U-500 Insulin

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Karin Terry
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Joined: 02/02/2009 - 08:13
U-500 Insulin

I am sure you all groaned when you saw the subject line!

I would love to hear some advice on how to handle U-500 insulin patients who insist on using their own insulin in the hospital.

Background: We do not carry U-500 insulin. The only time that we will handle it per policy is to get a refill for those patient's whose pumps use U-500. Then we get one vial from our outpatient pharmacy, fill the pump, and get rid of the vial.
We have a few U-500 patients who refuse to use our U-100 insulin and insist on using their own during admission. I am curious as to how others have (or would) handle this. We have done an informal FMEA to find the failure modes of different solutions, and given the high risk nature of this drug, none of them feel great.
Possible solutions:
-Keep U-500 insulin in pharmacy and have each dose drawn up in a syringe by pharmacy
-Keep U-500 on the floor where the patient is so that bedside barcoding of vial can occur. Biggest question here is how to draw it up. TB syringe? U-100 syringe? 1ml slip tip?
-Take a hard line approach and not allow the patient to use their home med at all during admission

Any insight from you all would be much appreciated!

Thanks,
Karin