Insulin_Infusion_Gui delines

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INSULIN INFUSION GUIDELINES : 

INSULIN INFUSION GUIDELINES GSPP JUNE 2010

INSULIN : 

INSULIN Insulin drips are used to treat conditions and diseases IDDM DKA Hyperglycemia associated with TPN/TEN Steroids Pancreatitis Infection SIRS

INSULIN : 

INSULIN Upon initiation of an Insulin drip ALL other Insulin must be stopped!!! An order to discontinue SSI or Lantus must be obtained - if this has not been done notify the practitioner

INSULIN : 

INSULIN If TEN or TPN is stopped while the patient is receiving an Insulin drip Notify the practitioner immediately Obtain an order and start D5 and ½ NS at the rate of the TEN or TPN Monitor BG every one hour until stable.

INSULIN : 

INSULIN The Insulin Guideline is found in the “GSPP LTACH Clinical Nursing Reference” binders at each nurses’ station There must be an “Independent Double Check” (IDC) when the infusion is started and with each change in the dose rate

INSULIN : 

INSULIN To indicate that an IDC has been done both RNs should second signature in VISICU During Rounds the RN needs to report the current dose rate (not the mL/hr) and the most recent BG

INSULIN : 

INSULIN This infusion must be run on the Alaris pump using the “Guardrail Drug” feature If a bolus is ordered it can be given through the Alaris pump The infusion must be documented in VISICU under “Infusions” at the bottom of the vital sign column by the RN with EVERY set of VS and BG

INSULIN : 

INSULIN The RN needs to assess for S/S of hypoglycemia c/o dizziness N/V Decreased MS (lethargy or obtunded) Seizure activity Diaphoresis – “cold & clammy” Pallor

INSULIN : 

INSULIN Remember this is only a Guideline and it is subject to change by the ordering practitioner An order MUST be obtained for EACH change in the infusion dose rate Documentation is very important and drip checks are required at change of shift with a second signature in VISICU

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