Insulin Safety

Introduced in 2010 by the National Patient Safety Agency.

Aim to reduce insulin error prescribing and administration and reduce patients deaths.

20% medical negligence claims are medication errors

Claims amount to £750 million a year

Why insulin safety ?

The RIGHT insulin

The RIGHT dose

The RIGHT way

The RIGHT time

Why Insulin Safety ?

There are over 20 different insulins availablemany with similar names and packaging. With more coming onto the market.

The Right Insulin

Insulin with Similar name

Humalog with Humalog Mix 25Humalog Mix 50

Novorapid with Novomix 30

Insuman Basal with Insuman Comb 25Insuman Comb 50Insuman Comb 15

Humulin S Humulin IHumulin M3

Insulin passports were introduced to reduce the number of prescribing and dispensing errors. Making patients more aware of the name and packaging of their insulin.

All patient prescribed insulin should have an insulin passport. In nursing and care homes should be with their notes or prescription.

The Right Insulin

To be kept with MARS sheet District Nurses to have

insulin passport in their notes

Full Name Date of Birth NHS Number

The Right Insulin

Insulin should be prescribed with the dose in full no abbreviations e.g units instead of U or IU.

Insulin comes in prefilled/disposable pens and cartridges with reusable pens and vials.

All should be clearly labelled. Insulin should not be omitted with out

advice from a HCP with experience in diabetes.

The Right Dose

Not all cartridges and pens are compatable.

It is always important to check the dose of insulin to be given

Syringes should not be used to withdraw insulin from cartridge

Ensure spare pen device if using cartridges

The Right Dose

Insulin should be injected at 90 degree angle.

You can use the abdomen, upper outer thighs and upper outer buttocks as injection sites.

Vary the injection sites to prevent fatty lumps (lipohypertrophy)

Insulin should be mixed (rock and roll) Change insulin pen needle for each

injection Do not store the needle on the pen.

The Right Way

The Right Way

The Right Way

The Right Way

The Right Way

Insulins have different profiles and modes of action.

Some such as mixed insulins, timing of the injections are important e.g. or Humulin M3 should be given 20mins before meals or Novomix 30 just before eating.

Insulins such as Lantus or Humulin I are usually not given in conjunction with food.

The Right Time

Store unopened supplies of insulin in the refrigerator

Insulin in use can be kept at room temperature but avoid storing in direct sunlight and heat e.g near radiators, window sills etc

Dispose of needles into a yellow sharpsbin Ensure enough supplies of insulin eg

weekends Dispose of any insulin 30 days after using

Storage and Disposal

Six steps of Insulin Safety – Diabetes on the Net

Safe Use of Insulin – Virtual College, Patient Safety Suite

E-learning

FIT4safety (2012) highlighted the need to reduce needle stick injuries inline with EU directive(2010/32)

National guidance was that by 2013 all injections should be given using a safety needle.

Locally it was decided that the BD Autoshield now the BD Autoshield Duo best met the needs of our patients and staff.

Insulin Safety Needles

Only available in a 5mm length Reduces risk of intramuscular injections No need to pinch skin Compatible with all insulin and GLP-1 pens Dual protection Clinicians should be trained before using

these needles. Locally or B-D will provide training.

Insulin safety needles

BD Autosheild Duo Needles

Blood Glucose monitoring informs you what your blood glucose level is doing

Recording blood glucose levels assists in making safe changes to a patients diabetes medication

Blood glucose testing should be agreed as a management plan with diabetes team/patient

Patients taking Insulin or Sulphonylurea should have access to blood glucose monitor

Safe Blood Glucose Monitoring

Meter list within Bradford and Airedale Each patient/resident should have access to

their own blood glucose meter People with Type 1 diabetes have access to

a blood glucose and ketone testing meter Glucomen LX meter, Optium meter, Neo

meter

Safe Blood Glucose Testing

Explain and ensure patient understands procedure

Wash patients hands in soap and water Ensure meter is prepared to use as per

guidelines Ensure test strips are in date and correct

test strips in use Select finger and area – use side finger Use single use lancet

Blood Glucose Testing

Apply blood to strip

Await result and record in patients records

Dispose of sharps and test strip

?Quality Control meters

Blood Glucose Testing

Every patient should have the correct insulin passport

Contact Diabetes team at Horton ParkPhone- 01274323226 press 3Fax- 01274 323738Following Information NeededPatient Name and DOBName of Insulin Insulin deviceAddress of Residential or Nursing home

2 passports will be sent 1 must go with patient if admitted to hospital

Insulin Passports