June 5, 2013

Safe Use of Insulin Vials

The Institute for Safe Medication Practices (ISMP) changes their mind again and is now urging hospitals to return to insulin vials and syringes and migrate away from the use of insulin pens in hospitals. This I can understand and appreciate as hospital personnel are nefarious for not following safe practices and creating cross patient contamination.

This is off topic, but the last time I was in the hospital, I lost count of the number of medical personnel that came by to listen to my heart and breathing. Did they clean their stethoscope before using it on me? Did they clean it before using it on the next patient? I cannot answer this positively, but the two times I asked, the doctor hesitated and said no. He asked why I asked, and I quickly said MRSA contamination. Then I next asked a nurse and was met with dead silence. I repeated the question and again received no answer. I then commented that it was no wonder we as patients needed to be concerned about safety and cross-contamination from other patients. This set off a litany of comments about patients not understanding medical procedures and should not be questioning their procedures.

Yes, we as patients need to be aware of the lack of safety procedures that are not practiced by our hospitals. Until hospital boards are faced with multimillion-dollar lawsuits for causing patient deaths, little with change from the top down. I emphasize top down, as there is no incentive for hospital staff to be concerned when policies do not come from the hospital boards to the administrators and then the department heads. Most often the staff is not made aware of good procedures and is told to be more careful to cut costs where possible. They see this as reusing needles for patients after patient, and creating cross contamination with both needles and insulin vials.

In this case, the Institute for Safe Medication Practices may be just flapping their gums, as without support at the highest levels of our hospitals, little will happen. I do give the ISMP good marks for recognizing some of the more egregious errors by hospital staffs. Hopefully the Centers for Medicare and Medicaid Services (CMS) will be able to aid in enforcement of some procedures.

I fear that the example used in the article may become commonplace and more deaths will occur. Most hospital staff is not aware of the distinction of insulin syringe and other parenteral syringes used by the hospitals. Medication errors will probably increase many times before the staff is made aware of the problems happening.

For patients entering the hospital, do everything in your power to discern the procedures followed by the hospital and if not an emergency hospital entrance, get as much in writing as possible allowing you the right to manage you own diabetes if possible. Do not trust this to the hospital for your own well-being.

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