Department of Pharmacy, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA.
Am J Health Syst Pharm. 2011 Jul 15;68(14):1349-52. doi: 10.2146/ajhp100535.
The impact of a hospital initiative to reduce staff needle-stick injuries and overall insulin costs by switching from use of insulin vials to use of insulin pens for treatment of inpatients was evaluated.
An interchange program entailing a switch from vial-and-syringe insulin administration to insulin delivery via prefilled injector pens was implemented at a specialty clinic and hospital. Patient and employee incident reports were reviewed to identify insulin-related staff needle-stick injuries and to assess patient safety indicators during six-month periods before and after implementation of the interchange. Pharmaceutical purchasing data were used to compare total insulin costs for the two periods.
In the six months after implementation of the interchange program, nurses treated 2,084 patients with subcutaneous insulin products; there was one staff needle-stick injury, compared with five injuries during the designated preimplementation period (2,118 patients treated). During the six months after the switch to insulin injector pens, there were four reports of wrong-drug errors (three errors during dispensing and one error during administration to the patient), all involving insulin detemir and insulin aspart pens; in addition, there was one reported wrong-time error associated with a sliding-scale order for insulin aspart. Total insulin product costs for the preimplementation and postimplementation periods were $124,181 and $60,655, respectively.
Using an interchange program to support the use of insulin pens at a specialty clinic and hospital provided increased staff safety and cost savings.
评估一项医院倡议的效果，该倡议旨在通过从使用胰岛素小瓶转换为使用胰岛素笔来治疗住院患者，从而减少员工的针刺伤和总体胰岛素成本。
在一家专科诊所和医院实施了一项互换计划，涉及从小瓶和注射器胰岛素给药转换为使用预填充注射器笔进行胰岛素输送。审查了患者和员工的事故报告，以确定与胰岛素相关的员工针刺伤，并在实施互换前后的六个月内评估患者安全指标。使用药品采购数据比较了两个时期的总胰岛素成本。
在实施互换计划后的六个月内，护士为 2084 名患者治疗了皮下胰岛素产品；与指定的预实施期间（治疗 2118 名患者）相比，有一名员工发生了一次针刺伤。在转换为胰岛素注射笔后的六个月内，有四起错误用药错误报告（分发过程中发生三起，给患者用药时发生一起），均涉及胰岛素地特胰岛素笔和胰岛素门冬胰岛素笔；此外，还有一起与胰岛素门冬胰岛素的滑动比例医嘱相关的错误时间错误报告。在预实施和实施后期间，胰岛素产品的总费用分别为 124181 美元和 60655 美元。
在一家专科诊所和医院使用互换计划支持胰岛素笔的使用，提高了员工的安全性并节省了成本。
