Blood Glucose Monitoring Update for ALF Providers

The Department of Social Services' Division of Licensing continues to identify infection control breaches during blood glucose monitoring while performing inspections.   When this occurs, DSS must contact the Healthcare Acquired Infection team within the Virginia Department of Health for assessment, guidance and training and possible testing of residents and staff.  This process can be emotionally distressing for all involved and can result in extra expense for the resident and potentially the facility, in addition to the risk of infection from exposure to disease.  The following guidance is issued in a continuing effort to improve practices to protect vulnerable residents and staff in facilities.  To ensure immediate compliance with these practices, if you have not already done so, the facility's infection control policies and procedures should be updated to incorporate these guidelines.  Inspectors will be citing violations identified during inspections for non-compliance in any of these areas beginning January 1, 2015.

  •  To ensure that everyone is clear on current acceptable practice, we are re-issuing the guidance from the CDC.  In summary, the only time multiuse fingerstick devices may be used is if the resident is totally independent in all aspects of BGM and no assistance is provided by staff.   In all other situations single use, auto-retractable disposable finger stick devices must be used.  The current CDC recommendations were incorporated verbatim into the registered medication aide curriculum in May 2013.
  • Any multi-use finger stick device (penlet) used by independent residents should be clearly labeled with the resident’s name.  All glucometers in the facility should be labeled with resident names in addition to the name labels on the outside of the kits.  In other words, each piece of resident equipment including the storage case must be labeled with a resident name.
  • “Whenever possible, blood glucose meters should not be shared.  If they must be shared, the device should be cleaned and disinfected after every use, per manufacturer’s instructions.  If the manufacturer does not specify how the device should be cleaned and disinfected then it should not be shared.”  (Copied from http://www.cdc.gov/injectionsafety/blood-glucose-monitoring.html  10/10/14)  It is important to note that soap and water do not disinfect; either an approved EPA disinfectant or a 1:10 bleach solution prepared daily may be used to disinfect glucometers.  Additionally, OSHA regulations require employers to have a bloodborne pathogen exposure control plan (all ALFs fall under this federal regulation) which includes safety controls for equipment such as needles and sharps.  Every ALF administrator should review this regulation to ensure current compliance.  OSHA regulations and related material can be found on the government website by clicking here.   

The original CDC guidance and information for obtaining single use, auto-retractable disposable fingerstick devices for Medicaid recipients and residents with other insurance are attached.  Please contact your inspector or the DSS medical health consultants for any questions and concerns you might have.