Preventing Bloodborne Pathogen Transmission: Recommended Practices during Blood Glucose Screening for Healthcare Workers

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Preventing Bloodborne Pathogen Transmission: Recommended Practices during Blood Glucose Screening for Healthcare Workers (PDF)

The Problem

CDC and FDA have noted a progressive increase in the reports of bloodborne infection transmission over the past 10 to 15 years (primarily hepatitis B virus), resulting from the shared use of finger stick and point of care blood testing devices. The infections occur in a variety of health care settings.

The following recommendations apply to any setting where finger stick procedures are performed and/or insulin is administered, including assisted living or residential care facilities, clinics, health fairs, shelters, detention facilities, schools, work sites, and camps. Protection from bloodborne viruses and other infections is a basic requirement and expectation anywhere health care is provided.

Four Requirements to Ensure Safe Practices during Blood Glucose Screening

1. Finger stick devices should never be used for more than one person, even if lancets are changed and attempts are made to clean and disinfect the device. If these devices are reused, it should only be by the same individual for self-screening of blood glucose.
2. Blood glucose meters should be assigned to an individual person and not be shared, whenever possible. If blood glucose meters must be shared, the device must be cleaned and disinfected after every use, per the manufacturer's instructions. If the manufacturer does not specify how the device should be cleaned and disinfected, then it should never be shared.
3. Insulin pens and other medication cartridges and syringes are for single patient-use only and should never be used for more than one person, even if needles are changed and attempts are made to clean and disinfect the device.
4. Perform hand hygiene before blood glucose screening and wear gloves during blood glucose screening; remove gloves and perform hand hygiene after each patient contact.

Insulin Pens and Other Injection Equipment

• Insulin pens that contain more than one dose of insulin are only meant for one person. They should never be used for more than one person, even when the needle is changed.
• Needles, syringes, and insulin vials are approved for single-patient-use only and should never be used for more than one person.

Gloves and Hand Hygiene

• Always wear disposable gloves when assisting with blood glucose screening and during any other procedure that involves potential exposure to blood or body fluids.
• Change gloves between patient contacts. Immediately change gloves that have touched potentially blood-contaminated objects or finger stick wounds before touching clean surfaces. Discard gloves in regular trash.
• Perform hand hygiene (wash hands with soap and water or use an alcohol-based hand rub) before patient contact and before putting on gloves for patient contact, and immediately after removing gloves and before touching other surfaces or medical supplies intended for use on other persons.