Nursing Procedure Checklist

COLLECTING PERIPHERAL BLOOD FOR GLUCOSE TESTING

Instruction: Check under Correctly Done if identified skill is correctly performed; Incorrectly Done if
skill is not performed correctly; and Not Done if the student failed to perform the skill.
Correctly Incorrectly Not Done
Procedure Done Done
1. Review the physician’s or qualified practitioner’s order
for glucose monitoring
2. Identify which type of equipment is available at your
facility.
3. Identify the patient and explain the procedure.
4. Perform hand hygiene.
5. Assemble all equipment at the bedside.
•Reagent strips/HGT strips
•Lancet or automatic lancing device
•Alcohol wipes/cotton balls with alcohol
•Dry cotton balls
•Disposable gloves
•Glucometer/Blood Glucose Meter
6. Have client wash hands with soap and water or
disinfect selected puncture site with a cotton ball with
alcohol.
7. Position client comfortably.
8. Remove reagent strip from the container and insert it
into the glucometer with the test pad facing up.
9. Apply disposable gloves.
10. Select appropriate puncture site and disinfect it with a
cotton ball with alcohol.
11. Perform skin puncture with a lancet or an automatic
lancing device.
12. Wipe away the first drop of blood from the site using
a dry cotton ball.
13. Gently squeeze the site to produce a large droplet of
blood.
14. Transfer the drop of blood to the reagent strip making
it sure that the droplet should transfer without smearing.
15. Apply pressure to the puncture site while waiting for
the glucometer timer to stop.
16. Read the meter for the result found on the unit
display.
17. Turn meter off and dispose of test strip, cotton balls,
and lancet properly.
18 Remove disposable gloves and place them in
appropriate receptacle.
19. Perform hand hygiene.
20. Document and notify the physician or qualified
practitioner of the result.

Comment: _________________________________________________________________________

Score: _______

Name of Student: Date Performed:

(Signature Over Printed Name)

Evaluated by: Date of Evaluation:

Nursing Procedure Checklist

(Signature Over Printed Name)