When prefilling mixed insulin syringes for a week:

[GingerSue]

When 7 syringes are needed, prefilled for a week, each to contain Regular with NPH, is there a way to use just one needle into each vial, for the purpose of inserting the air and withdrawing the insulin, in order to avoid changing to a new needle for each of the 7 syringes, when the second insulin is added to the first insulin in each syringe?

Otherwise, the needle must be changed at the point when the insulin is withdrawn from the second vial (after air has already been inserted into both vials and the regular insulin is now in the syringe).

[cn2007rn]

The order goes:

Inject air into NPH

Inject air into Regular

Draw up amount of needed Regular insulin

Draw up amount of needed NPH insulin

The only thing is, I thought once the 2 were mixed you need to give it immediately because the 2 start to breakdown and change once they mixed. I am a student but was taught as soon as you draw these up, it needs to be given right away.:caduceus:

[YogiBSN]

Yep, You cannot prefill NPH +regular mixed and let it sit. It will all 'become' NPH due to a protein reaction of some sort---don't recall the details of that though.

[TallGirlAni]

Also, are you changing insulin needles? Is this possible? I thought the needle and syringe were always one complete needle/syringe ensemble.

[shmily]

Yep, You cannot prefill NPH +regular mixed and let it sit. It will all 'become' NPH due to a protein reaction of some sort---don't recall the details of that though.

Any advice on how to approach this in a company who's "always done it that way"?

[TallGirlAni]

Do some research using the literature and evidence-based practice. Once you have the facts, present them to the "company," and your plan of action for how things should and could be done.

[CITCAT]

When 7 syringes are needed, prefilled for a week, each to contain Regular with NPH, is there a way to use just one needle into each vial, for the purpose of inserting the air and withdrawing the insulin, in order to avoid changing to a new needle for each of the 7 syringes, when the second insulin is added to the first insulin in each syringe?

Otherwise, the needle must be changed at the point when the insulin is withdrawn from the second vial (after air has already been inserted into both vials and the regular insulin is now in the syringe).

I question the rational of this, regualr insulin at the same amount is there no sliding scale of regular involved here, also if the insulin cannot be prefilled like that as the other nurses advisement , maybe there should be a inquiry into possible change insulin to mix such as 50/50, 70/30 etc etc with the clients physican . Be safe

[caliotter3]

When meeting with resistance from "the company always does it this way", there is no reason why you have to follow the herd. Do it the right way. Explain your rationale to the patient if necessary. You can beat your head bloody trying to change the minds of others, particularly if you are right about something and they are wrong. If it is just a matter of preference, then it doesn't make a difference and is not worth starting up ill feelings. Others will always criticize you when you go against their grain.