Several warning alerts have been issued by the Centers for Disease Control and Prevention (CDC) regarding unsafe practices by healthcare staff conducting or assisting individuals with blood glucose monitoring and insulin administration. These safety issues place those staff members at risk for transmission of bloodborne viruses (such as the hepatitis B and C viruses or HIV).
The Joint Commission has found that there are knowledge gaps among providers and/or organizational leaders that have resulted in unsafe practices and subsequent escalation to an Immediate Threat to Health or Safety. The Joint Commission has several standards that relate to this issue:
· Human Resources (HR) Standard HR.01.05.03: Staff participate in ongoing education and training.
· Element of Performance (EP) 1: Staff participate in ongoing education and training to maintain or increase their competency and, as needed, when staff responsibilities change. Staff participation is documented.
· HR.01.06.01: Staff are competent to perform their responsibilities.
· EP 5: Staff competence is initially assessed and documented as part of orientation.
· Infection Prevention and Control (IC) Standard IC.02.01.01: The hospital implements its infection prevention and control plan.
· EP 2: The hospital uses standard precautions, including the use of personal protective equipment, to reduce the risk of infection.
· IC.02.02.01: The hospital reduces the risk of infections associated with medical equipment, devices, and supplies.
· EP 1: The hospital implements infection prevention and control activities when doing the following: Cleaning and performing low-level disinfection of medical equipment, devices, and supplies.
· Leadership (LD) Standard LD.04.01.07: The hospital has policies and procedures that guide and support patient care, treatment, and services.
· EP 1: Leaders review, approve, and manage the implementation of policies and procedures that guide and support patient care, treatment, and services.
· Waived Testing (WT) Standard WT.03.01.01: Staff and licensed independent practitioners performing waived tests are competent.
· EP 4: Staff and licensed independent practitioners who perform waived testing that requires the use of an instrument have been trained on its use and maintenance. The training on the use and maintenance of an instrument for waived testing is documented.
To assist organizations in learning how to decrease infection control risks and ensure compliance with these standards when assisting with glucose monitoring and insulin administration, The Joint Commission has released an informational video. The “Consistent Interpretation” section of the May 2021 issue of Perspectives also details helpful information on compliance with these standards.
In “Focusing on Infection Control Risks: Glucose Monitoring and Insulin Administration,” Sylvia Garcia-Houchins, RN, MBA, CIC, Director, Infection Prevention and Control, The Joint Commission, examines some of the more common mistakes witnessed by The Joint Commission when staff perform glucose monitoring using shared blood glucose devices, insulin pens and other medication cartridges, which create a risk of spreading bloodborne viruses. She also explains how failure to follow manufacturer instructions for use, which are designed to protect patients from these risks, could be scored on survey.
