Blood Sugar Testing 

Purpose: 

To accurately measure blood glucose levels per physician’s order and ensure timely intervention when a resident experiences a change of condition. 

Policy: 

Blood glucose levels are measured per physician’s order and may be performed by a licensed nurse when a resident experiences a change of condition. Manufacturer’s instructions are followed for the type of equipment being used. Glucometers are cleaned between resident uses as per infection control policy. 

Procedure: 

7. Preparation: 

• Ensure the glucometer is accurately calibrated. 

• Turn on the glucometer and insert a correctly calibrated strip. 

8. Testing: 

• Swab the resident’s finger to be used for puncture with an antiseptic pad. 

• Puncture the finger with a lancet and place the droplet of blood onto the glucometer strip. 

• Wait for the allotted time until the result appears on the screen. 

9. Recording and Follow-up: 

• Record the blood glucose value on the Medication Administration Kardex and/or nurse’s note. 

• Follow the physician’s orders for insulin administration. 

• Notify the physician for any abnormal results if no insulin is ordered. 

10. Post-Procedure: 

• Clean the glucometer as per the infection control policy. 

• Document any actions taken in response to the blood glucose reading, including any notifications to the physician and administration of insulin or other medications. 

Compliance and Documentation: 

• Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

• Ensure all procedures and results are documented accurately in the resident’s medical record. 

• Regularly review and update techniques for blood sugar testing according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on proper blood glucose testing procedures to ensure accuracy and resident safety. 

• Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

• Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

• CMS Requirements of Participation for Nursing Homes.