In assessing an in-patient’s diabetic educational needs, I was reviewing with him his in-home regimen for his insulin therapy. Per his report, he stated that he took Levemir 50 units twice a day. I asked if it was by needle, syringe and vial preparation, which it was. I instructed him re: the shelf life of Levemir of 42 days once opened. He stated, “I throw it out after a month, but there is always insulin in the vial.” He also said he has more than an adequate supply. He was receiving his insulin by mail-order, receiving as he should, but not using it in a timely fashion. In other words, he was stockpiling his insulin.
I asked him to review with me again the dosing that he takes as I reviewed the math with him. If he is taking 100 units per day and a vial contains 1000 units, his Levemir should be gone in 10 days. Both he and his wife had quite a perplexed look on their face after they did the math in their head. She stated she always left his medication management to him. I reviewed his dosing again with him and reviewed how many vials he should go through in a month.
I taught them how to properly draw up and administer the insulin. He performed a return demonstration.
I requested that they work together as a team and to have his wife review with him his drawing up technique for accuracy. I encouraged them to follow up with me at discharge to discuss further questions/concerns.
- Inform patient about how long an insulin vial or pen should last. Inform the patient how long an insulin vial or pen should last once opened. This stresses the importance of proper expiration once opened versus shelf life.
- Explore with the patient not only what he or she is verbally telling you, but ask how often they use a new vial or pen, and if they have extras at home. If so, how many?
- Always perform a demonstration and ask for a return demonstration, and make sure the return demonstration is done correctly before discharge.
Janet Howard-Ducsay RN BA/BSN CDE
Diabetes Nurse Educator
Redlands Community Hospital
If you have a “Diabetes Disaster Averted” story, please let us know! If we feature your Disaster Averted in our Diabetes Clinical Mastery Series e-newsletter, you will receive a $25 gift card. Please click here to submit a short summary of the incident, what you feel you learned from handling the incident, and your name and title. If you prefer to remain anonymous, please let us know, but still give us your name and address (so we can send you the gift card).
Copyright © 2015 HIPER, LLC