How do you do double check insulin in an isolation room and scanning?

[tokmom]

If you have bedside medication barcode scanning, how do you do your insulin?

This is our process: We get the insulin out of the pyxis, take into room, scan patient and scan meds. Draw up insulin and Vocera a co-signer to come in and double check and co-sign.The vile is then wiped down and placed back into the pyxis.

I get the idea of taking a vial into an isolation room..but how to fix.

Managements idea: Draw up insulin in pyxis room that is checked against the computer in that room with a co-worker. The co-worker would then sign right there the insulin is drawn up correctly. Nurses are having a fit, because to make sure it's the right patient, that particular nurse will have to then follow the person in the room and double check again..

Management says there is no need to check the patient with the injecting/primary nurse.

Uhh hello! I'm not going to co-sign in a pyxis room and then let some nurse go waltzing down the hallway to inject God knows who, so yes, I would have to follow them.

So..what do you do?

[classicdame, MSN, EdD]

same here. We only double-check at the Pyxis, not at bedside

[KelRN215, BSN, RN]

The scanning does complicate things in that you are supposed to bring the vial into the room to scan it and most rooms do not (at least in my hospital they didn't) have individual refrigerators to store insulin in. In this situation, if I am going to be honest, I would draw up the insulin in the med room, double check the dose with another nurse and sign it off without scanning. I have never double checked insulin at the bedside.

[Guest343211]

I think each isolation room should have their own refrigeration and locked stocked drawer for meds, as well as their own scanner. Double checks are still a problem. Too bad they don't have computer sofware than can shoot the image of what you have drawn up and can confirm it with the order and the syringe measurements. Is there a window so that a nurse can come and check it at the window? The most efficent in my view would be software that could validate the doublecheck. Of course their ID would have to be on the patient where you could see it too. What about video imagining with computer verification to chart?

[beckster_01, BSN, RN]

We log in to the computer in the med room, open the patients chart, scan the vial and double check the insulin. When the second nurse consigns the insulin it "pends" the administration. Then I go into the room, scan the patient, and complete the administration in the room. So far everyone is happy. The medication is scanned, the patient is scanned, the insulin never leaves the med room. There really is very little room for error.

[Boog'sCRRN246, RN]

At my facility, each insulin vial has its own little booklet of bar code stickers that corresponds with the bar code on the vial. We draw up, verify dose, and co-sign in the med room, then place the sticker on the insulin syringe.

[linzjane88]

We do it the way Beckster has it laid out above. Draw up at pyxis in med room, verify amount, take a little sticker to scan at the bedside, and we're on our merry way. No second nurse needed in the room.

Grrr. I want to add a smiley but my phone isn't very compatible with the site!

[Julius Seizure]

At my facility each insulin vial has its own little booklet of bar code stickers that corresponds with the bar code on the vial. We draw up, verify dose, and co-sign in the med room, then place the sticker on the insulin syringe.[/quote']

We do this, and with some other multidose vial meds too. But I like becksters method better.

[Jory, MSN, APRN, CNM]

In the facilities I've worked in on both sides of the coast, the 2nd nurse is verifying only that the correct dose of the correct insulin is drawn--he/she does not have to accompany the original nurse to inject the patient.

So what management is proposing is actually rather commonplace practice, at least in my experience.

I agree with you completely. That is what we do as well.

[RNewbie]

At my facility we do not have to have a second nurse verify SQ insulin. It's a time saver.

[tokmom, BSN, RN]

I think each isolation room should have their own refrigeration and locked stocked drawer for meds, as well as their own scanner. Double checks are still a problem. Too bad they don't have computer sofware than can shoot the image of what you have drawn up and can confirm it with the order and the syringe measurements. Is there a window so that a nurse can come and check it at the window? The most efficent in my view would be software that could validate the doublecheck. Of course their ID would have to be on the patient where you could see it too. What about video imagining with computer verification to chart?

Any of our rooms can be isolation, and they don't want to spend any extra money. As it stands the vial HAS to go into the room to be scanned.

[tokmom, BSN, RN]

At my facility we do not have to have a second nurse verify SQ insulin. It's a time saver.

We do. It is policy

[tokmom, BSN, RN]

We log in to the computer in the med room, open the patients chart, scan the vial and double check the insulin. When the second nurse consigns the insulin it "pends" the administration. Then I go into the room, scan the patient, and complete the administration in the room. So far everyone is happy. The medication is scanned, the patient is scanned, the insulin never leaves the med room. There really is very little room for error.

This might work. We would have to change our computer system, but at least this makes sense. Thank you.