Alcohol wipes vs. hand washing for glucose testing on glucometer
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Currently we use alcohol wipes for cleaning the puncture site before glucose testing on our patients. Our Director received an email from someone up the corporate ladder with research she found concerning alcohol wipes usage for patients that had recently touched fruit vs. patients that touched fruit and washed their hands. Is this even a thing? How do other facilities handle this? What form of cleaning of puncture site does your facility do before fingerstick testing?
Thank you for any input!
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Here is the study:
http://care.diabetesjournals.org/content/34/3/596
So do you have your operators ask if patient has recently handled fruit and then wash with soap and water or do you have operators clean with alcohol swab and thoroughly dry before all glucose testing?
We use alcohol wipes. We have not had any problems with discrepant results
But I heard and read about patients with high glucose because of the powdered sugar or fruit juice in their hands.
Alcohol wipe does not clean powdered sugar from donuts off fingers or fruit juice.
Alcohol does not dissolve the sugar.
Ask the patient to wash their hands with soap and water and repeat test.
If it is a fasting sugar and result of glucose is higher than expected,
you might want to ask the patient if they ate something with sugar, fruit or anything sweet.
Hand washing vs. alcohol for finger stick glucose is on my radar as well. Thank you, Silka for the ADA article and Pet for weighing in on this issue. In a hospital setting, however, hand washing isn't practical and not efficient work flow. I would expect greater errors, due to fingers not getting completely dry prior to the lance.
I have seen this occur, where an elevated sugar was due to fruit and the repeat after hand washing was normal. So, I am going to incorporate the info regarding fruit contamination and hyperglycemia into my training classes.
What steps do you all plan on taking?
Thanks
Penny, we are currently having them wash the finger, that's because the educator before set it up that way. She found in the manufacture recommendations and in the nursing book (Mosby) that they recommend this. Can it be trying, by all means, but there are sinks in nearly every room in our facility, and most will take a damp 2x2 with light soap and use this. Also as part of the training that is done the nurses are informed that if they do not believe a result that they should repeat, when they do repeat they document this.
The place where there was the most discrepancies was in the nursing home when the residents would grab hard candy and then handle the candy before the finger stick, or touch anything else that had a glucose base to it
dave
Dave,
Thanks for that info. Our nurses also use Mosby's, so I will go review that info.
We have found that even hand lotion with sugar in it used by the RNs can leave a residue on the finger that will inaccurately elevate the POCT glucose.
We teach to either have the patient wash their hands or if alcohol wipes are used, that the finger is cleaned by swiping at least 5 times and allowed to dry before
the fingerstick.