Pharmacy-prepared insulin doses

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Fri, 09/13/2019 - 14:53
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Julie Botsford
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Joined: 08/07/2009 - 10:54
Pharmacy-prepared insulin doses

For those that are drawing up patient-specific doses, how do you handle larger doses (80-100 units or more):
-Do you split into separate syringes? (this can get complicated for dosing and administration with the EHR)
-Send a vial and have the nurse draw up?
-Any other ideas?

Our practice is to prepare all Lantus doses under 80 units. If a dose is larger than that, we send a vial. For other long acting insulins we send a vial or a pen, depending on the insulin.

We recently had an error on our maternity unit where a nurse mis-read the NPH vial label and used a non-insulin syringe to administer. She misread the concentration as 100 units per 3 mL, and gave 1.8 mL (180 units); intended dose was 60 units. We are now considering adding NPH to our list of insulins that we prepare in the pharmacy.
Thanks in advance for your insights!
Julie

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