Inpatient Insulin Dispensing Survey

Rhonda Kite's picture


I will piggyback on the last topic on insulin pens. I would like to find out how others are dispensing insulin in the hospitals. My hospital system of 22 hospitals do a mix of insulin pens, community vial, and patient specific vial. We are working on a standardization project and as you can expect, this is not an easy task when diabetes educators, infection prevention, nursing, and pharmacy are involved.

Insulin pump - transition errors

Emily Buchanan's picture


We continue to see errors with insulin pump management at my health system, specifically when insulin pumps are removed because a patient is unable to operate during the acute stay. The error is that basal insulin requirements are not met as patients are usually put on only sliding scale as a transition. Re-education has not been successful and since it's a low-occurrence situation we are struggling to come up with a good solution. Does anyone have a good EHR driven (or other) process in place? One idea was to somehow force a 'time-out' but looking for other ideas.

Patient-Managed Prandial Insulin Dosing

Daniel Kudryashov's picture


Our Endocrinologists are advocating to allow some hospitalized patients to manage their prandial insulin dosing based on carb counting and carb ratio. I am familiar with nursing-driven carb counting protocols, but not patient-driven. I would appreciate your responses to the below questions:

SURVEY: Nurse witness requirement for insulin administration

Julieth Formosa's picture


Good morning everyone,

I am currently reviewing our process for subcutaneous insulin administration with the aim to improve the med pass workflow for our nurses.

If you can please take a couple of minutes to answer this short 5 question survey, I will be posting the results next week.




My facility recently had an ER nurse use an adapter to attach a 3ml/300 units Humulin R vial to a 100 ml NS bag for a 1:1 insulin drip. Curious as to if second nurse verifications are required on all insulin orders? And also if any facilities predraw 1ml syringes of Humulin R to keep in Pyxis for drips?

Insulin SQ prepared in IV room

Jane Mauro's picture


Hello, I looked through the archives and only found one similar question with one response...

For those places that draw up SQ insulin doses in the IV room, do you draw up in a regular syringe or an insulin syringe?

If yes for insulin syringe, do you recap with original cap, or have some other capping mechanism?

Thank you!
Jane Mauro, PharmD
Irwin Army Community Hospital
Fort Riley, KS

Insulin Pens

Diane Schultz's picture


I know there has been some recent discussion on this lately, but one of our pharmacists has put together a survey on insulin pens so we really would appreciate any additional insight on the questions below. If easier, you email or private message back with the answers. Once collected we will summarize and post back on the site.
Thanks for your assistance! Diane

Multi-Dose Vials in patient rooms with isolation precautions

Stacie Ethington's picture


How does your organization address the use of multi-dose vials in patient rooms that are in isolation status?

Most inpatient care areas in my organization have medication storage just outside of the patient rooms (in a locked medication drawer). The question has come up for patients that are in isolation, what is the most appropriate way to store MDVs like insulin? We use BCMA and would typically prep the insulin at the bedside and return it to the drawer to be used solely for that patient. But if the patient is in isolation, that complicates things (risk of contamination).

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