Options for Managing Insulin With Automated Dispensing Cabinets

Meeting the Challenges of Multi-Dose Vials

Managing insulin for hospital patients poses numerous challenges for both nursing and pharmacy, including shortened expiration date when removed from refrigeration; numerous formulary variations that look-alike, sound-alike; and availability for precise scheduled dose times (meal time, etc.).

Perhaps the greatest challenge relates to handling vials of insulin that contain multiple doses that may or may not be used on multiple patients.

Although there is no single correct way to manage insulin through the automated dispensing cabinet (ADC), the Omnicell® medication dispensing system has some unique features available that may enable you to develop a better procedure for handling insulin at your facility.

Restricting Vials to a Single Patient

Restricting an insulin vial to one patient is recommended by the Institute for Safe Medication Practices (ISMP) and Centers for Disease Control (CDC). Omnicell SinglePointe™ software enables patient-specific medications to be managed in the ADC where they are stored in a patient-specific bin. With this system, multi-use items such as insulin can easily be issued from and returned to the ADC after each administration. Following are two examples using SinglePointe to manage insulin vials restricted to one patient:

Option 1: First Dose Delivered by Pharmacy

  • Pharmacy dispenses a 3 mL vial that is labeled for the patient, and stocks it in the SinglePointe bin assigned to that patient.
  • Nursing issues the prescribed dose of 5 units and uses the Omnicell ADC’s Medication Label Printer to print a label for the syringe.*
  • The vial is returned to the patient-specific bin in the ADC.

Option 2: Insulin Vials Stocked in ADC

  • Insulin vials are treated as floor stock and stored in a single-item (common stock) bin in the ADC.
  • When the nurse issues the vial for the first time to fulfill a patient order, the Medication Label Printer can be used to print a patient-specific label for the vial.
  • The nurse draws up a syringe for the prescribed dose of 5 units and prints a label for the syringe.*
  • The vial is returned to the patient-specific bin in the ADC.

Using Vials for Multiple Patients

If your healthcare facility’s approach is to use a single insulin vial for multiple patients, you can follow this example:

  • Insulin vials are treated as floor stock and stored in a single-item (common stock) bin in the ADC.
  • Upon removing the vial, the nurse draws up a syringe for the patient’s prescribed dose of 5 units and uses the Medication Label Printer to print a label for the syringe.*
  • The vial is returned to the common stock bin in the ADC where it is available for other patients.

The flexibility of the Omnicell system allows it to be configured to track inventory by units of insulin and/or vials for ordering, issuing, and returning.

Conclusion

The Omnicell system is flexible to fit multiple hospital policies, allowing for various approaches to insulin management. In the SinglePointe scenarios, storage, charging, issues, and returns are managed through the ADC. The Omnicell integrated Medication Label Printer adds safety by ensuring the individual doses are properly identified.

Do you have suggestions for managing insulin? Feel free to share them below.

 

*The label includes the dose for the active medication order and can be configured to include the item bar code, which supports bar code medication administration at the bedside.

Learn more about multi-dose vial safety:

Centers for Disease Control

Institute for Safe Medication Practices (ISMP)

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