Calls to Limit Fingerstick Devices to Just One Patient

The U.S. Centers for Disease Control and Prevention (CDC; Atlanta, GA, USA) and the U.S. Food and Drug Administration (FDA, Silver Spring, MD, USA) recommend that fingerstick devices should never be used with more than one person. Similar guidance was issued for point-of-care (POC) blood-testing devices such as glucometers, and for instruments used for insulin administration.

The new recommendation applies to fingerstick devices that are approved for obtaining blood from multiple individuals, in settings that range from public health fairs, medical facilities, and up to physician offices; the problem is most serious in long-term care and assisted-living facilities. According to the two U.S. federal agencies, the shared use of blood lancing and POC testing devices among different people has led to a steady rise in reports of bloodborne-pathogen infections--mostly involving hepatitis B virus--during the past 10 to 15 years.

In addition to stipulating a rule of one fingerstick device for one person, the FDA and CDC recommend that when clinicians obtain blood samples to monitor blood glucose levels, they should rely on fingerstick devices that automatically disable themselves after a single use, such as those with retractable blades. If it is not possible to dedicate a POC testing device to a single patient, clinicians should properly clean and disinfect the device between every use, as described in the product label.

The same concerns about preventing the spread of bloodborne pathogens were extended to insulin administration. Insulin pens, which contain several doses of insulin that patients can administer to themselves, should never be shared; when clinicians assign them to patients, the devices should be labeled for single-patient use. Additionally, whenever possible, multidose vials of insulin should be limited to a single person. If not possible, the vials should be stored and prepared in a dedicated area, away from the patient care environment and potentially contaminated equipment. Insulin should always be administered with a new needle and syringe, which likewise should never be used to administer insulin to more than one person, and then disposed of immediately after use in an approved sharps container.

Related Links:
Centers for Disease Control and Prevention
Food and Drug Administration