Multi-dose insulin vials

[Sunshine716]

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!

[Red398]

In the LTC facility I worked at, each patient had their own vial and/or pen. I've noticed hospitals I've done my clinicals at share one vial in the med room, as stated.

[kskarzin91]

Each patient has their own vial of sliding scale or 70/30. And pharmacy sends up lantus. Our unit is a 40 bed GI/ diabetic floor at a medium sized hospital. We give so much insulin a multi dose shared bottle isn't realistic. We'd be ordering a new bottle a couple times a day at least so it works out better if everyone has their own and takes it home with them when they leave.

[psu_213, BSN, RN]

At my facility, the floors use pens for just about every type of insulin (I believe 70/30 is the exception). The patient gets to keep the pen after discharge--with proper discharge teaching of course. The pharmacy would send up a vial if you had to give regular insulin IV (for example, for hyperkalemia).

[TheCommuter, BSN, RN]

I've been a nurse since early 2006. Every facility where I've ever worked has issued each patient his or her own vial of insulin. I've never had to deal with multi-dose insulin vials at any point in my career.

[AJJKRN]

We have multi dose vials for Novolog and Novolin R. You just draw up what you need in the med room but we keep it in the med room so all have access. No cosigner unless it's a gtt. Lantus comes up from the pharmacy but always has 5U of overfill.

[CmacD]

We had multi dose vials per patient. Just recently we have gone exclusively to insulin pens.

[Ladyscrubs]

We have Insulin multidose vials, and also have communal inhalers (gross I know, all tossed in a basket on top of the pyxis)which are used with a personal spacer.

[BSN-to-MSN, ADN, BSN, RN]

Lantus comes up from the pharmacy but always has 5U of overfill.

Why 5U overfill?

[BSN-to-MSN, ADN, BSN, RN]

SNF here, every patient has their own Novolog, Humulin, Lantus, etc. with tiny stickers on the bottles from pharmacy, held in one pink plastic container. Most are good for 28 days once opened. But if someone is totally out, ( no pharmacy on site, and STAT delivery means up to 4hrs), I have no problem borrowing. Patients need their insulin on time, end of story.

[BSN16]

Everyone gets their own pens at my hospital. love it, makes my life just a little bit easier

[madricka, BSN, RN]

I've only ever used the single-patient vials, regardless of insulin type. It comes from the pharmacy with the patient label on it and is never, ever shared with another patient. There are unopened stock vials if a patient runs out or pharmacy is closed or whatever. But no "community insulin".

[NurseKatie08, MSN]

Communal inhalers? Eww! If I were the patient I would refuse to take it! Spacer or no spacer

We have Insulin multidose vials, and also have communal inhalers (gross I know, all tossed in a basket on top of the pyxis)which are used with a personal spacer.