Insulin Administration by Syringe

1. Insulin Administration by Syringe 5/4/2012 1

2. Make sure the volume is turned up (volume button beneath the speaker’s picture) Make sure the volume on the computer is turned up (volume icon located on the right hand side of your computer taskbar) Contact your local IT department If audio and visual is lost during the program, go back to: http://media2.wi.gov/dpi/catalog/, and click on the Student Services Prevention and Wellness Team link on the left, then when the SSPW Team page of archived programs appears, select the program link desired. If problem persists, contact Rachel Gallagher (608) 266-8857. 5/4/2012 2

3. This webcast and test will satisfy the knowledge portion of medication training. This webcast covers basic procedures for administering insulin by syringe. There are different kinds of syringes, and variations in directions for different students. Demonstration, skills observation, consultation, and ongoing supervision by the school nurse or parent will be important for accurate and safe medication administration. 5/4/2012 3

4. Competency checklist are available at: http://dpi.wi.gov/sspw/schlnurse.html For more information regarding delegation and consultative service, see DPI question and answer document at: http://dpi.wi.gov/sspw/pdf/snpracticeact.pdf Products used were for demonstration purposes and are not an endorsement of the products. 5/4/2012 9

5. What topic will be discussed? What is diabetes? What is the prevalence of diabetes? What is the difference between type 1 and 2 diabetes? What is insulin? What are some important facts regarding insulin? What are the supplies needed? What are the parts of an insulin syringe? What is the insulin administration procedure? 5/4/2012 4

6. What is Diabetes? Chronic Disease Two major types – Type 1 and Type 2 Type 1 Diabetes – Pancreas produces no or small amounts of insulin. Type 2 Diabetes – Pancreas does not produces enough insulin and/or it does not work as it should (sensitivity) Both types require balancing food, exercise and insulin to keep blood sugar as close to the normal range (80-120 mg/dl) as possible. 5/4/2012 5

7. What is the prevalence of type 1 and 2 diabetes? 151,00 students with type 1 diabetes under the age of 20 (CDC, 2011) 1.7 per every 1,000 students 1-19 years has been diagnosed with type 1 diabetes. http://www.cdc.gov/diabetes/projects/cda2.htm 7.2 per every 100,000 student has been diagnosed with type 2 diabetes (CDC, 2011) http://www.cdc.gov/diabetes/projects/cda2.htm 5/4/2012 6

8. What is the difference between type 1 and 2 diabetes? Type 1 diabetes is a chronic disease where the pancreas produces no or little insulin needed to control blood sugars in the blood. Treated with insulin, monitoring blood glucose levels, exercise and healthy foods. Type 2 diabetes is a chronic disease where the pancreas does not produces enough insulin and/or the body is not able to use the insulin properly. Treated with healthy foods, exercise, oral medication and/or insulin. 5/4/2012 7

9. What is insulin? Hormone produced by the pancreas Regulates blood sugar levels in the body Used to treat diabetes Given by syringe, pen or pump 5/4/2012 8

10. What are some important facts regarding insulin? Check expiration date. Immediately after opening, place date on vial. Do not shake. Stored in a vial, which is effective for 28 days for after opening for fast-acting insulin. Stored at room temperature without exposure to sunlight. Measured in units. Administered in the subcutaneous tissue or the tissue between the skin and firm muscle mass. 5/4/2012 9

11. What is needed prior to administration of insulin by syringe? Medical provider and parent authorization Syringe Vial of insulin Gloves Alcohol swab(s) Authorized Sharps disposal container Glucose monitor 5/4/2012 10

12. What are the parts of a insulin syringe? 5/4/2012 11

13. What are the five rights? Right student Right medication Right dosage Right time Right route or method of administration Right to documentation 5 Rs + 2 Right Reason 5/4/2012 12

14. What is the procedure for administration of insulin? Gather supplies. Check the rights. Wash hands and apply gloves. 4. Check the insulin vial to make sure you have the correct type of insulin and it is has not expired. 5. Recheck the rights. 6. If the vial is new, remove lid. 7. Wipe stopper with alcohol swab. 8. Remove cap from insulin syringe without touching needle. 5/4/2012 13

15. Procedure cont. 9. Pull air into syringe by pulling back on plunger until the black bar is even with the line showing the exact units of insulin needed. 10. Push needle through rubber top of vial at a 90° angle. 11. Push plunger so that air goes from syringe into vial. 5/4/2012 14

16. Procedure cont. 12. Turn vial upside down. Pull insulin into syringe by slowly pulling back on plunger until top of its black bar is even with the line showing units of insulin needed. If present, remove all air bubbles (See demonstration of two methods). 5/4/2012 21

17. Procedure cont. 13. Select an injection site with the assistance of the student as appropriate. Insulin is most effective when sites are rotated. The most common places to inject insulin are the: abdomen, upper arm, upper buttock, and outer thighs. 14. Cleanse skin with alcohol swab (optional) and allow skin to dry. Never fan or blow on area cleansed with swab. 5/4/2012 15

18. Procedure cont. 15. Gently pinch skin of chosen injection site. Hold syringe at a 45-90° angle to skin, and push needle all the way in. 16. Let go of pinched skin and slowly push plunger to inject all of the insulin. 17. Wait 5 seconds before pulling out the needle. 18. Never recap needle. Place used needle in approved sharps disposal container. 19. Remove gloves and wash hands. 20. Document medication administration. 5/4/2012 16

19. Demonstration 5/4/2012 17

20. Questions Any comments regarding this webcast? Any suggestions on future school nursing topics? Contact: Rachel Gallagher (608) 266-8857 E-mail: rachel.gallagher@dpi.wi.gov 5/4/2012 18