Insulin Administration Using an Insulin Pen

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Insulin AdministrationUsing an Insulin Pen

• Created by Rachel Gallagher
• Former School Nursing Consultant

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• This unit covers basic procedures for
  administering insulin by insulin pen. There are
  different kinds of insulin pens and variations in
  directions for different students. Demonstration,
  skills observation, consultation, and ongoing
  supervision by the school nurse will be important
  for correct medication administration.

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• Competency checklists are available at
  http//dpi.wi.gov/sspw_schlnurse.html
• For more information regarding delegation and
  consultation, please see the DPI question and
  answer documents available at http//dpi.wi.gov/s
  spw/pdf/snpracticeact.pdf
• Products used were for demonstration purposes and
  are not an endorsement of the products.

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What Topics will be Discussed?

• What is diabetes?
• What is the prevalence of diabetes?
• What is the difference between type 1 and 2
  diabetes?
• What is insulin?
• What are some important facts regarding insulin?
• What are the parts of the insulin pen?
• What are the supplies needed?
• What is the procedure for giving insulin by an
  insulin pen?

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What is Diabetes?

• Chronic Disease
• Two common types Type 1 and Type 2
• Type 1 Diabetes Pancreas produces no insulin or
  a very small amount.
• Type 2 Diabetes Pancreas does not produce
  enough insulin and/or the insulin does not work
  as it should.
• Both types require balancing food, exercise and
  insulin to keep blood sugar as close to the
  normal range (80-120 mg/dl) as possible.

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What is the prevalence of Type 1 and Type 2
diabetes?

• 151,00 students with type 1 diabetes under the
  age of 20 (CDC, 2011)
• 1.7 per every 1,000 students 1-19 years has been
  diagnosed with type 1 diabetes.
• http//www.cdc.gov/diabetes/projects/cda2.htm
• 7.2 per every 100,000 students has been diagnosed
  with type 2 diabetes (CDC, 2011)
• http//www.cdc.gov/diabetes/projects/cda2.htm

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The difference between Type 1 and Type 2 diabetes?

• Type 1 diabetes is a chronic disease where the
  pancreas produces no or little insulin needed to
  control blood sugar levels in the blood.
• Treated with insulin, monitoring blood glucose
  levels, exercise and eating healthy food.
• Type 2 diabetes is a chronic disease where the
  pancreas produces not enough insulin and/or the
  body is not able to use the insulin properly.
• Treated with eating healthy food, exercise, oral
  medication and/or insulin.

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What is insulin?

• A hormone produced by the pancreas
• Used to treat Type 1 or Type 2 diabetes
• Insulin regulates blood sugar levels in the blood
• Insulin must be given by a syringe, insulin pen
  or insulin pump
• Insulin is measured in units
• There are different types of insulin

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Important facts regarding insulin pen cartridges

• Check expiration date.
• If using a new cartridge, label cartridge with
  date.
• Insulin cartridges not in use should be
  refrigerated.
• Do not shake insulin cartridges.
• Store at room temperature and prevent exposure to
  sunlight.
• Expiration date for each specific type of insulin
  pen cartridges varies always check with nurse
  regarding expiration dates.

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What are the parts of an insulin pen?
Insulin pen
Insulin cartridge stores the insulin
Pen needle
Protective cover
Needle
Cap
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What are the five Rs?

• Right student
• Right medication
• Right dose 5Rs 2
• Right time
• Right route
• Right documentation
• Right reason

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What is needed prior to giving insulin with an
insulin pen?

• Medical provider and parent authorization
• Insulin pen
• Gloves
• Alcohol swab(s)
• Unopened pen needle
• Insulin cartridge (may be inside the insulin
  pen).
• Authorized sharps disposal container
• Glucose monitor

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What is the procedure for giving insulin using an
insulin pen?

• Gather supplies.
• Check the five rights.
• 3. Determine type of pen that is used
• Prefilled disposable pen A prefilled insulin
  cartridge is already in pen.
• Reusable pen Most of the time the insulin
  cartridge will be in the pen. If not, load
  insulin pen cartridge into pen.
• 4. Wash hands and apply gloves.
• 5. Recheck the five rights.

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Procedure continued

• 6. Check expiration date for insulin pen
  cartridge or disposable insulin pen.
• 7. Attach pen needle by twisting the needle on
  end of insulin pen. (Wipe top of insulin pen with
  alcohol wipe if instructed to do so by nurse.)
• 8. Pull off and remove outer pen needle
  protective cap and cover (Do Not Touch Needle).

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Procedure continued

• 9. Prime pen by dialing 2 units.
• 10. Push the end of pen (plunger) to push out the
  2 units. A small drop of insulin should be
  visible. (This checks insulin flow and is called
  an air shot).
• If insulin does not appear,
• repeat steps 9 and 10.

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11. Once the pen has been primed, dial the
desired insulin dosage to be administered to
student .
Procedure continued
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Procedure continued

• 12. Choose a subcutaneous (tissue between the
  skin and muscle mass) injection site with the
  assistance of the student as appropriate. Insulin
  is absorbed more effectively by the body when the
  
• administration sites
• are rotated.
• abdomen
• upper arm
• upper buttock
• outer thigh

Subcutaneous Injection Sites
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Procedure continued...

• 13. Cleanse injection site with alcohol swab
  (optional) and allow skin to dry. Never fan or
  blow on area cleansed with swab.
• 14. Gently pinch skin of chosen injection site
  and insert pen needle at a 45-90 degree angle
  into skin.
• 15. Push button (plunger) down at end of pen
  completely to give insulin.
• 16. Wait 10 seconds while keeping insulin pen and
  pen needle in place, to ensure all insulin is
  given. (This is due to the fact that all insulin
  pens drip.)

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Procedure continued...

• 17. Pull the insulin pen and needle out from the
  injection site to remove needle.
• 18. Do not replace the protective needle cap
  carefully unscrew pen needle to remove from pen.
• 19. Dispose of needle in an approved sharps
  disposal container.
• 20. Remove gloves and wash hands.
• 21. Document insulin administration.

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• Demonstration

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• Questions or comments regarding this webcast?
• Suggestions on future school nursing topics?
• Please Contact
• WI Dept. of Public Instruction
• School Nursing Consultant
• 608-322-4816