Sharing Insulin Pens: Are You Putting Patients at Risk?

Schaefer, Melissa K.; Kossover, Rachel; Perz, Joseph F.

doi:10.2337/dc13-1522

Cited by 14 publications

(4 citation statements)

References 1 publication

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“…14,15 Insulin pens are approved for use only by a single patient, but reports of pen reuse in multiple patients have been published. 16,17 These reports are alarming because the patients involved were potentially exposed to blood-borne pathogens. The incidents of pen sharing involved 2114 patients at a federal hospital in Texas (reported in 2009), 1915 patients at a community hospital in New York (reported in 2013), 716 patients at a federal facility in New York (reported in 2014), and 3149 patients at a community hospital in Connecticut (reported in 2014).…”

Section: S5mentioning

confidence: 99%

Best practices for safe use of insulin pen devices in hospitals: Recommendations from an expert panel Delphi consensus process

Haines

Miklich

Rochester-Eyeguokan

2016

American Journal of Health-System Pharmacy

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Section: S5mentioning

confidence: 99%

Best practices for safe use of insulin pen devices in hospitals: Recommendations from an expert panel Delphi consensus process

Haines

Miklich

Rochester-Eyeguokan

2016

American Journal of Health-System Pharmacy

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“…For instance, to minimize the risk of contamination related to sharing the pen device among multiple users [ 7 ], study nurses performed a “sure self-identification” by asking name, surname, and date of birth to every patient. A more sophisticated electronic “code-number” system of identification could be more suitable over the long-term period [ 18 ]. We also recommend caution when generalizing our findings to nurses working in non-medical hospital units such as surgery or emergency departments.…”

Section: Discussionmentioning

confidence: 99%

“…This factor was also inversely related to time spent teaching patients how to self-inject insulin using pen devices. Nurses’ training programs for the implementation of pen devices in the hospital setting are mainly focused on reducing risk to the patient and personnel [ 6 , 18 , 19 ]. Our findings imply that nurses’ satisfaction can be strengthened during the training program by targeting all aspects related to nurses’ perceived workload.…”

Section: Discussionmentioning

confidence: 99%

Determinants of nurse satisfaction using insulin pen devices with safety needles: an exploratory factor analysis

Veronesi

Poerio

Braus

et al. 2015

Clin Diabetes Endocrinol

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BackgroundA paucity of data exists to examine nurses’ satisfaction with the use of insulin pens with safety needles in hospitalized patients with diabetes. We investigated major determinants of nurses’ preference of the method of insulin administration in the context of a General Hospital in Northern Italy.MethodsConsecutive patients admitted to three hospital units of different care intensity requiring insulin received insulin therapy through either the vial/syringe method (October to December 2012) or pen/safety needles with dual-ended protection method (January to March 2013). Before the implementation of insulin pens, floor nurses received a specific training program for proper insulin pen injection technique including individual testing of the devices (pen/safety needles). At the end of the study, nurses completed the Nursing Satisfaction Survey Questionnaire. Cronbach’s alpha was used to determine the internal consistency and reliability of the questionnaire. Major determinants of satisfaction were investigated through an exploratory factor analysis. The association between each retained factor and time spent to teach patients how to self-inject insulin with pen devices was also investigated.ResultsFifty-three out of 60 nurses (mean age ± SD 36.2 ± 8.5 years, 85 % women, 57 % with 10+ years of working experience) returned the questionnaire. Internal consistency of the questionnaire was satisfactory (Cronbach’s alpha > 0.9). Three months after their introduction, about 92 % of nurses considered pen devices an “improvement” over the vial/syringe method. Two factors explained 85 % of nurses’ satisfaction, one related to convenience and ease of use, and the other to satisfaction/time spent for dose preparation and administration. The latter factor was inversely correlated with time spent on patients’ training tasks.ConclusionsNurses’ satisfaction with pen devices was higher than previously reported, possibly reinforced by safety needles with dual-ended protection. Perceived workload was a major determinant of nurse satisfaction using pen devices with safety needles. To facilitate the introduction of insulin pens in the hospital setting, it should be specifically addressed during training programs in the switch-over period.

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“…These benefits are associated with patient preference, treatment satisfaction, betterquality of life so as to improve adherence to insulin treatment and achieve better glycemic control [7-12]. Despite these arguments and the wide availability of pen devices, vial/syringe for subcutaneous insulin injection is still the preferred system for in-hospital insulin delivery, mainly due to direct costs [13] and safety concerns both on the patients [14, 15] and on the healthcare professionals [16] sides.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Study for Introducing Insulin Pens and Safety Needles in a Hospital Setting. The SANITHY Study

Bossi

Veronesi²,

Poerio³

et al. 2016

CDR

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BackgroundTo assess costs and safety of insulin pen devices and safety needles as compared to vial/syringes in hospitalized patients requiring insulin therapy in a General Hospital in Northern Italy.Materials and MethodsIn a prospective 9-month study, consecutive patients admitted to three Hospital Units received insulin therapy through either a traditional disposable syringe method, or pen/safety needles with dual-ended protection, or disposable safety syringes. We compared the median direct (insulin and devices) and indirect (insulin supply at discharge, insulin wastage) costs of a 10-day in-hospital insulin treatment in the 3 study groups, additionally accounting for the costs related to the observed needlestick injury rate. Patients’ safety during in-hospital stay (hypo- and hyperglycemia episodes) and satisfaction were also assessed.ResultsN=360 patients (55% men, mean age 75.6 years, 57% with DM since ≥10 years) were recruited in the study. Insulin pens had higher median direct cost than both traditional syringes (43 vs. 18 €/patient, p<.0001) and safety syringes (21.5 €/patient, p<.0001). However, when also indirect and injuries costs were taken into account, the estimated savings for using pens over traditional syringes were as high as 32 €/patient (45.8 vs. 77.6 €/patient, p-value <.0001). No differences in patients’ safety were observed. 74% and 12% of patients using pens and syringes would like to continue the method at home, respectively (p<0.0001).DiscussionA selective use of individual pre-filled pens/safety needles for patients who are likely to continue insulin therapy at home may strongly reduce hospital diabetes treatment related costs.

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Sharing Insulin Pens: Are You Putting Patients at Risk?

Cited by 14 publications

References 1 publication

Best practices for safe use of insulin pen devices in hospitals: Recommendations from an expert panel Delphi consensus process

Best practices for safe use of insulin pen devices in hospitals: Recommendations from an expert panel Delphi consensus process

Determinants of nurse satisfaction using insulin pen devices with safety needles: an exploratory factor analysis

A Prospective Study for Introducing Insulin Pens and Safety Needles in a Hospital Setting. The SANITHY Study

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