratio, doesn't apply to our floor) or the patient is having glucose checked without a diabetes diagnosis, the RN has to do the check. We are Onc so we do have people on steroids who get checked and people with enteral feeds get checked as part of the protocol. Any idea why this would be? We were just told it was a new state regulation.

[RNsRWe, ASN, RN]

What State...and what regulation? Board of Health? Board of Nursing...?

[sistrmoon, BSN, RN]

New York State. They didn't cite the specific regulation.

I'd rather do all or none myself. This sounds tedious.

[akulahawkRN, ADN, RN, EMT-P]

If someone is citing a "new regulation" then I want to KNOW what that new regulation is. I tend to be very wary of "new regulations" that can't be cited...

[sistrmoon, BSN, RN]

I just looked at the email. It states the FDA and NY State Dept of health have deemed the change necessary for patient safety. But they still don't say why.

[akulahawkRN, ADN, RN, EMT-P]

I can certainly understand the rationale... but if they've "deemed it" necessary for patient safety, they still need to have that published somewhere publicly for it to be a regulation. Otherwise it's an "underground" regulation.

[sistrmoon, BSN, RN]

I guess I still don't understand why the differentiation with diabetes. All my dangerously low fingersticks have been on diabetic patients.

[akulahawkRN, ADN, RN, EMT-P]

My experience has generally been similar, but I've also seen patients with dangerously low blood glucose levels that weren't. Those usually were EtOH users that forgot to eat...

[MunoRN, RN]

It would seem your facility has chosen a somewhat non-sensical response to this:

NY DOH: Off-label Use of Glucose Meters

I'm not sure what difference it makes to have only RN's do BG checks when glucometers are used 'off-label'.

[exp626]

It would seem your facility has chosen a somewhat non-sensical response to this: http://www.wadsworth.org/labcert/clep/files/Glucose_meters_off_label_use_1_13_14.pdf

I'm not sure what difference it makes to have only RN's do BG checks when glucometers are used 'off-label'.

I've read the statement linked above. Are you licensed by the NY Dept of Education? In my state, RN's by licensed by the Dept of Health.

Besides that, it's a crazy regulation. Among other confusions, I can see blood sugars getting missed under this new rule. I'd rather just do all of my own.

[blondy2061h, MSN, RN]

When does steroid induced hyperglycemia become steroid induced diabetes?

[MunoRN, RN]

I've read the statement linked above. Are you licensed by the NY Dept of Education? In my state, RN's by licensed by the Dept of Health.

Besides that, it's a crazy regulation. Among other confusions, I can see blood sugars getting missed under this new rule. I'd rather just do all of my own.

I'm not licensed by either but I am just as confused as you as to what the NY dept of Education has to do with any of this.

It all seems to have come about after the FDA pointed out that using glucometers for anything other than the "ongoing management of diabetes" is off label, which wouldn't really seem to matter since there is a long list of things we do that are "off-label". Labelled indications don't limit how a device, medication, etc can be used, it limits how it can be marketed, so I really have no idea how limiting glucometer use in critical care and on non-diabetics to only RN's has anything do with the FDA's statement.