Impact of an interchange program to support use of insulin pens

Abstract

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.