Multi-dose insulin vials

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So, I'm working at this new facility and I've been a nurse for 12 years agency, ICU, PACU, etc. The new charge nurse I'm working with today looked at me like I was crazy when I asked her if we pull the regular insulin out of a shared vial in the pharmacy and return it (not bringing it into the patient's room, etc)- like I've done at many places.

She said, "oh no, no one has 'shared' vials of insulin anymore for the past ten years". That's ancient. Everyone is given their own vial of insulin (this is for outpatient surgeries in preop- patients that will literally be at the facility for no more than 3 hrs).

I know many places I had worked at we would only pull the 2 units in the pharmacy (or out of the pyxis), have it cosigned, and not waste an entire bottle for a couple units. Am I crazy? Everyone was backing her up and I felt like I was on another planet!

How does your facility do it? Is it a big hospital, outpatient, etc? Where can I find new protocols for multi-dose vials?

Thanks everyone!

Specializes in L&D Ninja.

My facility (Med/Surg in a medium sized facility) uses shared vials that you use to pull from in the med room. We keep 1-2 vials of each type of insulin that everyone on the floor pulls from. We draw up in the med room, have another nurse co-sign and then put them back in their respective tray. I've never seen it done any other way, and I'm curious what other facilities do.

Sun0408, ASN, RN

1,761 Posts

Specializes in Trauma Surgical ICU. Has 4 years experience.
My facility (Med/Surg in a medium sized facility) uses shared vials that you use to pull from in the med room. We keep 1-2 vials of each type of insulin that everyone on the floor pulls from. We draw up in the med room, have another nurse co-sign and then put them back in their respective tray. I've never seen it done any other way, and I'm curious what other facilities do.

We do it this way also.

Wow OP, this must be expensive and wasteful for the pt and hospital.

pixiestudent2

993 Posts

Each COW had multi dose vials of every type of insulin on it.

No one cosigned insulin unless it was a drip.

blondy2061h, MSN, RN

1 Article; 4,094 Posts

Specializes in Oncology. Has 15 years experience.

We have multi dose vials in the Pyxis everyone pulls their insulin from. They tried to switch to single use pens, one per patient, the another hospital in the area had a problem with multiple patients getting injections from the same pen, which is a cross exposure, so they ditched that plan.

nursej22, MSN, RN

2,976 Posts

Specializes in Public Health, TB. Has 38 years experience.

Each patient gets their own bottle of fast-acting, but they are only 3 cc vials. Lantus is drawn in the main pharmacy and delivered each day. No vials of anything is shared between patients, on the floor anyway.

smf0903

844 Posts

My facility (Med/Surg in a medium sized facility) uses shared vials that you use to pull from in the med room. We keep 1-2 vials of each type of insulin that everyone on the floor pulls from. We draw up in the med room, have another nurse co-sign and then put them back in their respective tray. I've never seen it done any other way, and I'm curious what other facilities do.

Our facility does this as well.

Specializes in Gerontology. Has 37 years experience.

Each pt gets their own insulin pen. We haven't used vials for over a year now.

EllaBella1, BSN

377 Posts

Specializes in ICU. Has 8 years experience.

We also use shared vials in the pyxis. Humalog and Levemir. We need a witness to pull from the pyxis too.

Each patient gets their own vial and their own pen if both fast acting and Lantus are ordered. Used to have multiuse vial but recently changed.

Sun0408, ASN, RN

1,761 Posts

Specializes in Trauma Surgical ICU. Has 4 years experience.

We did the pens about 4 years ago and stopped. I miss them but I guess it became to expensive for the hospital to continue. Back to the multi vials for SS. We don't have to have a witness

Sunshine716

13 Posts

Thank you everyone! That was really helpful! I knew I wasn't going crazy, but started to doubt myself. Lol.