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Reduce Adverse Drug Events Involving Insulin:
Permit Patients to Self-Administer Insulin

Many patients on insulin have been administering their own doses at home quite successfully for some time prior to their hospital admission. Yet, once in the hospital, we often take this responsibility away from them, only to give it back again at discharge. Involve patients in their own care by having them administer their own insulin while in the hospital if they feel comfortable doing so. Not only does this serve as an excellent opportunity to verify patients’ understanding of their medications and provide education, but it also helps prevent adverse drug events. Timeliness of insulin administration is important in preventing adverse drug events. Patients have the most at stake in making sure that their medications are administered correctly and on time and therefore are likely to try to do it correctly. Since patients have only their own medications to administer, they may have a better chance of doing so on time than busy nursing staff might.


Tips
  • Encourage patients who are experienced in doing so at home to administer their own medications while in the hospital, but don’t force the issue. If the patient is uncomfortable with the idea, it may be best not to take this course.
  • Encourage patients for whom insulin is newly prescribed to administer their own doses while in the hospital so they will become competent in doing so before they go home. Supervise administration to verify the patient’s understanding.
  • Have the parents of pediatric patients administer medications to their children as long as it is appropriate and they are comfortable with the idea.
  • Remember that older pediatric patients (not babies or toddlers) like to be included in their care and have a role, so consider ways for them to be involved in self-medication with appropriate supervision. This is particularly important for children with chronic illnesses.
  • Ensure that there is a good recording system in place to accurately capture information about doses that patients have administered themselves. Consider a patient-maintained medication administration record.
  • Re-assess patients regularly to ensure that they are still appropriate for self-medication, as their clinical condition and some therapies may affect their ability to do this well.