While each facility and each at home patient will have their own brand of glucometer, most are pretty similar. The big thing is to have the correct test strips for each machine.
Many hospitals have glucometers that automatically chart the results electronically, while Skilled Nursing Facilities (SNF) and at home patients must document manually.
Many facilities still have cleaning the finger with alcohol as part of the procedure . This is really unnecessary when taking a CBG (Capillary Blood Glucose) but many nurses feel it’s easier to open an alcohol wipe than to ask the patient to wash their hands if dirty. The only thing alcohol in that small amount does is to de-fat the finger of natural oils and makes the stick hurt just a little more.
All that is needed is a finger that is clean.
If you DO use alcohol, make sure that the finger is completely dry before obtaining the blood sample. No, don’t blow on the finger, let it air dry for a few seconds. Taking a sample with a finger damp with alcohol can give inaccurate results.
Make sure the finger is warm. If cool, you will have a harder time getting a sufficient amount of blood.
You can have the patient hang their arm down to assist in blood flow.
You can “milk” the finger from knuckle to fingertip to push the blood to the end. Don’t just keep squeezing the fingertip.
Excessive squeezing and pinching of the finger can lead to an inaccurate reading.
If someone is on an anticoagulant (blood thinner) you may get quite the surprise when to stick the patient with the lancet and squeeze the finger. You may end up having blood squirt out so be gentle at first.
Measure blood glucose first thing in the morning before the patient eats or drinks anything.. Taking before meals and bedtime before administering insulin is also normal procedure.
Normal range is 70-130.
Depending on the machine, periodic calibration of the results using the included high or low control fluids ensure you are still getting accurate results. Usually on the bottle of each control it will tell you what results you should expect. Anything not within the range given means to stop using the machine and call the manufacturer for guidance.
Some machines are geared to take samples from alternate sites from the fingers.
Medications such as antibiotics and steroids such as prednisone will raise glucose levels and make it very difficult to bring the levels under control. That is why many times people admitted to the hospital end up on insulin while an inpatient but do not need it once returning home.
If patients are on diabetic medication due to these high blood sugars, watch carefully once they complete their treatment that the glucose levels don’t drop too low. Their diabetic medication may need to be reduced or discontinued by the physician.
Usual reporting parameters are to call the physician if CBG (Capillary Blood Glucose) is above 400. Insulin is held and the physician called if less than 70.