Quality Improvement Initiative and Safety of Insulin Pen Usage in a Small Hospital.

Abstract

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 (N = 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% (P < .01). Similarly, compliance with the return of insulin pens to proper storage areas increased by 16%, from 78% at baseline to 94% post intervention (P < .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.