- Insulin – is a hormone secreted by the pancreas that promotes glucose
utilization, protein synthesis, formation and storage of natural lipids.
- Continuous IV Infusion – is a method of administering IV medication to a patient at a constant rate through a syringe pump to maintain a stable level of the medication in the blood.
- To standardize methods of intravenous insulin administration.
- To provide guidelines for monitoring patients receiving insulin infusion.
- To reduce the occurrence of possible complications.
INTRAVENOUS INSULIN ADMINISTRATION
PROCEDURES & RESPONSIBILITY
- Continuous insulin IV infusion shall have a written physician order, as well as a separate specific order for each rate, changed based on capillary blood sugar results.
- Regular insulin is the only insulin that can be given through IV.
- A patient who is on continuous IV insulin infusion should be kept under close observation.
- An infusion pump should be used for IV insulin infusion.
- Insulin infusion should be a separate IV site whenever possible.
|Write the order for the administration of insulin infusion and clearly document the specific order for each rate change based on the result of the capillary blood glucose.||Physician|
|Document all the pertinent information in a timely manner in the medical record.||Physician|
|Prepare the IV insulin infusion using the following solution:
50 ml Normal Saline containing 50 units Regular Insulin (1 unit/ml).
|Baseline blood sugar by finger stick should be checked before starting an insulin infusion.||Registered Nurse|
|A copy of physician order should be sent to the pharmacy (Unit Dose System).||Registered Nurse
|Initiate and regulate the IV insulin infusion according to the doctors’ order.||Registered Nurse|
|Document IV site condition, infusion setting and patient level of consciousness at the beginning of infusion and any additional information in the nurse’s notes.||Registered Nurse|
|A patient on continuous IV infusion shall have a capillary blood glucose monitoring every 1-2 hourly, and if it remains stable may decrease to 4 hourly.||Registered Nurse|
|Monitor the patient every 2 hours or as ordered by the doctor for the
· Level of consciousness
· Signs and Symptoms of Hypoglycemia
· Other pertinent parameters
|Use professional judgment and ongoing assessment when caring for a patient who is on IV insulin infusion.||Registered Nurse|
|Notify the attending physician of any changes in the patients’ status.||Registered Nurse
|Check the urine ketones if blood glucose is 250 mg/dl and above. Notify the physician for positive ketone bodies.||Registered Nurse|
|Discontinue the infusion as ordered by the treating physician.||Registered Nurse
|Check capillary blood glucose 30 minutes after discontinuing the infusion, then repeat every 6 hourly or as may be ordered by the physician, and if any change (deterioration) in the level of consciousness.||Registered Nurse
- CBAHI 3rd Edition Standards
- JCIA 5th Edition Standards