TPN with insulin

[gtmoore]

I always thought that when TPN has insulin added to it, two nurses had to verify the order sheet against the TPN bag. Today, two nurses thought I was crazy for asking for a witness. We need a witness for insulin given IV/SQ. What's the difference?

[TiffyRN, BSN, PhD]

Everywhere I've worked required 2 RN's to verify TPN ingredients whether or not there was insulin; both with adults and neonates.

[Cardiac-RN]

Everywhere I've worked required 2 RN's to verify TPN ingredients whether or not there was insulin; both with adults and neonates.

Agreed- TPN is a double-check at my work regardless.

[RobCPhT]

You really need to double check those. There are so many ingredients and dynamics involved.

[gtmoore]

OK, thanks all for the input on double checking TPN in general. By the way, our policy does not mention double checking. However, as good practice, I will from now on.

Thanks

[NurseguyFL]

Insulin administration varies from place to place. Some hospitals require IV/SQ insulin to have a witness and even a cosigner. Others don't. Even when I am working in hospitals that don't require a witness I always ask another nurse to check insulin with me whenever I'm drawing it up. Regarding TPN, I've never worked in any place where it isn't a requirement for two nurses to check it before it is hung.

[RedCell]

Why does your facility require a witness before administering insulin or TPN?

[RNforLongTime]

I've never had to have two nurses double-check TPN. And I have worked in four different hospitals in my 10 yr career.

[powernurse]

wow...i work for a HHA and we are adding insulin et al to the TPN in the home.... no other nurses to double check for us ..... never knew it was done differently in the hospital

[Hoozdo, ADN]

I've never had to have two nurses double-check TPN. And I have worked in four different hospitals in my 10 yr career.

Me either, or insulin injections. The only thing required checking by two nurses is blood products.

[BittyBabyGrower, MSN, RN]

We don't have TPN double checked, only our IL. When hanging insulin it has to have 2 RN's signatures on the MAR.

[KaroSnowQueen, RN]

We only double check insulin alone. Not when its in TPN.