Timing aspart insulin after blood sugar check

[AVRN87]

I work night shift and in my facility, the noc RN takes a blood sugar for sliding scale aspart insulin but the day RN administers it.

How long can you take after checking a blood glucose level to administer aspart insulin? I always thought administration of insulin (in general - across the board) should be immediate or at least within an hour of taking the blood sugar.

My dilemma:

Sometimes the night RN takes the blood glucose at 0600 (I've seen nurses even take it at 0530) - mostly because they pass meds at that time and also it allows them time to finish their charting to start report at 0700. I have seen that the day shift RN is administering the aspart insulin around 0830 - 0930 while using the value taken at 0600. Is this safe?!!

[Sassy-RN]

You should check your facilities policy on that. Those times seem a little too spread out. The hospital I work at we give the insulin right after it is checked.

[AVRN87]

You should check your facilities policy on that. Those times seem a little too spread out. The hospital I work at we give the insulin right after it is checked.

Thanks for your response, Sassy RN! I did look at my hospital policy but there was not an actual "time frame" from when you take the blood sugar to administering the insulin. I agree with your facility that administration SHOULD be right after you take the blood glucose value. It is widely accepted at my hospital that the noc RN takes a blood sugar & gives the regular insulin SS (even if it's given at 0600) and, fine, I can be *slightly* ok with that... But aspart?! To me, that is compromising patient care!

[NutmeggeRN, BSN]

If it were me, I would retest....sliding scale is based on the CBG. If the gap is too long, they could get more insulin than needed if their sugar drops. If there is not a specific policy in your facility, I would follow up with pharmacy and maybe initiate getting a written policy. I wouln not want to be on the hook for an abnormaly low blood sugar based on such a situation.

[wizski]

If it were me, I would retest. Generally I don't like to administer insulin until at the very least their tray has been ordered or has arrived. Because the insulin acts so quickly, I want to ensure that they do eat, especially in the morning when their blood sugars can lower more quickly due to not eating over night.

[Fancypants09]

Just the fact that there are TWO nurses to check blood glu & then administer insulin...is a huge red flag for me. That compromises patient safety right there and increases risk of med errors. Re test it yourself, don't go by what somebody else recorded even though it may be accurate.