Background Insulin is a high-risk drug not always used properly in hospitals according to the current recommendations.
Purpose To find out what is the usual practice in use and storage of different types of insulin delivery devices (vials-pens) in hospital.
Material and methods Pharmacists surveyed nurses in non-critical wards concerning safety, handling and storage conditions of insulin in a general hospital (420 adult beds).
Results A total of 77 questionnaires were returned. Concerning safety, vials were used for several patients (100%). Pens were generally used in the right way, however some nurses (32.5%) admitted using them occasionally for different patients, taking out doses with a syringe. Dispensing sealed pens from the pharmacy was considered an effective safety measure (92%).
In terms of handling the vials, 83% of nurses used them with safety insulin syringes. Pens were used with conventional, non-safety needles (100%), without purging in 52% of cases and 80% removed the needle from the pen after administration. About how the needle was removed: 39% unscrewed it directly to discard it, 35% covered it first with the outside protector and 14% with the inside one. At discharge 50% delivered an opened pen to the patient; otherwise, the pens were left in the unit’s medicines storage area or discarded.
Opened pens and vials were stored in the unit’s medicines storage area, mostly in the refrigerator (67% and 57%, respectively). Lack of specific training was detected when the patient was isolated (no response in 35%). Insulin vials were only identified with the opening date (71.5%). 70% of nurses identified opened pens with the patient identification label and also 12% with the opening date.
Conclusion Nursing staff are generally familiar with the safe handling and storage of insulin delivery devices, although we found a high variability in some of their responses. Publishing recommendations by the Pharmacy Department in this regard would be helpful to reach a greater uniformity in the practice.
References and/or acknowledgements Nursing
No conflict of interest.
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