The Centers for Medicare and Medicaid Services recently released a survey memorandum regarding point of care testing in nursing homes. Specifically, the memorandum addresses the practice of using a blood glucose meter or other point of care device for more than one resident. Such devices must be properly cleaned and disinfected after use with each resident. Finger stick devices may not be used for more than one resident. Improper or non-cleaning of point of care devices such as blood glucose meters and using a finger stick device for more than one resident are deficient infection control practices. The CMS memo clarifies that if a surveyor observes a facility reusing finger stick devices or using blood glucose meters for different residents ,without cleaning and disinfecting them, the facility is deficient in infection control and the surveyor should follow the interpretive guidelines, investigative protocol, and severity determination information to determine the severity of the deficiency.
CMS will be revising the example related to the use of blood glucose meters in Appendix PP to the State Operations Manual to state the following:
An example of a negative outcome that occurred or has the potential to occur at Severity Level 4 as a result of the facility’s deficient practices may include:
The facility failed to follow Standard Precautions during the performance of routine testing of blood glucose. The facility reused fingerstick devices for more than one resident. This practice of re-using fingerstick devices for more than one resident created an Immediate Jeopardy to resident health by potentially exposing residents who required blood glucose testing to the spread of bloodborne infections in the facility.
The websites for the Food and Drug Administration and Centers for Disease Control also contain additional information regarding the recommended use of point of care devices.
