Glucose Monitoring Procedure

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Considerations:

  • Provide the student with as much privacy as possible
  • Encourage the student to assist in the procedure as much as he/she is able to help student learn self-care skills
  • Ensure strips are contained in a tightly sealed container and show no signs of discoloration
    • Prolonged exposure of test strips to air may lead to inaccurate results
    • Discolored test strips should be discarded

Supplies:

  • Blood glucose monitor
  • Testing strips
  • Sterile disposable lancet
  • Automatic lancet or lancet pen
  • Cotton ball
  • Sharps container
  • Individualized Health Plan (IHP) and/or Healthcare provider’s order

skill competency procedure download

blood-glucose-monitoring
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  1. Position student to provide as much privacy as possible
  2. Explain the procedure to the student at his/her level of understanding
  3. Encourage the student to assist in the procedure as much as he/she is able to help student learn self-care skills
  4. Gather supplies and place on a clean surface
  5. Check expiration date on testing strips
  6. Ensure strips are contained in a tightly sealed container and show no signs of discoloration
    • Discolored test strips should be discarded
  7. Perform quality control on equipment per manufacturer’s instructions
    • Or verify that appropriate quality control has been completed
  8. Wash hands
  9. Put on gloves
  10. Have student wash hands or clean the student’s fingertip with warm wet cloth, let it dry
  11. Insert the monitor specific test strip into meter
    • Calibrate meter by matching test strip code to code on the meter (if required)
  12. Insert new lancet into lancing device (per lancet devise manufacturer’s instructions)
  13. Using lancing device on the side of student’s fingertip or other specified location (per meter specific or medical order), to get a drop of blood
    • Do not use pads of fingers
  14. Gently squeeze or massage finger until a drop of blood forms
  15. Touch and hold the edge of the test strip to the drop of blood, and wait for the result
  16. Blood glucose level will appear on the meter’s display
    • Meters do not only display numbers
    • Some display “Lo” or “Hi” for results outside of the meter’s parameters
    • Some display error messages
    • Consult with the meter manual to determine the meaning of messages
  17. Hold cotton ball on student’s finger until bleeding stops
  18. Place used lancet in sharps container
  19. Once blood glucose level was displayed, remove test strip and throw away per school policy
  20. Remove gloves
  21. Wash hands
  22. Document blood glucose reading in student’s healthcare record
  23. Follow health care provider’s orders for snacks, hyper or hypoglycemia, or insulin coverage
  24. Update parent’s and healthcare provider as needed

Resources:

2013 Consumer Guide: Continuous Glucose Monitors

American Diabetes Association (2013).  Diabetes Forecast: The Healthy Living Magazine.  Available at:http://forecast.diabetes.org/files/images/v66n01_p50-51_0.pdf

2013 Consumer Guide: Blood Glucose Meters

American Diabetes Association (2013).  Diabetes Forecast: The Healthy Living Magazine.  Available at:http://forecast.diabetes.org/files/images/v66n01_p41-47_1.pdf

2013 Consumer Guide: Insulin Pumps

American Diabetes Association (2013).  Diabetes Forecast: The Healthy Living Magazine.  Available at:http://forecast.diabetes.org/files/images/Jan13_pumps_2-27_spread.pdf

2013 Consumer Guide: Insulin Pens

American Diabetes Association (2013).  Diabetes Forecast: The Healthy Living Magazine.  Available at: http://forecast.diabetes.org/files/images/v66n01_p60_0.pdf

2013 Consumer Guide: Infusion sets

American Diabetes Association (2013).  Diabetes Forecast: The Healthy Living Magazine.  Available at: http://forecast.diabetes.org/files/images/v66n01_p56-57_0.pdf

American Diabetes Association: Webinar: Safe at School: Keeping Kids with Diabetes Safe at School
Video is geared toward parents of children with diabetes but provides a helpful perspective for the school nurse on the information that is being given to parents on how to work with the school staff to provide a safe environment for their child.

American Diabetes Association: Training Resources

National Diabetes Education Program: Diabetes in Children and Adolescents Webinar Presentation

National Diabetes Education Program: Helping the Student with Diabetes Succeed: A Guide for School Personnel

References:

American Diabetes Association.  (2013).  Checking Your Blood Glucose.  Available at: http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose-control/checking-your-blood-glucose.html.

Bowden, V. R., & Greenberg, C. S. (2012). Pediatric nursing procedures (Third Edition). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

Connecticut State Department of Education. (2012). Clinical Procedure Guidelines for Connecticut School Nurses. Available at:
http://www.sde.ct.gov/sde/lib/sde/pdf/publications/clinical_guidelines/clinical_guidelines.pdf

Acknowledgment of Reviewers:

Andrea Monicken, BSN, RN
Diabetes Educator
Aurora Healthcare