How do you scan insulin?

THELIVINGWORST, ASN, RN · Dec 1, 2015

We have the same system. Pharmacy knows they need at maximum 100 stickers per 100unit vial. Very simple. Minimum dose is 1 unit so one sticker per unit in the vial :)

AJJKRN · Dec 1, 2015

I have a sticker stuck to the back of my badge. Not technically suppose to do this but we're not technically suppose to run out of stickers all of the time also! :whistling:

PS: I only keep one sticker for Novolog which is what we use 99% of the time for sliding scale coverage. Any other insulin either has a Pt sticker on it from pharmacy (Lantus, etc) or I get the appropriate sticker to scan for it.

Ndy-RN · Dec 1, 2015

I have a question for those who use medication scanners and that administer insulin. At our hospital we have insulin that is given, but in order to scan it we have to scan these little stickers. We are supposed to get a new little sticker each time we have to give insulin, which for some patients that can be four or more times. Pharmacy are the ones that are supposed to be making sure we have these stickers, but its something that often gets overlooked. And I feel like it's sorta stupid to have to call Pharmacy just to print stickers, plus it's a time suck waiting for them to bring the stickers. What ends up happening is that the nurses take one sticker and put it on the underside of our badge so we don't have to get a new sticker each time. But this is against the rules.
So my question is, how do you scan insulin at your hospital? Do you have any ideas that I might be able to bring to management to make this process go more smoothly?
We mentioned just have a laminated card that could be taken to the room with us and can then be returned to the med room. But we were told that we need a new sticker with each administration to ensure we are giving the right medication.

Your hospital really needs to get organized and updated . My hospital there are little barcode sticker on the insulines and what we do is scan the nurse who is to give it(with our own individual permanent barcode), then scan the patient identification band, then can the insulin to be given. No need to wait for pharmacy for extra this or that...acuity where I work is high and nothing will get done if we wait too long.

Seaofclouds, BSN, RN · Dec 1, 2015

We scan the barcode on the insulin vials. For Novolog, the patients have the pens which have barcodes we scan. If the patient is on regular insulin, we get a vial for them. Lantus is in a vial in the fridge as unit stock. We take the vial, scan it, and return it to the fridge when done.

turtlesRcool · Dec 2, 2015

We log into the med administration system with our own ID and password, and scan the barcode on the vial. If it's a sliding scale, we enter the amount we are giving (e.g. 2 units, 6 units, etc.). Then we have to get another nurse to sign-off on what we drew up; this means scanning the barcode on the back of another nurse's badge. I'm pretty sure the other nurse should be witnessing the first nurse draw up the insulin, but in practice, it's more like "hey, can I scan you for 4 units?" I always show the other nurse my syringe, though, to give him/her the chance to verify I've drawn up the correct amount. Only then can we scan the patient's ID bracelet and administer the insulin. The sticker thing seems strange to me.

TheCommuter, BSN, RN · Dec 2, 2015

Upon admission, each patient receives their own insulin pen that is kept in our medication carts. These insulin pens have barcodes that we scan after we have scanned the patient's armband.

Nurses at my facility must also verify the amount of insulin administered with another nurse, or else the computer will not allow you to sign off the insulin as 'given.'

sjalv · Dec 2, 2015

For short acting insulin (Apidra), we scan the barcode of the actual vial. When removing it, we have to override to access the refrigerator, but we don't specify what we're removing. For instance, the flu shots, pepcid IV, intubation meds, etc are kept in the fridge, but for Apidra, we just search for 'refrigerator access' in the Pyxis. We draw up our own Apidra.

Lantus is sent up from pharmacy with a sticker attached to it to scan. We never have issues with stickers not being attached to it. We don't draw up our own Lantus, it comes in a prefilled syringe from pharmacy.

nynursey_ · Dec 4, 2015

Novolog is provided as a Novolog Flexpen; each patient has their own individual flexpen and it is scanned each time a patient has a due dose of insulin, whether it is prandial, or supplemental. Levemir is also available via flexpen and that system operates similarly.

The vials we keep in the medication fridge are for Humulin N, Humulin R, and Lantus. Those come with a roll of labels with blank spots for marking the dose in units and the patient's name. The label also comes with a barcode that you can scan at the patient's bedside. The only insulin my current facility requires a cosigner for is U-500, which must come prepared from the pharmacy, and 2-RN verified before administration. My previous facility had all nurses verify ANY insulin administration as it was deemed a "high risk medication."

Scarlettz, BSN, RN · Dec 10, 2015

We are supposed to have stickers in the pockets but they are never there or get wet and ruined. So we have a barcode sheet of all the insulins at the COW.

Anna Flaxis, BSN, RN · Dec 10, 2015

We have insulin pens and just scan the barcode on the pen.

blackribbon · Dec 25, 2015

How does scanning a sticker not attached to the actual vial protect the patient? Couldn't you in theory, scan the right sticker but pick up the wrong med and draw it up? We scan the bottle that we pull the insulin out of. For insulins like Lantus that are not sliding scale, the prefilled syringe is delivered into their patient specifics with a scan code attached to the syringe.