Our facility has been having issues with remembering to remove medications from the patient med drawer or boxes in the rooms upon discharge. We have added a hard stop to printing the AVS where a nurse must say she has removed medications from the drawer/box but they continue to select yes and not actually complete the task. Does anyone have anything that works as far as hard stops/forcing function for removal of medications from drawers upon patient discharge? A little more info: Our current process is that RNs are responsible for this task as EVS cannot touch the medications.

Has anyone had success in decreasing the incidence of BG<50 after the administration of insulin? We struggle with this measure. Thanks in advance!

Hello,
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.

ISMP states that

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.

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:

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.

https://forms.office.com/Pages/ResponsePage.aspx?id=DQSIkWdsW0yxEjajBLZt...

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?

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

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 diane.schultz@seattlechildrens.org