Tips to Improve Insulin Safety
Full update March 2022
The checklist below provides strategies and resources to help prevent insulin errors.
Goal |
Suggested Approach |
Safely prescribe/order insulin |
|
Prevent product mix-ups |
|
Be aware of factors that can impact blood glucose. |
|
Understand special considerations with U-500 insulin |
|
Accurate dosing by patients |
|
Safe use of insulin pens |
|
Time insulin doses properly |
|
Educate about insulin use |
|
Store insulin properly |
|
References
- Cobaugh DJ, Maynard G, Cooper L, et al. Enhancing insulin-use safety in hospitals: Practical recommendations from an ASHP Foundation expert consensus panel. Am J Health Syst Pharm. 2013 Aug 15;70(16):1404-13.
- ConsumerMedSafety.org. U-500 insulin errors. https://consumermedsafety.org/tools-and-resources/insulin-safety-center/u-500-insulin-errors. (Accessed February 17, 2022).
- Association of Diabetes Care and Education Specialists. Diabetes coding table. 2021. https://www.diabeteseducator.org/docs/default-source/practice/Reimbursement-Expert/diabetes-coding-table.pdf?sfvrsn=2. (Accessed February 17, 2022).
- American Diabetes Association Professional Practice Committee; American Diabetes Association Professional Practice Committee, Draznin B, et al. 16. Diabetes Care in the Hospital: Standards of Medical Care in Diabetes-2022. Diabetes Care. 2022 Jan 1;45(Supplement_1):S244-S253.
- ISMP. High-alert medications in acute-care settings. August 23, 2018. https://www.ismp.org. (Accessed February 17, 2022).
- ISMP. Look-alike drug names with recommended tall man letters. November 20, 2016. https://www.ismp.org/recommendations/tall-man-letters-list. (Accessed February 17, 2022).
- ISMP Canada. Knowledge translation of insulin use interventions/safeguards. http://www.ismp-canada.org. (Accessed February 17, 2022).
- Instructions for use: Entuzity KwikPen. Updated August 17, 2020. http://pi.lilly.com/ca/entuzity-ca-ifu-kp.pdf. (Accessed February 17, 2022).
- Saltiel-Berzin R, Cypress M, Gibney M. Translating the research in insulin injection technique: implications for practice. Diabetes Educ. 2012 Sep-Oct;38(5):635-43.
- ISMP Canada. Alert: use of one insulin pen for multiple patients is a high-risk practice. May 22, 2013. https://www.ismp-canada.org. (Accessed February 17, 2022).
- CDC clinical reminder: insulin pens must never be used for more than one person. https://www.cdc.gov/injectionsafety/pdf/clinical-reminder-insulin-pen.pdf. (Accessed February 17, 2022).
- ConsumerMedSafety.org. Insulin pen safety. http://www.consumermedsafety.org/tools-and-resources/insulin-safety-center/insulin-pen-safety. (Accessed February 17, 2022).
- ISMP. List of error-prone abbreviations. February 5, 2021. https://www.ismp.org. (Accessed February 17, 2022).
- Product monograph for Entuzity KwikPen. Eli Lilly Canada. Toronto, ON M5X 1B1. March 2021.
- Product information for Humulin R U-500. Lilly USA. Indianapolis, IN 46285. November 2019.
- Shubrook JH, Becerra NM, Adkins SE, Guo A. Insulin: a 2014 primer, part 2 insulin delivery and insulin pumps. Primary Care Reports. 2014;20:101-10.
- Samaan KH, Dahlke M, Stover J. Addressing safety concerns about U-500 insulin in a hospital setting. Am J Health Syst Pharm. 2011 Jan 1;68(1):63-8.
- ISMP. As U-500 insulin safety concerns mount, it’s time to rethink safe use of strengths above U-100. October 31, 2013. https://www.ismp.org. (Accessed February 17, 2022).
Cite this document as follows: Clinical Resource, Tips to Improve Insulin Safety. Pharmacist’s Letter/Prescriber’s Letter. March 2022. [380308]