Klug Mikayla J, Cady Kevin, Tate Janice, Rivey Michael P
PGY-1 Pharmacy Practice Resident, Pharmacy Department, University of Montana, Community Medical Center, Missoula, Montana.
Clinical Pharmacy Manager, Pharmacy Department, Community Medical Center, Missoula, Montana.
Hosp Pharm. 2016 Feb;51(2):158-164. doi: 10.1310/hpj5102-158. Epub 2016 Feb 1.
The Institute for Safe Medication Practices (ISMP) has stressed the need for hospitals to re-evaluate their methods of insulin delivery in an effort to minimize complications of insulin pen use. Improper use of insulin pens can lead to adverse effects, such as hypoglycemia or blood-borne infections.
This study was an American Society of Health-System Pharmacists (ASHP) quality improvement activity focused on insulin pen safety in the hospital. The objective of this study was to improve insulin pen delivery and patient health and to reduce adverse effects related to insulin pen use. The purpose of the impact activity was to utilize pharmacist experts to evaluate processes related to the use of insulin pens within the hospital and then implement quality improvement efforts to address potential safety concerns.
Baseline and postintervention questionnaires were administered to all nursing personnel ( = 400) to assess their analytical and procedural knowledge regarding insulin pen use and administration. Insulin administration observations and insulin pen storage and labeling audits were also conducted at the same time points in 3 patient care areas where insulin administration was common. Process improvements were made after the baseline data were collected.
An overall improvement in insulin pen use was determined after implementation of the quality improvement plan. The greatest improvements were seen for insulin pen administration. The proper storage of insulin pens had 69% compliance at baseline that rose to 98% compliance post intervention, an improvement of 29% ( < .01). Similarly, compliance with the return of insulin pens to proper storage areas increased by 16%, from 78% at baseline to 94% post intervention ( < .05).
An improvement in insulin pen usage was promoted by a quality initiative in a small hospital setting. Periodic education about safety procedures along with yearly reviews for all nurses will improve the ongoing safety of insulin pen usage within the hospital.
安全用药实践研究所（ISMP）强调医院需要重新评估其胰岛素给药方法，以尽量减少胰岛素笔使用的并发症。胰岛素笔使用不当可能导致不良反应，如低血糖或血源感染。
本研究是美国卫生系统药师协会（ASHP）开展的一项聚焦于医院胰岛素笔安全的质量改进活动。本研究的目的是改善胰岛素笔给药情况和患者健康状况，并减少与胰岛素笔使用相关的不良反应。此次影响活动的目的是利用药师专家评估医院内与胰岛素笔使用相关的流程，然后实施质量改进措施以解决潜在的安全问题。
向所有护理人员（n = 400）发放基线问卷和干预后问卷，以评估他们关于胰岛素笔使用和给药的分析及操作知识。同时在3个胰岛素给药常见的患者护理区域，于相同时间点进行胰岛素给药观察以及胰岛素笔储存和标签审核。在收集基线数据后进行流程改进。
实施质量改进计划后，胰岛素笔使用情况总体得到改善。胰岛素笔给药方面改善最为显著。胰岛素笔的正确储存基线依从率为69%，干预后升至98%，提高了29%（P <.01）。同样，胰岛素笔归还至正确储存区域的依从率从基线时的78%提高了16%至干预后的94%（P <.05）。
在一家小型医院环境中，一项质量改进举措促进了胰岛素笔使用情况的改善。对所有护士定期进行安全程序教育以及每年进行审查，将提高医院内胰岛素笔使用的持续安全性。
