Reducing potential errors associated with insulin administration: An integrative review

Abstract

Rationale, Aims, Objectives Around one‐third of medication errors resulting in death within 48 h involve insulin therapy. Despite a growing number of interventional strategies that have been published over the past decade, it remains unclear which of these interventions is effective in reducing insulin errors. Therefore, the study aimed to synthesize interventions to reduce the frequency of insulin errors in either home or health care settings. Methods This integrative review was conducted based on Whittemore and Knafl's four steps, which includes problem identification, literature search, data analysis and presentation. Six databases including Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, PubMed, Scopus, PsychInfo and Cochrane were searched from January 2010 through July 2021. The level of evidence quality was assessed according to the Johns Hopkins Nursing Evidence‐Based Practice grading scale. Results Sixteen studies meeting inclusion criteria were reviewed. The results provide strong support for teaching patients how to use automated bolus calculators and educating patients to self‐administer insulin to prevent insulin errors in the home setting. Computerized protocols, education and double‐checking procedures were also found to be effective strategies for minimizing insulin errors in healthcare settings. Conclusion While the strategies might be effective in reducing insulin administration errors in the home settings, computerized protocols, continuing education and the manual validation of insulin products appear to be the most effective strategies for reducing such insulin errors in healthcare settings. Understanding these findings may help clinicians and patients to decrease the number of insulin errors administration.

The assemblage of skin findings in the type 1 DM with incorrect injection technique: A case report

“…There are other methods like double-checking procedures and computerized protocols that were also found to be effective strategies for reducing insulin errors. [ 6 ]…”

Errors in diabetic insulin therapy and the vitality of proper precautions in Bangladesh: Real-life insights from the developing world

“…[ 4 ] About 31% of patients with diabetes are treated with insulin, and a significant proportion of medication errors resulting in death within 48 h involve insulin therapy. [ 5 6 ] From 2007 to 2011, there were over 97,000 emergency room visits annually related to insulin, with about one-third of these events resulting in hospitalization. [ 7 ] The most common reason for insulin-related hypoglycemia was incorrect medication administration.…”