glucose monitoring, own finger

Question 1

what equipment to take?

Answer 1

a. Blood glucose monitor
b. Blood glucose strips (check expiry)
c. Lancet
d. Non-sterile gloves only if you are not performing this skill on yourself
e. 1 alcohol swab (check expiry)
f. Sharps bin
g. 2 pieces of gauze – one to wipe away first drop of blood, one to wipe away the second drop of blood
h. Plaster – open the plaster for easy access later.
i. Blood glucose recording chart

Question 2

how do you approach the patient?

Answer 2

3. Introduce yourself to patient, tell them you are going to demonstrate how to do a capillary blood glucose monitoring, obtain patient consent, then get patient’s full name and NRIC.
4. Tell them it is best to perform blood glucose measurement before meals as after meals, your blood glucose will naturally go up and be higher than normal.
5. Name and explain each equipment to them.
   a. Set the depth of the lancet to the shallowest while explaining to them.
6. Check the expiry date of the blood glucose strips

Question 3

How do you measure the blood glucose level?

Answer 3

7. Turn the blood glucose monitor on.
8. Insert one of the strips with electrodes facing up.
9. For the red-colour blood glucose monitor: Ensure code that appears on the monitor corresponds to the one written on the container.
10. Meter will beep and a blood droplet will start flashing on the screen to show that the monitor is ready for use.
11. Wear non-sterile gloves at this point if you are not performing this skill on yourself.
12. Check the expiry date of the alcohol swabs. Clean the side of the 3rd or 4th finger of non-dominant hand using alcohol swab, explaining that those are the areas of the fingers you use the least.
13. Wait for alcohol on finger to dry before pricking.
14. Ensure that the depth on the lancet is set to the shallowest. Remove the protective cover on lancet.
15. Place the lancet perpendicular to the skin surface and perform puncture by pressing lancet FIRMLY against skin. Discard lancet into sharps bin immediately or you will fail. Tell patient they can use a metal tin at home.
16. “Milk” the finger downwards to get 1st drop of blood out.
17. Use gauze to wipe away 1st drop of blood, explaining that it probably has alcohol in it.
18. “Milk” the finger downwards to get 2nd drop of blood out.
19. Take the blood glucose monitor and place the inserted strip perpendicular/90-degrees on the 2nd blood drop.
    a. Blood will be sucked into the yellow capillary tip of strip.
    b. Explain that yellow tip of the strip should be covered with blood completely.
    c. Meter will beep and an hourglass will appear, meaning it is processing the result.
20. Meanwhile, apply pressure to puncture site using 2nd piece of gauze.
21. Apply plaster to puncture site.
22. When result is out, remove and discard the blood glucose strip.
23. Discard of all other waste.

Question 4

How to remove PPE (if you doing on others?)

Answer 4

24. Remove non-sterile gloves using aseptic technique – outside of glove can only touch outside of other glove. Pinch wrist part of 1st glove and pull it down, turning 1st glove inside-out along the way to trap any pathogens. Ball up 1st glove in 2nd-gloved hand. Use exposed finger to insert under the cuff of 2nd glove and pull down to remove 2nd glove inside-out. Discard both gloves.
25. Hand rub

Question 5

What do you do after removing PPE?

Answer 5

25. Hand rub
26. Record the blood glucose reading in the chart. Normal fasting blood glucose: 4.0-6.0mmol/L.
27. If reading is too high or too low, patient should visit the nearest doctor as soon as possible.
28. Keep the blood glucose monitor in its carrier when not in use, away from heat and direct sunlight.
29. Thank the patient.