Infection Prevention and Control Guidelines for Blood Glucose Monitoring in Care Homes

Routine diabetes care involves monitoring blood glucose levels by taking a sample of capillary blood with a fingerprick lancing device and testing it with a glucometer. Outbreaks of hepatitis B in care homes have been attributed to confusion between different types of lancing devices, the inappropriate and incorrect use of lancing devices, and to poor infection prevention and control practices (for example inadequate cleaning of glucometers, vials or surfaces and inadequate hand hygiene). Investigation of such incidents indicate that standard infection control precautions and recommendations regarding the correct type of lancing device may not have been followed. The Medicines and Healthcare products Regulatory Agency (MHRA) has issued guidelines which highlight the risks associated with the inappropriate use of lancing devices. Information on general infection prevention and control in care homes is already available but the following is more detailed guidance on techniques to minimise cross infection associated with diabetes care. The guidance here is based on that published by the US Centers for Disease Control and Prevention.