Insulin, correction factor, sliding scale... HELP!!

[godofkahn]

Hi everyone,

I'm not fully understanding the orders for giving insulin for patients in an acute care hospital (med surg). Will different patients have different orders for insulin? Like will some have a scheduled doses, correction dose, or both? What will it look like in the orders? Will it be in standing orders or correction does order? I'm confused. Also, my preceptor said sliding scale is discouraged because we want to treat the blood sugar before it gets high. So a basal/ bolus insulin regimen should be used. Can someone just clarify everything that insulin medication entails and how I would be able to recognize different orders for insulin in the EMR? Is there any specific calculations that the nurse would have to do on their own or do we just follow the scale? Thank you..

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

It will be spelled out in the doctors orders. If he/she says to utilize the facility sliding scale protocol, we will. If he orders insulin specific to an individual, we follow that.

Some will only have sliding scale orders; some will have specific 'other insulin' orders; some will have both; and some will have neither.

Follow the physicians' orders regardless of what anyone tells you....unless patient condition dictates otherwise. If that's the case, inform the physician of the issue and follow his/her directive.

[NotMyProblem MSN, ASN, BSN, MSN, LPN, RN]

FYI: there will be a grid similar to: glucose

150-200....2 units.

201-250....3 units;

etc...

just an example.

You could also see a formula that says something like: blood glucose minus 100, divided by 40, equals # of units.

All of this is already spelled out. If it is not, contact the physician for corrective insulin orders if none were provided....unless the physician clearly stated/ordered DO NOT GIVE INSULIN.