| Infection Control in Long-Term Care February 2010 -- New Emphasis on Glucometer Cleaning / Disinfection During Nursing Facility SurveysLong-term care facilities recently have been cited for inadequately cleaning or disinfecting glucometers used by multiple residents. In addition to outlining how/where glucometers are mentioned in the new infection control guidelines at F-Tag 441 of the CMS State Operations Manual, ASCP has also researched individual glucometer manufacturers' cleaning recommendations, along with the Centers for Disease Control and Prevention (CDC), Environmental Protection Agency (EPA) and American Diabetes Association (ADA) guidelines on this matter. This information should be helpful when developing or assuring the adequacy of your facility’s or facilities’ policies and procedures. Download the ASCP's glucometer cleaning summary document (PDF) here.Be familiar with which glucometer manufacturer(s) your facility(ies) use(s) and the cleaning procedures recommended by that manufacturer(s). If the manufacturer does not provide specific cleaning recommendations or as a conservative approach to infection control for glucometers with minimal cleaning requirements, facilities might want to consider cleaning glucometers with high-level disinfectants. Be familiar with the amount of time the disinfectant solution is supposed to contact the equipment or how long active cleaning should be performed to ensure complete disinfection. For example, simply wiping equipment with a disinfectant-soaked swab may not be adequate. Wiping for a specific length of time or ensuring the equipment is “wet” or saturated for a specific length of time may be required. Cleaning time frames may be dictated by CDC guidelines or by the disinfectant manufacturer in their “instructions for use.” CMS State Operations Manual for Nursing FacilitiesOn July 20, 2009, the Centers for Medicare & Medicaid Services updated the State Operations Manual to strengthen provisions relating to infection control. Download the CMS memorandum (PDF) here. Included in this memorandum is this paragraph:"Because of increases in MDROs, review of the use of antibiotics (including comparing prescribed antibiotics with available susceptibility reports) is a vital aspect of the infection prevention and control program. It is the physician’s (or other appropriate authorized practitioner’s) responsibility to prescribe appropriate antibiotics and to establish the indication for use of specific medications. As part of the medication regimen review, the consultant pharmacist can assist with the oversight by identifying antibiotics prescribed for resistant organisms or for situations with questionable indications, and reporting such findings to the director of nursing and the attending physician." The consultant pharmacist has an important role in assisting nursing facilities with infection control issues, and a variety of resources and links are provided below to assist in this responsibility. Centers for Disease Control and Prevention (CDC)
Association for Professionals in Infection Control and Epidemiology (APIC)The Society for Healthcare Epidemiology of AmericaInfluenza and Immunization Resources |
