University of Washington Medical Center, 1959 NE Pacific Street, Box 356015, Seattle, WA 98195, USA.
Am J Health Syst Pharm. 2010 Aug;67(16 Suppl 8):S9-16. doi: 10.2146/ajhp100172.
To summarize essential information for the hospital pharmacist to support the safe and effective use of insulin for the treatment of inpatient hyperglycemia.
Ensuring optimal insulin utilization in the hospital setting requires collaboration of a multidisciplinary team, including physicians (and endocrinologists specifically), nurses, pharmacists, dieticians, diabetes educators, laboratory staff, quality management staff, and others. The role of pharmacists in this multidisciplinary team is to assist in the standardization of insulin therapy via selection of appropriate insulin treatment protocols, participate in formulary management of insulin products, and contribute to the development of order sets and policies and procedures to minimize the risk of medication errors and misadventures. In addition, pharmacists can provide guidelines or treatment recommendations in special situations, such as those involving patients receiving enteral or parenteral nutrition or high-dose corticosteroids and the transition from i.v. to subcutaneous insulin therapy. Education of patients and providers is another key role for pharmacists. Nurses are important allies in the effort to ensure safe insulin use, as they are at the bedside of patients administering and adjusting insulin therapy. Recommendations are provided for the safe and effective use of insulin for the treatment of inpatient hyperglycemia.
Pharmacists are an integral part of the multidisciplinary team ensuring the safe and effective implementation of inpatient hyperglycemic control and insulin usage.
总结支持医院药师安全有效使用胰岛素治疗住院高血糖所需的基本信息。
要确保在医院环境中优化胰岛素的使用，需要多学科团队的协作，包括医生（特别是内分泌科医生）、护士、药师、营养师、糖尿病教育者、实验室人员、质量管理人员等。药师在多学科团队中的作用是通过选择适当的胰岛素治疗方案来协助胰岛素治疗的标准化，参与胰岛素产品的处方管理，并有助于制定医嘱集和政策程序，以最大程度地降低用药错误和不良事件的风险。此外，药师可以在特殊情况下提供指南或治疗建议，例如涉及接受肠内或肠外营养、大剂量皮质类固醇以及从静脉内胰岛素治疗过渡到皮下胰岛素治疗的患者。教育患者和医务人员也是药师的一个重要角色。护士在确保安全使用胰岛素方面是重要的盟友，因为他们在床边为患者管理和调整胰岛素治疗。为治疗住院高血糖症安全有效地使用胰岛素提供了建议。
药师是确保安全有效实施住院高血糖控制和胰岛素使用的多学科团队的组成部分。
