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/clinical/nursing-hub/npg/quick-help/resources/Quick-Help-for-Nurses-Insulin-Pump-2017-FINAL.pdf

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Clinical Hub,Nursing Hub,Nursing Practice Guidelines,Quick Help for Nurses,Resources

Insulin Pump - Nursing Quick Help

Insulin Pump - Nursing Quick Help - Clinical Hub, Nursing Hub, Nursing Practice Guidelines, Quick Help for Nurses, Resources


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Hello Nurses. We are the Diabetes Clinical Nurse
Specialists for adult and pediatric patients here
at UW Health. To your left you will find some
quick topics to help you take care of patients
with insulin pumps.
Just click on the pictures to the left to
learn more.
Quick Help for Nurses:
Insulin Pumps
Nursing Practice Innovation, 2017

Quick Help for Nurses:
Insulin Pumps
Orders & Documentation
Special Considerations Patient Responsibilities
Nurse Responsibilities

Orders & Documentation

Order sets must be used by providers to enter insulin pump
orders for Pediatrics & Adults.

HOME
Required
Documentation
Chart
patient-
administered
doses in
IV/IV MAR

Chart
competency
assessment
in Patient
Education
activity
Caring for
Patients with
Insulin Pump:
What Every
Nurse Needs
to Know
Confirm MAR
orders match
pump
programming
Chart
site/LDA in
IV/IV MAR
(twice daily)
Nursing Practice Innovation, 2017

Nurse Responsibilities
HOME
Competency Assessment
(Assessment Guide for
Insulin Pump Self-
Administration Competency)
Agreement form (provider
completes with patient,
every admission)
What to do for
tests/surgery/etc.
See Caring for Patients with
Insulin Pump: What Every
Nurse Needs to Know
Check blood glucoses
using hospital glucose
meter
Assess infusion site
twice daily
Document bolus doses
(covers meals &
hyperglycemia) and
Total Daily (24 hour)
dose
Nursing Practice Innovation, 2017
Helpful Forms and Links

HOME
Patient
Responsibilities
Patient (or family)
must be able to
manage pump
independently.
Must communicate
with staff about
changes, doses,
and questions.

Must be able to
change the infusion
site.
Must let staff
check their blood
glucoses on the
hospital glucose
meter.
Should know how to
troubleshoot pump
problems by calling
pump company at
minimum.
Must provide own
pump supplies
Patient Responsibilities
Link to Health Facts for You (#7012): Using Your Insulin Pump in the Hospital

Nursing Practice Innovation, 2017

Special Considerations

HOME
What is an insulin pump?
• Answer: An insulin pump is a computerized device powered by an external
battery. The pump has a reservoir that is filled with rapid-acting insulin in
most cases.
How does an insulin pump work?
• Answer: The insulin infuses subcutaneously through a thin plastic catheter
called an infusion set. The pump is worn 24 hours a day and continuously
delivers pre-programmed amounts of insulin. Bolus doses of insulin are given
to cover carbohydrate intake and to correct hyperglycemia.
What should be done if patient needs procedure/surgery?
• Answer: If a procedure/surgery involves radiation, magnetic fields, or
electrocautery, it must be removed and taken out of the room. If surgery is
less than 2 hours, the patient may be able to keep the pump on. If longer than
2 hours, the pump needs to be removed and another source of insulin given.
What if patient refuses to remove pump for a procedure or surgery?
•Answer: Offer the Health Facts for You and explain the reason for removal. Ask
the team to discuss with patient. If patient still refuses, document in EHR. If
radiation is involved, cover pump with lead shield. More glucose checks may be
needed after test. If having surgery, notify Anesthesia.
My patient has a Continuous Glucose Monitor (aka, “CGM”
or “sensor”). What is it and what should I do with it?
• Answer: These devices continuously monitor and record interstitial fluid
glucose. It does not replace POC glucose checks. It should NOT be thrown
away but kept/labeled for a patient if it needs to be removed. There are
similar restrictions for procedures/surgery as there are for insulin pumps.
• Link to Policy 2.3.19: Subcutaneous Insulin Pump (Patient's Own) and Continuous
Glucose Monitor Use in the Hospital Setting (Adult and Pediatric)
• Link to Continuous Glucose Monitoring (CGM): Information for Clinicians