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

[tokmom, BSN, RN]

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?

[Meriwhen, ASN, BSN, MSN, RN]

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.

[Tait, MSN, RN]

Yeah we have to double check the dosage and insulin type, not the patient, so this seems pretty common to me as well.

[applewhitern, BSN, RN]

Same here. We only double-check the insulin type, and dosage, but not the patient. This is done in our med room. We discuss who it is for and what their blood sugar was at that time, but we don't go and eyeball the patient. It is right there on the computer for us to see, anyway.

[AMR21, BSN, RN]

We check everything in the room.bpt, glucose, type, dose, order, primed the pen, etc.

Our facility has gone to pt specific pens for all insulin. They r kept in the locked med bin in each Pts room. That does take the Pyxis step out

[MunoRN, RN]

Back when we double checked SQ insulin and heparin we did it the pyxis room, only type and dose were checked.

[RNperdiem, RN]

Or you can stand in the doorway all gowned and gloved with insulin syringe and scanner in hand and accost the first nurse that walks by the room.

[dudette10, MSN, RN]

Or you can stand in the doorway all gowned and gloved with insulin syringe and scanner in hand and accost the first nurse that walks by the room.

That's how we do it! LOL

[linzjane88]

We draw up in the med room and have someone verify dose there but no one follows us to check the patient.

Wouldn't the 'waltz down the hallway and inject some random person' thought apply to all other meds?

[Morainey, BSN, RN]

Or you can stand in the doorway all gowned and gloved with insulin syringe and scanner in hand and accost the first nurse that walks by the room.

That's my style! "Hey, hey, could you check this insulin with me?"

Barcode scanning makes things awkward. I usually check the insulin with an RN in the doorway of the patient's room, have them sign off, then gown and glove up and go in the room to scan everything and give the patient their meds.

[tokmom, BSN, RN]

We draw up in the med room and have someone verify dose there but no one follows us to check the patient.

Wouldn't the 'waltz down the hallway and inject some random person' thought apply to all other meds?

No, the meds that are taken in the room are scanned and don't leave the room.

Remember the nurse is suppose to SCAN the vial as well. How do you do that the vial cannot go in the room?

[tokmom, BSN, RN]

Do your scanners reach the door? Our are connected to the computer and don't travel. We do have some lead, but not enough to get to the door.

I wish we could do pens, but we are told they are too expensive.

That's my style! "Hey, hey, could you check this insulin with me?"

Barcode scanning makes things awkward. I usually check the insulin with an RN in the doorway of the patient's room, have them sign off, then gown and glove up and go in the room to scan everything and give the patient their meds.