Augmentation and Patient Dedication of Glucometer Inventory To Reduce Opportunities for Transmission of Infection in Hospital Settings

Background:

Blood borne pathogens have been transmitted between patients in health care settings by inadequate cleaning and disinfection of glucometers.  New glucometer technologies provide an electronic record of device use in addition to glucose measurements.

Objective:

To assess the impact and the cost of augmentation and dedication of glucometer inventory as strategies to reduce cleaning and disinfection responsibilities borne by clinical staff and to reduce opportunities for transmission of blood borne pathogen infection.

Methods:

Glucometer usage data were assessed before and after augmentation and targeted dedication of glucometer inventory in a 214 bed hospital that provides a full range of non-obstetrical adult medical and surgical care.  Costs for augmentation of glucometer inventory were collected. 

Results:

During October 2008, 11,665 tests were completed on 803 patients by 37 glucometers.  9310 (79.8%) tests were performed sequentially on different patients and of these, 9302 (99.9%) and 5664 (60.9%) were performed within 24 hours and 1 hour, respectively.  22 glucometers on three high use units accounted for 8295 (71%) of all tests.  Minimum time required to clean and disinfect the glucometers between use on different patients while following manufacturer’s instructions was 310 hours (1.94 FTE) across the hospital.  From October 28 through November 10, 2009, and following augmentation of glucometer inventory to 83 in the high use units so as to allow dedication of glucometers to patients during their stay on these units, sequential glucometer use between different patients within 24 hours was reduced by 96.2% on those units and by 58% for the hospital after adjustment for differences in lengths of measurement periods and despite a slight increase (1%) in rate of glucometer usage in 2009.  Cost for augmentation of the glucometer inventory was $48,400.     

Conclusions:

The magnitude of point of care glucose monitoring by glucometers and the responsibility placed upon clinical personnel to clean and disinfect glucometers between patient use in hospital settings are significant and revealed by new glucometer technologies.  Augmentation and patient dedication of glucometers in high use areas can reduce opportunities for transmission of blood borne pathogens, as well as common bacterial pathogens, at relatively low, single expenditures of financial resources, the benefits of which are sustained over time.  Further analysis of glucometer usage data on low use units to determine the incremental augmentation of inventory that would allow patient dedication of glucometers throughout the hospital is warranted.