Novolog Flexpen

[widi96]

Hi everyone,

Just wondering if anyone uses the Novolog Flexpen. Our hospital does, but when I was oriented (a year ago) I was told by my preceptor that a lot of people don't trust that they give the correct dose, so they draw it up in an insulin syringe. I have been doing that I was talking to our manager today and she said that doing that jams the pen, plus potentially throwing off the dosing for those who would use the pen with the adaptive needle. I also brought up the points of - pts in isolation (do we leave the insulin in the room, or break isolation) and patients who get other insulins that could be mixed with Novolog (go ahead and stick them twice because it is the pen?). It appears that the entire hospital needs to do one or the other though because those of us who are drawing it up to verify dose are screwing up the pens for those who use them with the adapter needle. Just wondering what you all think of this. Do you think the pen is accurate in dosing? Do you leave the insulin in isolation patient's rooms? Stick them twice if the insulin could be mixed?

[megananne7]

We dont use insulin syringes anymore. Every insulin we have is in pen-form.

We leave them in isolation rooms and if they require 2 different types of insulin, just stick 'em twice.

[racing-mom4, BSN, RN]

We use the pens, each pt has an order for insulin has thier own so the isolation issue is not a factor for us. We also stick them twice if need be.

Personally I love them. We got them soon after I became a nurse, so I only drew up actual insulin a few times, I feel very comfortable using them and trust them. We do do a practice dose of 2 units before use,just to make sure the needle is working, a few times we have found they do not. So that is our policy, 2 unit test, then click to the desired dose.

[widi96]

Every patient gets their own pen here too - the isolation issue is that we are repeatedly told never to leave a medication in a patients room.

[classicdame, MSN, EdD]

The manufacturer claims the dosing is MORE accurate, as some people cannot see syringes markings well. Also, they do not recommend taking the medication from the pen for any reason.

If the pens are left in the room then the patient can learn about self-management. If that is an issue why not just put them in ziplock bags for the trip between room and medicine drawer?

In Europe close to 80% of diabetics use some type of pen for insulin delivery, compared to about 15% in USA. It can work.

[bettyboop]

We do do a practice dose of 2 units before use,just to make sure the needle is working, a few times we have found they do not. So that is our policy, 2 unit test, then click to the desired dose.

we also do the 2 unit practice pre dose dial, as a RN who used the insulin syrnges for years i much prefer the pens and beleive they are more acurate, each pt has their own pens with pts own med labels attached.

[tiggerdagibit]

I can't reply to the hospital factor because the hospitals I have clinicals at both use syringes/vials, but as a diabetic I LOVE my pen. I wish the hospitals would switch. They are so easy to use.

[megananne7]

In terms of medications in isolation rooms, at my facility any isolation room.. if you have a multi-dose container of medication (e.g. eye drops, insulin pens, nystatin creams/powders, etc.) it is all kept in the pt room.

[suanna]

We have used the pens for about a year now. Better than half the staff draw up the insulin into a syringe out of the pen. I'm sure the dose delivered is more accurate but time and again you see the insulin dribble back out of your injection site. I don't know if it is due to a shorter needle or a change in the pressure applied by the pen but we have seen a marked increase in elevated sugars since the pens went into use. I hate them!

[heygurlhey]

I used the Novolog Pen before I got an insulin pump. I would NOT recommend anyone drawing insulin from the pen. Its way too easy to inject air into the cartridge and screw up the next dose! The pens are very accurate if used correctly. As for having to stick someone twice, you would need to anyway as Novolog and Humalog/ aspart insulin are not supposed to be mixed.

[kellye]

we use the flex pen. i like them. i have seen others drawing up from the pen (claiming that it is inaccurate and they do not trust them) i can tell if someone has drawn up from the pen because we are to prime the needle using 2 units. we can repeat the priming up to 5 times. i think when insulin is drawn out it screws up the plunger in the pen and you can sometimes see small air bubbles in the cartridge.

[locolorenzo22, BSN, RN]

See at our hospital the whole "you don't know if a client is going to self-medicate" means that you can NEVER leave any medication at the bedside. Everyone's got their own drawer for extra meds like that, but the meds don't touch anything else....personally, I'm a fan of wiping stuff like that down once it comes back out of the room...