am dose of insulin and oral antidiabetic neds

[wrkoutgirl]

which shift gives am dose of insulin and oral antidiabetic meds in your hospital. I am curious to know what your hospital does. i find that it is extremely difficult to give these meds on time and alow these meds to be therapeutic. for example insulin is supposed to be given before breakfast, some po antidiabetic meds are supposed to be given at least 15- 30 minutes before breakfast and some with breakfast. some other meds like renagel must be given with breakfast and meals. what about ASA, KCL and so on. in my unit, breakfast comes in promptly at 7:30. i find that at this time many things can be happening. i could still be getting report, something can come up with one of my pts and i can be unavailable to give these meds on times, some times several of my pts need these meds. sometimes when none of the avobe comes up guess what? you got it! the med is not in the drawer. by the time i get in touch with pharmacy and i physically get the med it is 10;00 . i presented this case to the nurse educator but she said i should discuss this with my manager, she agreed that i have a point.:kiss but there are other people who could help me better. i want your oppinion and or info about what is the routine at your unit. thank you , monica:rolleyes:

[P_RN, ADN, RN]

What type of nursing mode?

How many patients?

What type of insulin?

What manner of med system....pharmacy drawers/pyxis/bedside cubby...?

Pharmacy has set admin times for routine meds (9-1-5-9 etc).....BP, cardiac, muscle relaxant etc.

If a patient is scheduled for early treatment off unit eg: dialysis, then the kitchen is instructed to send early breakfast 630A-7A and the night shift nurse gives the insulin only. Patients aren't allowed to eat in the dialysis unit.

Depending on the number of patients you need to give meds to, I'd give the diabetics theirs first with a request they call if their tray arrives before you get there. This would be manageable for maybe 5-6 patients. Then I'd make a second drug run for routines.

Get as much input from your coworkers and those on other similar units. Put together a plan if need be. Others may have already mastered one that works quite well.

[deespoohbear]

Our hospital the dietitian and the pharmacists are in charge of this stuff. The problem is now we are giving meds almost every hour of the shift for some people. Not very realistic when you have 8 pts who need meds all the time. Day shift usually gives the insulin because we want to make sure the pt eats. Could be screwed if the pt receives their insulin at 6:45 and does not eat breakfast. Our internist does not want Humalog given until the food hits the pts mouth!! Our trays come up at 7:30. We also have a nurse at the hospital who is the diabetes educator and she also helps with the timing of the diabetic meds. Sounds like you need to get pharmacy and the dietitian involved. Good luck.