INTRAVENOUS INSULIN ADMINISTRATION USING SYRINGE PUMP

DEFINITION

1. Insulin – is a hormone secreted by the pancreas that promotes glucose
   

   INTRAVENOUS INSULIN ADMINISTRATION

   utilization, protein synthesis, formation and storage of natural lipids.

2. Continuous IV Infusion – is a method of administering IV medication to a patient at a constant rate through a syringe pump to maintain a stable level of the medication in the blood.

PURPOSE

1. To standardize methods of intravenous insulin administration.
2. To provide guidelines for monitoring patients receiving insulin infusion.
3. To reduce the occurrence of possible complications.

INTRAVENOUS INSULIN ADMINISTRATION

PROCEDURES & RESPONSIBILITY

1. Continuous insulin IV infusion shall have a written physician order, as well as a separate specific order for each rate, changed based on capillary blood sugar results.
2. Regular insulin is the only insulin that can be given through IV.
3. A patient who is on continuous IV insulin infusion should be kept under close observation.
4. An infusion pump should be used for IV insulin infusion.
5. Insulin infusion should be a separate IV site whenever possible.

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Procedures	Responsible Person/s
Write the order for the administration of insulin infusion and clearly document the specific order for each rate change based on the result of the capillary blood glucose.	Physician
Document all the pertinent information in a timely manner in the medical record.	Physician
Prepare the IV insulin infusion using the following solution: 50 ml Normal Saline containing 50 units Regular Insulin (1 unit/ml).	Registered Nurse
Baseline blood sugar by finger stick should be checked before starting an insulin infusion.	Registered Nurse
A copy of physician order should be sent to the pharmacy (Unit Dose System).	Registered Nurse Pharmacy
Initiate and regulate the IV insulin infusion according to the doctors’ order.	Registered Nurse
Document IV site condition, infusion setting and patient level of consciousness at the beginning of infusion and any additional information in the nurse’s notes.	Registered Nurse
A patient on continuous IV infusion shall have a capillary blood glucose monitoring every 1-2 hourly, and if it remains stable may decrease to 4 hourly.	Registered Nurse
Monitor the patient every 2 hours or as ordered by the doctor for the following: ·         Level of consciousness ·         Signs and Symptoms of Hypoglycemia Read more6 IPSG - International Patient Safety Goals ·         Other pertinent parameters	Registered Nurse
Use professional judgment and ongoing assessment when caring for a patient who is on IV insulin infusion.	Registered Nurse
Notify the attending physician of any changes in the patients’ status.	Registered Nurse Physician
Check the urine ketones if blood glucose is 250 mg/dl and above. Notify the physician for positive ketone bodies.	Registered Nurse
Discontinue the infusion as ordered by the treating physician.	Registered Nurse Physician
Check capillary blood glucose 30 minutes after discontinuing the infusion, then repeat every 6 hourly or as may be ordered by the physician, and if any change (deterioration) in the level of consciousness.	Registered Nurse Physician

ATTACHMENTS:

[embeddoc url=”http://obaid.info/wp-content/uploads/2018/02/BLOOD-SUGAR-ANALYSIS-CHART.docx” download=”all” viewer=”microsoft”]

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REFERENCE

• CBAHI 3^rd Edition Standards
• JCIA 5^th Edition Standards