Schools of Health and Allied Health Sciences

College of Nursing

CLINICAL PERFORMANCE EVALUATION CHECKLIST

Obtaining a Capillary Blood for Glucose Testing

Name: _________________________________ Group & Year: __________ Date: _______________

Inclusive Dates of RLE: ______________________________

Done Done Multiple

PROCEDURE Correctly with errors
with No Error Seen
Errors
ATTITUDE: 30% (15 POINTS) 3 2 1
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. Answers rationale questions readily.

TOTAL

KNOWLEDGE AND SKILLS: 70% (60 points)

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

Instructor’s comments:

__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________

Attitude: x .3 =

Knowledge and Skills: x .7 = __________

Prepared by:

Jessel C. Seboa, RN, MAN

MS LECTURER

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

MS LECTURER