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Clinical Hub,Patient Education,Health and Nutrition Facts For You,Diabetes, Endocrine

Using Your Insulin Pump in the Hospital (7012)

Using Your Insulin Pump in the Hospital (7012) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Diabetes, Endocrine

7012









Using Your Insulin Pump in the Hospital

If you use an insulin pump at home, this Health Fact for You will help you decide if it is safe to
use your pump in the hospital. It will explain what your healthcare team will expect of you if
you stay on your pump. It will also describe what you can expect from your team. Please tell
your nurse or another member of the healthcare team if you do not want to use your pump.

What We Expect of You

 Manage Your Pump
 You must be able to use your pump without help from healthcare team members.
 You must be able to review pump settings like basal rates, bolus doses, and
correction doses. If changes are needed, you will need to do this without help
from healthcare team members.
 You must let us know how you correct or “fix” your high blood sugars.
 You must let us know about changes you make to your pump settings. We need to
record the doses of insulin you give.

 Provide Pump Supplies
 You must provide all of your pump supplies. If you do not have supplies, we will
likely need to stop your pump and inject insulin with syringes.
 If needed, we can provide the insulin. Talk with your nurse and/or pharmacist
about this.

 Change Infusion Site
 You must be able to change your infusion site without help from healthcare team
members. This should be done every 2-3 days. If you change your site more or
less often, let a member of your healthcare team know.

 Let Staff Check Your Blood Sugars
 You must allow us to check your blood sugars using our hospital blood glucose
meters. These meters are checked every day for accuracy. The results are also
recorded so that all team members are aware of the results.
 Use these results to decide how much insulin to give yourself.
 You may use your own lancet device if you prefer.


 Count Carbohydrates (“Carbs”)
 If you did not count carbs at home, you do not need to do so in the hospital.
 If you do count carbs, you must tell the healthcare team what your insulin to carb
ratio is. If the ratio varies during the day, let us know.

 Troubleshoot
 You must be able to deal with pump problems. You should at least know the toll
free 1-800 phone number for the pump company. If the problem cannot be fixed,
let staff know right away so that we can help to figure out the next step.

 Communicate
 Help us to keep you safe! You must be willing to talk with your team about your
pump. Some staff like those taking x-rays, may not know that you have a pump.
They need to know that you have a pump in order to provide the best care
possible.
 You must let nursing staff know about changes you plan to make with your pump
settings.
 You must let nursing staff know if you do not have enough supplies to keep using
your pump.
 Ask questions if you have any!

What to Expect from Your Healthcare Team

 Assess Your Ability to Use a Pump Safely
 We will ask you questions about your pump. Questions will include:
o What type of insulin do you use?
o Can you show me the basal rates that you have programmed?
o How much insulin do you give to cover meals? What about snacks?
o How do you treat your high blood sugars?
o What do you do with your pump when you have a low blood sugar?
o Do you know how to change your pump settings?
o What do you do if you think the pump is not working?
o How often do you change your infusion site?
 We will also be sure that you do not have any mental or physical issues that could
impact safety.
 Nurses will ask how much insulin you have given for food and high blood sugars.
They will also confirm your basal doses. This will be recorded in your record.

 Check Your Blood Sugars
 The nursing staff will check your blood sugar at least 4 times a day.
 If your blood sugar is high (>250 mg/dL), your healthcare team will help to find a
cause. If no cause can be found and the blood sugars stay high, you may need to
stop using your pump. Insulin can be given using syringes instead. In some
cases, an intravenous (IV) infusion will be needed.


 Look at Your Infusion Site
 Staff needs to look at your infusion site. They need to look for signs of infection
or other skin problems.

 Coordinate Special Circumstances
 X-rays, CT, MRI, PET Scan or other tests using magnetic fields: It is not safe
to have your pump connected when you have certain tests. If you need these
tests, you will be asked to disconnect your pump. It should be kept in a safe place
outside of the room where you are having the test. Your healthcare team will help
to coordinate this.
 Surgery: Talk with your team about whether it is safe to keep your pump on
during surgery. It may be possible if the surgery is less than 2 hours.
 If your pump needs to be removed for more than 1-2 hours, you may need insulin
injections with syringes. In some cases, an intravenous (IV) infusion will be
needed. Your healthcare team will discuss the changes with you.

 Prioritize Your Safety and Health
 Our priority is your health and safety. If it is no longer safe for you to keep using
the pump, it will need to be removed. Reasons could include:
o You are no longer able to use the pump without help from the team.
o You have high blood sugars that cannot be controlled using the pump.
o You have repeated low blood sugars.
o You do not communicate with us about the insulin you are giving.
 If your pump needs to be disconnected for any reason, insulin will be given using
a different method.


Please let us know if you have any questions or concerns.














Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911.Copyright © 7/2015. University of Wisconsin Hospital and
Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7012

Patient’s Bedside Record for Insulin Pump Use in the Hospital


Please help us to keep track of how much insulin you are using through your pump. Let us know
if you have any questions. Thanks!

Today’s Date: __________

Brand/Model of Insulin Pump: ______________
Type of Insulin: _________________
Current infusion site started on _______________ (date) Location: ____________
If infusion site changed today – Time: __________

Total Daily Dose (Past 24-hour total): __________________ units

ξ The nurse will ask you for this information every morning. We ask that it be charted in your
medical record.
ξ It is the total amount of insulin given during your day yesterday.
ξ You should be able to find this amount in the "Utilities" or "History" menu or "Home/My
records" section based on the brand of the pump you use. Please ask the nurse for help if you
can’t find it.

Date Time Blood
Sugar
Bolus Dose Comments
RN Initials
(once
reviewed)
units
units
units
units
units
units
units
units
units
units
units
units


RN Instructions:
1. Provide a new flow sheet to patients every day.
2. Document Total Daily Dose and Bolus doses in the IV/IV MAR.
3. As needed, refer to Policy 8.37: Use of a Subcutaneous Insulin Pump (Patient's Own) in the
Hospital Setting and other resources on U-Connect (Diabetes Management/Insulin Pumps).