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Beware diabetics in hospitals and other healthcare settings

It never ceases to amaze me how very often just common sense seems to elude many in healthcare and the danger some of them pose to  us.

Will


http://www.medscape.com/viewarticle/758772

. Insulin pens are designed to be used multiple times, for a single person, using a new needle for each injection. Increasingly, insulin pens are being used by healthcare personnel to administer insulin to patients in hospitals and other healthcare settings. However, some providers seem to have a dangerous misperception about insulin pens: They believe that because the pen may be used multiple times, for a single person, it is acceptable to use the same pen for multiple patients as long as the needle is changed. This is completely untrue.

If you reuse a pen on another patient, you may be injecting another patient's blood in addition to insulin. Studies have shown that both blood and skin cells can reflux back into cartridges as insulin is administered. Using the same insulin pen for more than 1 patient is equivalent to using the same syringe to administer medication to multiple patients. Providers need to understand that these practices can expose their patients to bloodborne pathogens, including hepatitis viruses and HIV. Changing the needle on the insulin pen or syringe does not make it safe for reuse on additional patients.

Despite numerous warnings, CDC continues to receive reports of insulin pen sharing. We know of instances in which providers were aware that they were sharing pens but did not understand the risks this posed to patients. In other instances, sharing of pens was accidental. Either way, this is an unacceptable and risky practice.

The following infection-control recommendations should be reviewed by all providers to ensure that they are not placing themselves or persons in their care at risk

.As is true with syringes, using insulin pens for more than 1 person poses unacceptable risks and should be considered a "never event." Don't do it.




8 Responses
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148588 tn?1465778809
http://todayhealth.today.msnbc.msn.com/_news/2012/02/22/10471434-today-investigates-dirty-surgical-instruments-a-problem-in-the-or

"The departments responsible for cleaning and reassembling surgical instruments -- usually known as “sterile processing” -- are frequently found in hospital basements and sometimes staffed by underpaid hourly laborers. These workers can be a forgotten and neglected part of the team involved in a surgical procedure. As the CPI report indicates, the sterilization workers say they feel more like they’re doing an unrecognized service, with pressure from nurses and surgical staff to make the process as fast as possible. The faster the instruments make it into the operating rooms, the more patients are moving through the surgical suites. But what may seem like a push for efficiency can backfire, with disastrous consequences.
New Jersey is the only state that requires hospital sterilization workers to undergo training.
Sharon Greene-Golden, head of “sterile processing” at Bon Secours Mary Immaculate Hospital in Virginia, points out that this is a job that must be done by skilled and certified technicians.  She thinks of her team as the unseen patient advocates and says, “It is a job that cannot be given to robots because the robot doesn’t have the critical thinking to say this is still dirty.”
Helpful - 0
1815939 tn?1377991799
Thanks for posting that Will.

It is my opinion that there is a very good chance that a large number of the 40% who have no idea where they contracted Hepatitis C contracted it through unsterile, improperly cleaned, and/or shared medical/dental/acupuncture/ supplies or equipment. I have seen too many health care personnel do things that could and most surely have spread infectious and blood born diseases.

Sad, but true.  
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Avatar universal
For crying out loud
Helpful - 0
Avatar universal
OMG! This is unthinkable.
Helpful - 0
1765684 tn?1333819168
I had an upper endoscopy for an esophagus issue a couple of months after being diagnosed with HCV.   Having T1 diabetes and refusing to take off my insulin pump for 12 hours before the procedure (not sure what their thinking was there), they tested my blood sugar with their meter.

I don't know how old this thing was but it was the size of a cinder block and required about 30 times more blood than my meter does.

But the time she was finished, my blood was all over the darned thing.  She was pretty careless about squirting my blood everywhere and I was pretty shocked.
Helpful - 0
683664 tn?1330966324
Agree with Pooh.  Yes, pretty soon they are going to start putting 2 and 2 together.  Why do we have this silent epidemic of hep C?
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1815939 tn?1377991799
Yes, those glucose meters that go from patient to patient are filthy and surely harbor all sorts of bacteria and viruses in all of those little crevices.

And don't forget the lancet pen holding the lancet (reused and reused and reused for years). The lancet is changed, but not the pen that holds it.

My history as an RN is over 20 years in critical care, then 3 years in ER, then 11 years in the SF City and County Jail Medical Services (clinic). I had been accustomed to fairly good infection control practices, at least the rules and guidelines were faiely good, not that everyone followed them. In 2002 I started a new job after moving to a new city. It was in a county jail in a city of 100,000. We had about 250 inmates. I was shocked. I thought I had just stepped out of the 21st century and back into 19th century. I simply could not believe what I was seeing. Not only that, poor infection control practices were sanctioned by the supervising nurse in charge. Here is one example: When a diabetic was admitted (incarcerated) his insulin type and dose was verified and a bottle of insulin was (usually) ordered from the pharmacy. Then a packet was put together containing containing the bottle of insulin, the lancets, the lancet pen, and the glucose meter. The glucose meter and the lancet pen were not new. They had been used many times and "cleaned" in between inmates by the medical assistant. This equipment was sent to the jail housing unit in which the patient was housed and stored on the medication cart. The jail custody staff passed the medications. For the insulin, the inmate used the diabetic equipment including drawing up his/her own insulin and administering it. Okay, first I never felt the equipment (glucometer and lancet) was really cleaned well between patients. Second, and this was the real shocker, when I started to work there the nurses (and the nurse supervisor) were taking the partially used insulin vials which had belonged to released inmates (vials which the inmates had been using themselves) and wiping them down with alcohol wipes. Keep in mind, the inmates had checked their own glucose via fingersticks and then with sometimes (often) bloody fingers held the vial and drew up their insulin. This was done multiple times by the inmate depending on how long they stayed. Often there was blood on the outside of the vial and on the rubber top (through which the needle passed). So the nurses wiped them down with alcohol and then put them in a package for the next inmate. I was shocked.Just for the record,  I never did it, and I talked to the other nurses (there were only 3 of us) about it and one stopped doing it. She knew better but was afraid to confront the supervisor. The other nurse and the med. assistant reported me to the supervisor for throwing away (perfectly good) insulin that could be reused (what was left in the vial). The supervisor respected me so she did not say much, just that we were supposed to reuse them, but she never actually enforced it after I confronted her about the infection control issue. It did not take long before that practice ceased entirely. These were all RNs, so these nurses should have known better. That is only one example.  I have also witnessed the MD director of an ER put a disposable piece of cauterizing equipment back in a cupboard for reuse with zero cleaning in between. He even said, this is supposed to be one time use, but that is wasteful. So it is not all the low paid poorly trained staff contributing to the spread of diseases. Some of the better educated medical personnel are doing the same.  

I can tell you, I really hate the thought of being admitted to a hospital. Scares me to death.
Helpful - 0
1765684 tn?1333819168
I work with those 'in conflict with the law' and know of one inmate who gave himself a 'little extra' insulin...  To enjoy a little fresh air on his trip to the hospital...

I *know* that my own lancet pen has had blood on it.  Wow, that's truly scary.  :(
Helpful - 0
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