Insulin safety is a key priority nationally for healthcare organizations, the Institute for Safe Medication Practice (ISMP) Canada and provincial governments. There is a growing interest in the adoption of insulin pens in the hospital setting as a means to improve insulin administration safety and ensure continuity of insulin product use by the patient from the community to the hospital setting and at discharge.
The Pharmacy leaders at the University Health Network (UHN) and Hamilton Health Sciences (HHS) agreed to collaborate for insulin pen implementation in 2013, as both organizations were undertaking conversion to insulin pens at one or more of their sites. The knowledge gained from this project led to the development of a toolkit to provide guidance and stewardship to other healthcare organizations in the safe implementation of insulin pen use in a variety of adult patient care settings.
The collaboration examined the following:
- To evaluate the effectiveness of the toolkit tools in the safe conversion to insulin pens on selected patient care areas at HHS and UHN.
- To evaluate outcome measures related to insulin administration to further inform healthcare organizations.
- To evaluate the work flow and workload changes related to conversion from insulin vials and syringes.
- To facilitate knowledge translation principles of synthesis, dissemination, exchange and application of knowledge to improve health services.
- To evaluate outcome measures related to insulin administration.
- To capture lessons learned for the benefit of other healthcare organizations.
- To develop a best practice education and implementation plan for replication by other healthcare organizations across the country.
In order to help other organizations embark on the shift in clinical practice to use of insulin pens, UHN and HHS have developed a toolkit within the framework of five guiding dimensions of what is required to successfully achieve such a practice change. This framework is supplemented, in a series of appended documents, with checklists designed as considerations for healthcare organizations to take into account as they contemplate this clinical practice change.
The framework offered in the toolkit captures the essence of the UHN and HHS experience and is offered from an evidence based perspective as an essential component for successful adoption of clinical practice changes related to insulin administration. (Health Standards Organization, 2015)