An insulin pump trainer who worked with a pump company recently trained one of our patients in his home.
The patient had never worn a pump before but had decided to go on it because his physician had explained that it would be easier. The patient had a couple of phone follow-up calls during which he assured the trainer that he had no questions or problems. We saw the patient for a 90 day follow-up and his A1c came back at 13.1.
I asked the patient what was happening each day and he went through step-by-step how he controlled his pump during the day. When it came to meal times he was not bolusing for his meals or for high glucose, and had no idea he was supposed to. I asked the patient if he had learned about bolusing during his training and he commented, “They taught me that stuff in case the ‘automatic feature’ on the pump stopped working.”
We retrained the patient on how and when to do a mealtime or correction bolus and then spoke with the pump trainer about what had happened.
Due to changes in the insulin pump business more training seems to be getting done by company trainers. These trainers are probably the most knowledgeable on the pump and how to use it, but there is less long-term interaction between the trainer and the patient.
All trainers should be following up with patients and ensure that their patients know the step by step process before turning them out on their own. They should not assume that all is well even if the patient says so. Trainers should also let the office doing the patient follow-up know that the patient has been started so the physician and medical staff can be involved in the follow-up with the patient, since they will be working with the patient after the training.
Mary Johnsbeth, RN, CDE
Report Medication Errors to ISMP:
Diabetes in Control is partnered with the Institute for Safe Medication Practices (ISMP) to help ensure errors and near-miss events get reported and shared with millions of health care practitioners. The ISMP is a Patient Safety Organization obligated by law to maintain the anonymity of anyone involved, as well as omitting or changing contextual details for that purpose. Help save lives and protect patients and colleagues by confidentially reporting errors to the ISMP.
And if you have a “Diabetes Disaster Averted” story, please also send it in separately to Diabetes In Control. If we use it you will receive a Visa Gift Card worth $50.00. Click here to let us know the details. (You can use your name or remain anonymous if you prefer.) Please note that ISMP is not associated with this Gift Card promotion.
Copyright © 2013 Diabetes In Control, Inc.
|←Previous Diabetes Disaster Averted
Diabetic Complications and Frostbite
Next Diabetes Disaster Averted →