The Right Way to Mix, A Step by Step Guide for Student Nurse's and Parents of Type 1 Diabetes on How to Draw up Mixed Insulin using an Insulin syringe

Background The incidence of Type 1 Diabetes in children is growing at the rate of 6.4% per annum (ISPAD 2014). The only treatment for Type 1 Diabetes is insulin replacement. Therefore, correct administration of insulin is... [ view full abstract ]

Background

The incidence of Type 1 Diabetes in children is growing at the rate of 6.4% per annum (ISPAD 2014). The only treatment for Type 1 Diabetes is insulin replacement. Therefore, correct administration of insulin is essential to maintain normal glucose levels. Maintaining glucose levels in the target range has been conclusively demonstrated to prevent and delay the onset of diabetes complications (DCCT 1993).

The NHS Patient Safety Agency (2010), issued new guidelines of insulin administration in response to 3,881 incorrect insulin doses between 2004-2009. The 4th National Patient Safety Agency (2007), cited, insulin as one of the top ten high alert medicines and as one of the medicines most commonly associated with incidence that lead to death or severe harm.

Aims & Objectives

Given the potential harm from not mixing insulin correctly, a teaching poster was devised to teach student nurse's and newly qualified staff the correct way of mixing insulin on the designated diabetes ward at a Dublin children's hospital. This poster was designed to improve knowledge and practice and to promote the safe mixing of insulin in a consistent and uniformed manner.

Description of innovation

A poster describing a 5 step approach for mixing insulin was devised which included rationale for each step. The poster was visual and colour coded that made it easy to follow, remember and implement. The 5 step approach was in alignment with local drug administration guidelines and policies and also underpinned by the ISPAD (2014) insulin administration guidelines.

Impact of Innovation

All Junior staff were taught the five step approach to mixing insulin using the poster as a guideline which was available in the clinical area where the insulin was prepared. The development of nursing knowledge and competency in insulin safety and administration was achieved. The poster is now used as part of induction for all new staff to the clinical area.

Conclusion

It is hoped that this five step approach of mixing insulin will be expanded to other clinical areas so to standardise the approach to mixing insulin and reduce the potential for error and ensure safe practice.