Diabetes Care Raises Alarm

[Guest guest]

CDC 01-06-11

NORTH CAROLINA: " Diabetes Care Raises Alarm "

News and Observer (Raleigh NC) (12.26.10):: Goldsmith

In 2010, a hepatitis B outbreak at Glen Care Mount Olive assisted-living

facility in Wayne County resulted in six fatalities. State investigators found

poorly trained staff and unsafe diabetes care were to blame. But experts say

that rather than being a one-off event, the situation at Glen Care is likely to

be repeated in the coming years.

State and federal law dictates that only trained professionals, like registered

and licensed practical nurses, can administer insulin at nursing homes, whose

residents typically need advanced care. But guidelines are more lenient in

state-overseen assisted-living facilities. There, unlicensed medical

technicians, who may only have received one-on-one training from a nurse, can

take blood glucose samples and inject insulin.

" We know that the majority of staff in assisted-living are paraprofessionals

that don't have a degree in health care, " said CDC epidemiologist Nicola

. " With more people with diabetes and more people in long-term care, the

situation is unlikely to get any better. "

While assisted-living centers are more affordable than nursing homes because

their primary services are non-medical, " The reality is that there are more

people in assisted-living with major health care needs, " said Polly ,

former executive director of the state Board of Nursing and current CEO of the

Foundation for Nursing Excellence.

The state Division of Public Health's investigation reported that at Glen Care,

the infected patients' caregivers had not taken a state-approved infection

control course, and no staff member was tasked with coordinating infection

control. Glenn Kornegay, the facility's administrator, disputes the state's

conclusions and maintains the infections could have originated elsewhere.

In the 1990s, the state Board of Nursing proposed uniform standards for medical

technicians. " We had hoped that this would be a requirement across all settings

where medications were given, " said. However, " In the political process,

it was only passed in connection with nursing homes. "

As part of national health care reform legislation, the state Department of

Health and Human Services is receiving more than $578,000 in federal funds to

improve training, create career paths and develop certification for

personal-care aides.