Infection Prevention in Point of Care Testing

Point of Care Testing (POCT) Diagnostic testing at or near the site of patient care Uses portable handheld devices In facility setting, devices used for multiple patients Glucose testing most common

Infection Control Concerns Shared POCT devices are a potential vehicle for transmission of blood-borne pathogens, such as Hepatitis B Some outbreaks of Hepatitis B in healthcare settings tied to lapses in standard precautions when glucometers and lancing devices were used for multiple patients

Evaluate Equipment Review POCT equipment such as lancing devices and glucometers to determine if equipment is designed for: –Single-use (disposable) –Health care professional use, intended for multiple patients –Patient self-testing, intended for use by one patient Equipment designed for patient self-testing should not be employed for facility POCT

Hand Hygiene and Gloves Wear gloves during fingerstick blood glucose monitoring Change gloves that have touched potentially blood-contaminated objects or fingerstick wounds before touching clean surfaces. Remove and discard gloves after every patient Perform hand hygiene immediately after the removal of gloves

Lancing Devices Disposable single-use lancing device: –Discard entire device after one and only one use Multiple use-capable lancing devices: –Both FDA and CDC recommend multiple use- capable lancing devices be labeled for use only on a single patient

Glucometer Shared glucometer is a potential vehicle for HBV transmission Meter manufacturer must indicate that use on more than one patient is permissible Meter must be cleaned and disinfected after each and every use

Insulin Pens Risk of transmission of blood-borne pathogens from shared use FDA: insulin pens and insulin cartridges are never to be shared among patients Even if needles are changed between patients, any blood contamination of the pen reservoir could result in transmission of already existing blood-borne pathogens from the previous user

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