Table 2.

Recommended Practices for Preventing Bloodborne Pathogen Transmission during Blood Glucose Monitoring and Insulin Administration in Health Care Settings¹⁵

BLOOD GLUCOSE MONITORING

Finger-stick devices

• Restrict use of finger-stick devices to individual persons. They should never be used for more than one person. Select single-use lancets that permanently retract upon puncture. This adds an extra layer of safety for the patient and the provider.

• Dispose of used lancets at the point of use in an approved sharps container. Never reuse lancets.

Blood glucose meters

• Whenever possible, blood glucose meters should be assigned to an individual person and not be shared.

• If blood glucose meters must be shared, the device should be cleaned and disinfected after every use, per manufacturer's instructions, to prevent carry-over of blood and infectious agents. If the manufacturer does not specify how the device should be cleaned and disinfected, then it should not be shared.

GENERAL

• Unused supplies and medications should be maintained in clean areas separate from used supplies and equipment (e.g., glucose meters). Do not carry supplies and medications in pockets.

INSULIN ADMINISTRATION

• Insulin pens should be assigned to individual persons and labeled appropriately. They should never be used for more than one person.

• Multiple-dose vials of insulin should be dedicated to a single person whenever possible.

≫ If the vial must be used for more than one person, it should be stored and prepared in a dedicated medication preparation area outside of the patient care environment and away from potentially contaminated equipment.

≫ Medication vials should always be entered with a new needle and new syringe.

• Dispose of used injection equipment at point of use in an approved sharps container. Never reuse needles or syringes.

HAND HYGIENE (hand washing with soap and water or use of an alcohol-based hand rub)

• Wear gloves during blood glucose monitoring and during any other procedure that involves potential exposure to blood or body fluids.

• Change gloves between patient contacts. Change gloves that have touched potentially blood-contaminated objects or finger-stick wounds before touching clean surfaces. Discard gloves in appropriate receptacles.

• Perform hand hygiene immediately after removal of gloves and before touching other medical supplies intended for use on other persons.

TRAINING AND OVERSIGHT

• Review regularly individual schedules for persons requiring assistance with blood glucose monitoring and/or insulin administration.

• Provide a full HBV vaccination series to all previously unvaccinated staff persons whose activities involve contact with blood or body fluids.

• Establish responsibility for oversight of infection control activities. Provide staff members who assume responsibilities for finger sticks and injections with infection control training.

• Assess adherence to infection control recommendations for blood glucose monitoring and insulin administration by periodically observing staff who perform or assist with these procedures and tracking use of supplies.

• Report to public health authorities any suspected instances of a newly acquired bloodborne infection, such as HBV, in a patient, facility resident, or staff member.

• Check with state authorities for specific state and federal regulations regarding laboratory testing.