Double check insulin doses

[Joycean]

What is your current standard when giving insulin to patients?

[frankie]

We currently give insulin almost exclusivly by adding into TPN - iv therapy. I did have a nurse once misunderstand a doctors handwriting - he wrote 15 u - she took this slurred u and thought the doctor ordered 150 units of NPH insulin. She gave it to the patient. This was an ER - the patient was given alot of D50W and admitted. The nurse quit. frankie

[Nurse K-Bear]

Always no matter what type of insulin is checked by another nurse. This is the way I was taught and it is the policy of the hospital. Although we do not have to document the second nurses initials anywhere.

[pebbles, BSN, RN]

No double checking at my facility. Just given, five rights, one nurse, like other meds.

Only thing we *have* to two-nurse check is epidurals, I think.

[Joycean]

The Pharmacists at our facility brought this to the attention of the hospital P&P Counsel. Apparently this is coming from a national level and is due to sentinal events. I was taught to double check insulin long ago in nursing school and have seen it go away over the years ( I see some nurses continue the practice). I will take the info from this thread back to the counsel. When this is put into policy, it will require documentation of the double check. Thanks for the input/info!

[misti_z]

We do not have any policy for double chcking insulin dosages. Although I personally get a 2nd nurse to check usually high doses and any IV doses, as do most other nurses on my floor.

[globalRN]

no 2 nurse checks

[Brownms46]

Originally posted by Joycean

The Pharmacists at our facility brought this to the attention of the hospital P&P Counsel. Apparently this is coming from a national level and is due to sentinal events. I was taught to double check insulin long ago in nursing school and have seen it go away over the years ( I see some nurses continue the practice). I will take the info from this thread back to the counsel. When this is put into policy, it will require documentation of the double check. Thanks for the input/info!

I two was taught a long time ago to have another nurse check insulin prior to given, just because of the what Frankie posted about and I someone else also. The fact that there have been misinterpretation of the U when transcribing a med. On assignments I have rarely had another nurse ask me to check insulin with her, but I always ask someone to check with me. And no one has ever given me a problem or asked why I was having them check with me. So it leaves me to believe that many have been taught to do the same thing. I think doing a two nurse check of insulin especailly where you have written orders from MDs who write so badly, is a check to avoid a med error that I have seen and heard of happening way too much.

[stressedlpn]

I always have someone check with me on iv and high doses, it is not hospital policy just the way I was taught,

[Bermuda]

We do not have a policy in writing stating insulin should be checked by 2 nurses..but I was taught that way many moons ago and it seems to be the exception to the rule..myself and 1 other nurse check each other and the other girls tease us...girls from old school but it only takes a minute to be right...just my thing...

[OBNURSEHEATHER]

Ours is hospital policy. All insulin AND heparin must be double checked by another RN. Not that I mind. In OB, it's honestly very rare that I ever give Heparin, and actually semi-rare that we give insulin (our MFM docs are awesome at keeping their gest. diabetics diet controlled), so I'd want to double check it anyways.

Heather

[Sleepyeyes]

I just plain feel safer having IV insulin or heparin or even some cardiac IV meds like Nitro gtt, or even high doses of IV pain meds (demerol 50 mg IVP is a lot, to me, to a central line, for instance) double-checked by another nurse, whether it's policy or not.