Toolkit - Strategies for Ensuring the Safe Use of Insulin Pens in the Hospital

Online Tool Kit

This tool kit contains sample policies and procedures, assessment tools, newsletters, and educational resources that can be customized for use within your hospital related to the use of insulin pen devices in hospitalized patients and management of hyperglycemia in non-critically ill hospitalized patients. It also contains an interactive video tool for testing YOUR knowledge of insulin pen safety, as well as suggestions for incorporating the videos into educational programs in your hospital.

Be sure to also visit the Resource Center for useful web sites and published resources related to these topics.

The majority of the tool kit documents are presented in Word format so that they can be customized to meet your hospital’s needs, and they should be updated, as necessary, as the evidence-based literature evolves.

Note: If a sample document includes brand names, that refers to the products used in the hospital submitting the document and does not represent endorsement of specific products. Customize the document to reflect the products used in your hospital.

Test Your Knowledge

Can you identify errors related to the injection of insulin using an insulin pen? After doing this yourself, check out the tool kit teaching tool describing ways to incorporate the insulin pen videos into staff educational programs.

Question #1

Please watch Insulin Pen Video 1 in its entirety before answering the following question. The video depicts a nurse preparing to administer insulin using a pen device to a patient. The video concludes as the nurse is about to attach a pen needle to the device.

Question

Listed below are the steps performed by the nurse during the video. Which of the steps, if any, were NOT correctly performed? (Select ALL that apply.)

Hand hygiene
Reviewing medication administration record
Identifying patient
Preparing device and needle for needle attachment
All steps were correctly preformed

Submit

Answer

D – You should have selected option "d" (Preparing device and needle for needle attachment) because the rubber stopper at the end of insulin pen device was NOT swabbed with alcohol prior to attaching the insulin needle.

Reset Question

Question #2

Please watch Insulin Pen Video 2 in its entirety before answering the following question. The video depicts a nurse preparing the insulin pen device including the dose to be administered. The video concludes as the nurse selects the insulin dose.

Question

Listed below are the steps performed by the nurse during the video. Which of the steps, if any, were NOT correctly performed? (Select ALL that apply.)

Attaching needle to device
Priming pen device
Checking the dose
Selecting the correct dose
All steps were correctly performed

Submit

Answer

B – You should have selected option "b" (Priming pen device) because the insulin pen was NOT primed prior to selecting the dose. The pen device should be primed by dialing 2 units on the dose selector, pointing the needle upward so that bubbles are forced to top, and pressing the plunger. A drop of insulin should appear at the end of the needle. If not, the priming procedure should be repeated until a drop of insulin appears. If no drop appears after 6 attempts, the insulin pen device should be exchanged for a new one.

Reset Question

Question #3

Please watch Insulin Pen Video 3 in its entirety before answering the following question. The video depicts a nurse administering insulin to a patient using an insulin pen device. The video concludes as the nurse is disposing of the needle.

Question

Listed below are the steps performed by the nurse during the video. Which of the steps, if any, were NOTcorrectly performed? (Select ALL that apply.)

Selecting an appropriate injection site
Inserting the needle at appropriate depth and angle
Administering the insulin dose
Disposing the pen needle
All steps were correctly performed

Submit

Answer

C – You should have selected option "c" (Inserting the needle at appropriate depth and angle) because the dose of insulin was NOT correctly administered. Although the nurse appropriately pinched a skin fold, after the needle is inserted the skin fold should be let go and only then should the insulin dose be injected. In addition, the insulin pen device should be held against the patient’s skin for at least 5 seconds before the needle is withdrawn.

Reset Question

Use of Insulin Pen Devices in Hospitalized Patients

Within this section you will find tools to help you identify potential safety risks related to the use of insulin pens in your hospital and strategies to improve their safe and appropriate use. In addition, sample policies, newsletters, and job aids on insulin pen safety submitted by U.S. Hospitals are provided.

Reports of Participants from Mentored QI Impact Activity for Insulin Pen Safety

Review reports submitted by participants in the 2014-2015 Mentored Quality Improvement Impact Activity for Insulin Pen Safety to learn from their experiences and get ideas for implementing strategies for ensuring insulin pen safety in your hospital.

Ashtabula County Medical Center, Ashtabula, Ohio

Community Medical Center, Missoula, Montana

CVPH Medical Center, Plattsburgh, New York

Goryeb Children's Hospital, Morristown, New Jersey

Kosair Children's Hospital, Louisville, Kentucky

Indiana University Health Ball Memorial Hospital, Muncie, Indiana

Magee Rehabilitation Hospital, Philadelphia, Pennsylvania

Mercy Hospital of Joplin, Joplin, Missouri

Munson Medical Center, Traverse City, Michigan

Ochsner Medical Center, New Orleans, Louisiana

Our Lady of Fatima Hospital, North Providence, Rhode Island

St. Joseph’s/Candler Health System, Savannah, Georgia

UF Health, Shands Hospital, Gainesville, Florida

Management of Hyperglycemia in Non-critically Ill Hospitalized Patients: Sample Documents Submitted by U.S. Hospitals

Within this section you will find sample documents submitted by U.S. hospitals that will be helpful in implementing best practices in the management of hyperglycemia in noncritically ill patients in your hospital.