[Momto2Boys]

I need verification on insulin.

If a resident has an order of 18 units of NPH at 4:30 and a sliding scale at 4:30 for regular (lets just say they needed 6 units) do you pull them up in the same needle or seperate needles?

I am a new nurse and I was taught one thing in nursing school and saw it done different in the LTC so I just wanted to double check how other nurses do this.

Thanks!

[suzanne4]

You draw them up in the same syringe so that the patient gets only one injection. Insulin syringes normally have a non-removable needle, it does not come off to change.

You always draw up the regular insulin first, then the NPH.

[Momto2Boys]

Suzanne,

Thank you so much! That is what I was taught in nursing school but not what was done at work. I guess I just needed to hear it from someone else the right way.

Do you know what will happen if anything if they gave NPH & regular in seperate injections at the same time??

Sorry I am a new nurse and I have so many questions. Being a student nurse and working nurse is so different.

[suzanne4]

No problems at all, but it just saves the patient a stick. The facility may do it that way, just to make it easier for another nurse to check it. Remember that insulin requires the signature of two licensed personnel before giving it, that they have verified the correct dosage, etc.

[Momto2Boys]

Thank you again very much for your response!!

[jaimemds]

You have to have two nurses sign for insulin before you give. Is this just in Texas or other places too??

[PoohGirl]

Originally Posted by jaimemds

You have to have two nurses sign for insulin before you give. Is this just in Texas or other places too??

Doesnt get done here in NY...

[TheCommuter]

I am an LVN at a nursing home in Texas, and I administer insulin injections without signatures from two nurses to verify it. There's no need for another nurse to come and verify my work. After all, what's the point of my license?

I also administer Darvocet, Vicodin, Oramorph, Narco, Morphine, and other controlled substances that remain in a locked drawer in my medication cart. No other nurse is required to verify whenever I administer narcotics.

[suzanne4]

Insulin and heparin injections need two signatures, and this is per JCAHO. And this is if given by an RN or an LPN. This is because of mistakes made in the past and documented all over.

It doesn't matter what you are licensed to give or not give, it is trying to keep you from going to court in the future.

Nursing homes are a different thing, but hospitals require it.

[SouthernLPN2RN]

Originally Posted by suzanne4

Insulin and heparin injections need two signatures, and this is per JCAHO. And this is if given by an RN or an LPN. This is because of mistakes made in the past and documented all over.

It doesn't matter what you are licensed to give or not give, it is trying to keep you from going to court in the future.

Nursing homes are a different thing, but hospitals require it.

Suzanne, is this a state thing? The hospital I work at doesn't require 2 signatures. Probably is a good idea though.