2012
DOI: 10.2146/ajhp110628
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Changes to medication-use processes after overdose of U-500 regular insulin

Abstract: A multidisciplinary team recommended modifications to the medication-use system regarding U-500 regular insulin after review of a medication error. No errors involving U-500 regular insulin have been reported since implementation of the changes.

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Cited by 13 publications
(10 citation statements)
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“…In this section, we further develop the results and provide theoretical interpretations. Double checking in its different forms is seen as a trusted practice , and has been shown to be helpful in a number of studies and ISMP advisories in spite of the lack of supporting evidence . Some advisories allude to double checking being misunderstood and/or overrated .…”
Section: Discussionmentioning
confidence: 99%
“…In this section, we further develop the results and provide theoretical interpretations. Double checking in its different forms is seen as a trusted practice , and has been shown to be helpful in a number of studies and ISMP advisories in spite of the lack of supporting evidence . Some advisories allude to double checking being misunderstood and/or overrated .…”
Section: Discussionmentioning
confidence: 99%
“…It is recommended that hospitals have institutional policies for use of U-500 insulin in the inpatient setting. 8,10,43-45 These policies should define where U-500R will be stored in the pharmacy and/or nursing unit. The policy should dictate whether the syringe is filled in the pharmacy or on the patient care unit, how U500R should be prescribed, and how it should be administered.…”
Section: Inpatient Use Of U-500rmentioning
confidence: 99%
“…Because hospital formulary policies for U-500R predominantly use tuberculin/volumetric syringes (milliliter markings) 44,45 and U-100 syringes are the most often used syringes in outpatient settings (apart from Veterans Administration facilities), instruction (or reinstruction) on the use of U-100 insulin syringes may be needed at discharge. Upon reviewing the conversion of actual units of U-500R to measured unit markings on a U-100 syringe, the diabetes educator can also ensure that take-home instructions and prescriptions include actual units of U-500R in addition to the U-100 syringe unit markings.…”
Section: Inpatient Use Of U-500rmentioning
confidence: 99%
“…These included storage of U‐500 insulin vials in pharmacy only, restricting prescribing to the endocrine service, developing a specific order set for U‐500 insulin, preparing U‐500 insulin in pharmacy as patient specific doses, using tuberculin syringes for U‐500 insulin, double checking of the dose by two pharmacists at the time of dispensing and by two registered nurses at the time of administration. New patient education materials were also produced . Where intravenous insulin infusion is required patients must be switched back to U‐100 insulin, but may require high infusion rates at higher blood glucose levels .…”
Section: Guidelines For Usementioning
confidence: 99%