P&P for Capillary Sticks - Waste the first drop or Not?
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I recently was approached by the diabetic educator regarding Inform ll procedure for finger sticks. She told me that the new protocol (study in hospitals have shown) for capillary collection is "use the first drop" no need to waste a drop prior to collecting the specimen for testing. I reviewed my P&P and the manufactures information packet and we (POCT) support the waste the first drop due to the risk of no alcohol residue, contamination, no interstitial fluid contamination, etc. Standard Laboratory procedure, EBP and Best Practice. Has anyone come across this issue/concern and what does CAP, TJC or your State DOH view this?
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See the attached WHO article I have found very helpful and instructful.
I have found most clinicians are wary about contaminating these fingerstick samples with interstitial fluids so milking the finger and wiping the first drop away are essential to ensure a more pure and consistently accurate sample.
That I am aware of, neither inpatient nor outpatient educators have questioned 'wipe the first drop' in our SOP. We have TJC for WT and I'd be greatly surprised if 'wipe the first drop or not' would come up during a survey. The surveyors would expect that we do what we have in the SOP.
Good question!
Our NYS inspectors have actually gone to the floors and observed the nurses doing finger sticks, and seeing if they follow our SOP. Believe it or not, some have gone rouge on us and will do things the way they want to and an inspector actually observed them not following our procedures. Want to see some managers go nuts have that happen. First thing they did was come to me and say why did they do this were they not trained properly, pull out there sheets with the Quiz on it and show that they know and now they are on the hook.
Long story but wanted to show just because it is part of the SOP, doesn't always mean that they follow it
dave