Southwestern University

College of Nursing
Villa Aznar, Urgello St., 6000 Cebu City
Telefax No. (032) 418-72-78 Email Add: [email protected]

CLINICAL PERFORMANCE EVALUATION CHECKLIST

Obtaining a Capillary Blood Sample for Glucose Testing

Name: _________________________________ Group & Year: __________ Date: _______________

Inclusive Dates of RLE: ______________________________ Clinical Area: _____________________

Done Done Not

PROCEDURE and but not Done
Correct Correc
t
ATTITUDE: 30% ( 10 POINTS ) 2 1 0
1. Displays readiness in performing the procedure.
2. Accepts criticisms by showing effort to correct mistakes.
3. Shows enthusiasm and interest in performing and learning pertinent
points related to the procedure.
4. Shows professionalism, reliability, and confidence in performing the
procedure.
5. Answer rationale questions readily.

TOTAL

KNOWLEDGE AND SKILLS: 70% ( 40 points )

1. Check the patient’s medical record or nursing plan of care for monitoring
schedule.
2. Gather equipment.
3. Close curtains around the bed or close the door to the room if possible.
4. Identify the patient. Explain the procedure and instruct the patient
about the need for monitoring blood glucose.
5. Perform hand hygiene. Put on non-sterile gloves.
6. Prepare a lancet using aseptic technique.
7. Remove the test strip from the vial. Recap container immediately. Test
strips also come individually wrapped.
8. Turn the monitor on. Check that the code number for the strip matches
the code number on the monitor screen.
9. Insert strip into the meter according to the directions for that specific
device.
10. For adults, massage the side of the finger toward the puncture site.
11. Have the patient wash hands with soap and warm water and dry
thoroughly. Alternatively, the skin may be cleansed with an alcohol swab.
Allow the skin to dry completely.
12. Hold the lancet perpendicular to the skin and pierce the site with a
lancet.
13. Wipe away the first drop of blood with gauze square or dry cotton ball
if recommended by the manufacturer of the monitor.
14. Encourage bleeding by lowering your hand, making use of gravity.
Lightly stroke the finger, if necessary, until a sufficient amount of blood
has formed to cover the sample area on the strip, based on monitor
requirements ( check instructions for monitor ). Take care not to
squeeze the finger, not to squeeze at the puncture site, or not to touch the
puncture site or blood.
15. Gently touch a drop of blood to pad on the test strip without smearing
it.
16. Apply pressure to the puncture site with a dry cotton ball.
17. Read blood glucose level and inform patients of test results.
18. Document appropriately at bedside.
19. Turn the meter off, remove the test strip, and dispose of supplies
appropriately. Place the lancet in a sharps container.
20. Remove gloves and perform hand hygiene.
TOTAL

Instructor’s comments:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

Attitude: x .3 =

Knowledge and Skills: x .7 = __________

________________________________________
Signature over Printed Name of Student

________________________________________
Signature over Printed Name of Clinical Instructor

Prepared by:

MAHLOU S. VILLAFLOR, MAN., RN.

Level 3 RLE Coordinator

Noted by:

JILL MARIE CABRERA HERMOGINES

Assistant Dean

Approved by:

Michelle B. Yu, RN, DM

Dean
 Southwestern University
College of Nursing
Villa Aznar, Urgello St., 6000 Cebu City
Telefax No. (032) 418-72-78 Email Add: [email protected]

OBTAINING A CAPILLARY BLOOD SAMPLE FOR GLUCOSE TESTING

Blood glucose monitoring provides information about how the body is controlling glucose
metabolism. Controlling patient’s blood glucose levels reduces complications, saves lives, shortens
hospital stays, and reduces healthcare costs ( Levetan, 2005 ). It is indicated in the care of patients
with many conditions, including diabetes, seizures, enteral and parenteral feeding, liver disease,
pancreatitis, head injury, stroke, alcohol and drug intoxication, and sepsis. Point-of-care testing
( testing done at the bedside, where samples are not sent to the laboratory ) provides a convenient,
rapid, and accurate measurement of blood glucose ( Ferguson, 2005 ). Blood samples are commonly
obtained from the edges of the fingers for adults, but samples can be obtained from the earlobe,
forearm, and anterior thigh, depending on the monitor used. Avoid fingertips, because they are more
sensitive. Rotate sites to prevent skin damage. It is important to be familiar with and follow the
manufacturer’s guidelines and facility policy and procedure to ensure accurate results. Normal fasting
glucose is 60-110 mg/dl ( Levetan, 2005 ).

Equipment:
● blood glucose meter ( glucometer )

● sterile lancet

● testing strips for meter

● cotton balls or gauze squares

● alcohol swabs or soap and water

● non-sterile gloves

Assessment:
Assess the patient’s history for indications necessitating the monitoring of blood glucose
levels, such as high-carbohydrate feedings, history of diabetes mellitus, or corticosteroid therapy. In
addition, assess the patient’s knowledge about monitoring blood glucose. Assess the area of the skin to
be used for testing. Avoid bruised and open areas.

PROCEDURE RATIONALE
1. Check the patient’s medical record or nursing plan This confirms scheduled times for checking
of care for monitoring schedule. glucose.
2. Gather equipment. This provides an organized approach to the task.
3. Close curtains around bed or close door to room if Provides patient privacy.
possible.
4. Identify the patient. Explain the procedure and Ensures the right patient receives the
instruct patient about the need for monitoring blood intervention and helps prevent errors.
glucose. Explanation helps to alleviate anxiety and
facilitate cooperation.
5. Perform hand hygiene. Put on non-sterile gloves. Reduces the spread of microorganisms. Gloves
protect the nurse from exposure to blood or
bloody fluids.
6. Prepare lancet using aseptic technique. Aseptic technique maintains sterility.
7. Remove test strip from the vial. Recap container Immediately recapping protects strips from
immediately. Test strips also come individually exposure to humidity, light, and discoloration.
wrapped.
8. Turn monitor on. Check that code number for the Allows monitor to be used. Matching code
strip matches code number on monitor screen. numbers on the strip and glucose monitor
ensures that the machine is calibrated correctly.
9. Insert strip into the meter according to the Correctly inserted strip allows meter to read
directions for that specific device. blood glucose level accurately.
10. For adult, massage side of finger toward puncture Encourages blood flow to the area.
site.
11. Have patient wash hands with soap and warm Cleanses puncture site. Warm water also helps to
water and dry thoroughly. Alternately, the skin cause vasodilation. Alcohol can interfere with
maybe cleansed with an alcohol swab. Allow skin to accuracy of results if not completely dried.
dry completely.
12. Hold lancet perpendicular to skin and pierce site Proper position facilitates proper skin
with lancet. penetration.
13. Wipe away first drop of blood with gauze square Manufacturers recommend discarding the first
or dry cotton ball if recommended by manufacturer of drop of blood, which may be contaminated by
monitor. serum or cleansing product, producing an
inaccurate reading.
14. Encourage bleeding by lowering hand, making
use of gravity. Lightly stroke the finger, if necessary,
until sufficient amount of blood has formed to cover An appropriate-sized droplet facilitates test
the sample area on the strip, based on monitor results. Squeezing can cause injury to the
requirements ( check instructions for monitor ). patient and alter the test result.
Take care not to squeeze the finger, not to squeeze
at punctured site, or not to touch punctured site or
blood.
15. Gently touch drop of blood to pad on test strip Smearing blood on strip may result in inaccurate
without smearing it. test result.
16. Apply pressure to punctured site with a dry cotton Pressing causes hemostasis. Alcohol stings and
ball. may prolong bleeding.
17. Read blood glucose level and inform patient of Patient has the right to know the accurate result.
test result.
18. Turn meter off, remove test strip, and dispose Proper disposal prevents exposure to blood and
supplies appropriately. Place lancet in sharps accidental needle sticks.
container.
19. Remove gloves and perform hand hygiene. Prevents the spread of microorganisms.
20. Document appropriately. Proper documentation for legal purposes.

Evaluation
The expected outcome is met when the patient’s blood glucose level is measured accurately
without adverse effect; the blood glucose level is within acceptable limits; the patient participates in
monitoring; and the patient verbalizes comfort with the procedure.

Documentation
Document blood glucose level in medical record flow sheet, according to facility policy.
Document pertinent patient assessments, any intervention related to glucose level, and any patient
teaching. Report abnormal results and/or significant assessments to primary healthcare provider.

Unexpected Situations and Associated Interventions

● Extremity is pale and cool to touch: Begin by warming the extremity. Have adult
patients warm their hands by rubbing them together. Warm moist compress also may
be used.
● Blood glucose level results are above or below normal parameters: Assess the
patient for signs of hypoglycemia or hyperglycemia. Check medical record for ordered
interventions, such as insulin dosage or carbohydrate administration. Notify
healthcare provider of results and assessment.

Prepared by:

Jessel C. Seboa, RN, MAN

Level III Clinical Instructor
NCM 103 Final Term Lecturer

Noted by:

Jill Marie C. Hermogenes, RN, MAN, EdD

Level III Chairman

Isabelita N. Pandaan, RN, MAN

Supervising Instructor

Approved by:
Belinda R. Rosales, RN, MAN, EdD
Acting Dean