2 Nurses needed??? - page 4

We are having a "dispute" of sorts at our small hospital. For the longest time, we have not had a policy that 2 nurses had to verify amount/type of drawn up Insulin and Heparin. Many people think... Read More

  1. by   Going80INA55
    I have worked on the floors and in the unit in my faciluty and BOTH places require checks on insulin and heparin.

    For heparing there is a stamp that we have to verify we did the math and sign off on. However, we DO NOT have to check the rate on the pump...so that is where I will see mistakes. A dose of a 1000 will be set on the pump as 20 instead of 10.

    I would wonder why your unit does not have such measures in practice. In ICU/CCU where folks are very sick even a small mistake can be deadly.
  2. by   JnJTyson
    Thats it!! Lupron!! I know they are amazinly expensive..my monitary estamite might be off....but holy heck!!
  3. by   Zee_RN
    It is not a strict policy at my place. It is advised and I frequently have my insulin double checked but not always (depends on who's around!).

    It's even more of a good idea now, though, because they have changed our syringes. Both the tubercuin and the insulin syringes come in the exact same orange-color wrapping. It is very confusing! Our TB and Insulin syringes have always been kept in the same drawer on the med cart; TB has always been blue and insulin has always been orange. Now they are the same! Stupid, stupid idea!!!
  4. by   kaycee
    It is policy where I work to double check both Heparin and Insulin. Old school or not I have always had someone double check insulin for me no matter where I worked.
  5. by   Mattigan
    Strictly enforced policy at my hospital.
  6. by   Dr. Kate
    Sometime in the late 80s thought was that if we taught patients to give themselves their own insulin and not double check that there was no reason for nurses to double check. Well, times change, things happen (sentinel incidents) and what looked like "old school" practice becomes standard practice again. I have worked places where insulin, heparin, dig, and a few other things were double checked and documented. Here and now, the double check is done but there is no documentation. In Peds, Nsy, NICU they double check all drug calculations. It does make sense.
    With medication errors being a national patient safety issue, better safe than sorry.
  7. by   litebrite
    I was shocked that so many people check insulin and herparin. I don't think it's wrong. I went to school in the same hospital where I work and have never read anything about checking with another nurse unless it's peds. On my floor we give a lot of both those drugs. I would be checking all night long. Let's say I have 8 patients. 5 probably get insulin if not more (many times over 20 units) and twice in my shift. Plus, this is the same for the other RN's, ouch that would be very time consuming. Not to say it wouldn't make things safer but it would take a lot of time. Then taking more time the RN's would be busier and rushing and probably make an error another way. I guess it work though if so many of you do it.

    Do you mean you check SQ heaprin or just IV? We don't check either but SQ Heparin is given to like 95% of our patients. We give a lot of IV too, we have lots of DVT's. Never do we check with each other. The only thigs we check check with each other is blood and PCA's (that just started a few months ago). PCA's are co-signed when they are hung, changed or D/C. That policy was made because of so many errors. I have lost count on the amount of error I have found on PCA's, it's crazy.
  8. by   JohnnyGage
    I think if you have a lot of patients you should be checking more often. You definitely don't want to give one patient another's insulin or heparin dose by mistake.
  9. by   MishlB
    Originally posted by CougRN
    So NewCCU i have seen you on the CRNA board many times. So when you become a CRNA are you going to ask the circulator if you are giving the correct dose of Sux or Diprivan? I'm not saying I never ask for help because I do. But I also now how to do my 5 rights before I give any medication. I don't need a policy to tell me that before I give a med I should make sure I'm giving the right one at the right dose and so on. Think what you want about my skills but I am a very competent nurse and I know when to ask for help. But not every time I give a drug.

    I have asked around my facility because I really thought this was odd. It is required on the floors, med/surg and so on, but not in the ICU's. Maybe it has to do with having a number of patients and trying to keep everything straight. I'm sorry but I had never heard of this and really thought it was strange. But no, i'm not a student and i'm not a scary nurse.
    The reason someone double checks is to ensure the right amount is drawn up, not the 5 rights. Humans make mistakes, and sometimes the wrong amount may get drawn up. Sorry if not everyone is as perfect as you apparently are. For your next act will you walk on water? Please?
  10. by   howie122832
    Originally posted by MishlB
    The reason someone double checks is to ensure the right amount is drawn up, not the 5 rights. Humans make mistakes, and sometimes the wrong amount may get drawn up. Sorry if not everyone is as perfect as you apparently are. For your next act will you walk on water? Please?





    My thoughts exactly!! Oh, yea, by the way, there are now 6 rights!

    1) right med
    2) right time
    3)right dose
    4)right patient
    5) right route
    6)right documentation

    Always, always, always, have heparin and insulin and every other med that you are not sure of double checked by a second set of eyes!! It's worth that little extra time to do it, or you could spend that time later explaining why you screwed up!
  11. by   emily_mom
    Originally posted by Dr. Kate
    Sometime in the late 80s thought was that if we taught patients to give themselves their own insulin and not double check that there was no reason for nurses to double check. Well, times change, things happen (sentinel incidents) and what looked like "old school" practice becomes standard practice again. I have worked places where insulin, heparin, dig, and a few other things were double checked and documented. Here and now, the double check is done but there is no documentation. In Peds, Nsy, NICU they double check all drug calculations. It does make sense.
    With medication errors being a national patient safety issue, better safe than sorry.
    Right, but if a patient gives themself the wrong dose, it's their fault. If a nurse gives the wrong dose, it's his/her license.

    Your last line says it all.
  12. by   MusicLuvnNurse
    When I became a nurse, my son had been diagnosed as a diabetic for ten years. By that time, I was very comfortable as well as knowledgeable about diabetes and insulin. I was completely shocked by the amount of questions i received regarding insulin. For example, one nurse came up to me and said "humalog is the same as nph, right?" i shudder to think what may have happened if she had given humalog as nph. Hopefully, she would have looked it up if I wasn't available. Anyway, it's only since being on the frontline that I realize diabetes and insulin can be kind of tricky if you're not used to treating it on a regular basis. What's the harm in double checking something that can have such severe consequences? Take care all..
  13. by   Hellllllo Nurse
    I work in chronic dialysis. There, technicians (6 weeks on-the-job training) are permitted to give intra-arterial heparin, without a second or even a licensed person checking.

    I disagree with the policy.
    Last edit by Hellllllo Nurse on Apr 3, '03

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