title: Evaluation of the potential for bloodborne pathogen transmission associated with diabetes care practices in nursing homes and assisted living facilities, Pinellas County.
abstract: OBJECTIVE
  To evaluate and characterize routine blood glucose monitoring practices in nursing homes and assisted living facilities (ALFs).
  
  
  METHODS
  Cross-sectional, self administered survey and facility site visit.
  
  
  METHODS
  Two hundred eighty-nine licensed long-term care facilities in Pinellas County, Florida.
  
  
  METHODS
  Stratified random sample of 48 long-term care facilities (17% overall sample).
  
  
  METHODS
  Data on facility characteristics, infection control policies, staff practices, and equipment used for blood glucose monitoring. Differences between facilities in each stratum were compared and evaluated using the Pearson chi-square or Fisher exact test.
  
  
  RESULTS
  Fifteen nursing homes and 17 small and 16 large ALFs participated; 53 declined (48% participation rate). Bloodborne pathogen training (P=.02), hepatitis B vaccination (P=.003), and blood glucose monitoring (P<.001) policies were reported less often at ALFs. Staff glove use during blood glucose monitoring was lowest (50%) at small ALFs (P=.02). Reusable fingerstick devices intended for personal use were most often in use at ALFs (P<.001); four of 18 facilities (including 1 nursing home) were inappropriately using them for multiple residents. At 22 facilities (including all nursing homes), multiple residents shared blood glucose meters; only six (27%) reported cleaning them after each use.
  
  
  CONCLUSIONS
  Despite existing recommendations, practices that facilitate bloodborne pathogen transmission during blood glucose monitoring were identified at nursing homes and ALFs. Infection control practices and policies were most often lacking at ALFs. Better training and oversight of blood glucose monitoring in long-term care is needed to prevent transmission of bloodborne pathogens.
authors.affiliation: Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. ndthompson@cdc.gov
authors.forename: Nicola D
authors.initials: ND
authors.lastname: Thompson
authors.forename: Vaughn
authors.initials: V
authors.lastname: Barry
authors.forename: Karen
authors.initials: K
authors.lastname: Alelis
authors.forename: Dongming
authors.initials: D
authors.lastname: Cui
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Perz
mesh_terms: D040561:Assisted Living Facilities; D016470:Bacteremia / Q000635:transmission*; D001786:Blood Glucose / Q000032:analysis*; D017848:Blood-Borne Pathogens / Q000302:isolation & purification*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000097:blood; D004784:Environmental Monitoring / Q000592:standards; D005431:Florida; D006801:Humans; D009735:Nursing Homes
chemical_list: D001786:Blood Glucose