Hospital pharmacists... HELP!

[PharmacistReb]

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I'm looking for ways to prevent insulin waste in the pyxis machines. Our nurses are constantly forgetting to date the insulins they open and when we audit the refrigerators we are having to pull these insulins. Also, we're wasting a lot of insulin due to expiration.

How cost effective is it to pre-draw the insulin into a syringe and store it?

Does anyone have any other suggestions for ways to cut down on insulin waste?

We're on pace right now to waste $13,500 of insulin this year.

 

[WVUPharm2007]

I'm looking for ways to prevent insulin waste in the pyxis machines. Our nurses are constantly forgetting to date the insulins they open and when we audit the refrigerators we are having to pull these insulins. Also, we're wasting a lot of insulin due to expiration.

How cost effective is it to pre-draw the insulin into a syringe and store it?

Does anyone have any other suggestions for ways to cut down on insulin waste?

We're on pace right now to waste $13,500 of insulin this year.

This is an issue EVERYWHERE. Unfortunately, pharmacy directors do not have the pull to punish nurses whose laziness costs thousands of dollars. Charge Nurses typically only give you lip service if you complain. They have many things to worry about...and the pharmacy dept budget is pretty low on that list. The only way to ensure a decrease in waste is to not allow them to keep the insulin over there...and unfortunately, that means tons of manpower on the pharmacy side of the equation.

You could draw them up with the IVs if the work load won't overwhelm your staff...that's really a institutional specific problem that needs an institution specific solution...

 

[Praziquantel86]

I'm looking for ways to prevent insulin waste in the pyxis machines. Our nurses are constantly forgetting to date the insulins they open and when we audit the refrigerators we are having to pull these insulins. Also, we're wasting a lot of insulin due to expiration.

How cost effective is it to pre-draw the insulin into a syringe and store it?

Does anyone have any other suggestions for ways to cut down on insulin waste?

We're on pace right now to waste $13,500 of insulin this year.

Are you talking about regular/fast-acting insulin or long-acting?

Pharmacy individually draws up every Lantus order for the day, which is a big pain but ends up saving a ton of money. We switched to Lantus pens for about two months, hemorrhaged cash, and switched right back.

If you can find a solution for waste on fast-acting insulin, you deserve a Nobel Prize.

 

[PharmacistReb]

Are you talking about regular/fast-acting insulin or long-acting?

Pharmacy individually draws up every Lantus order for the day, which is a big pain but ends up saving a ton of money. We switched to Lantus pens for about two months, hemorrhaged cash, and switched right back.

If you can find a solution for waste on fast-acting insulin, you deserve a Nobel Prize.

I'm talking about long acting and short acting. All of our insulin is just sort of strewn around in the pyxis refrigerator. And the nurses are totally disregarding the attempted segregation that we have tried to establish with labels and what not.

Would it be beneficial to draw up the insulin, all kinds, and place unit doses in the refrigerator? Or would it take too long to draw up short acting?

 

[Praziquantel86]

I'm talking about long acting and short acting. All of our insulin is just sort of strewn around in the pyxis refrigerator. And the nurses are totally disregarding the attempted segregation that we have tried to establish with labels and what not.

Would it be beneficial to draw up the insulin, all kinds, and place unit doses in the refrigerator? Or would it take too long to draw up short acting?

I don't think it would be practical to draw up the short-acting insulins, unless you have very good data on the amount used and standardized dosing. It also might be a problem with the JC if you have all that predrawn insulin lying around.

Long-acting, on the other hand, shouldn't be too much of a problem if you have standardized dosing times for them and deliver PRN. The techs also won't be too happy about it (I know I wasn't), but it will end up saving a TON of money.

 

[flrx]

Would it be possible to keep the vials in the pharmacy and have the nurses call to "borrow" them when needed? then they can send the vials back right after using the amt needed? ...would be weird sending multi-dose vials back and forth I guess..and they would get lost anyway..bad idea..The hospital where I work keeps regular insulin vials in each acudose (pixix) *1/floor and these get wasted all the time.
We also have the flexpens but these seem to get lost a lot or come back to the pharmacy after barely being used.

 

[rxlea]

We charge their department if it is a significant discrepancy and call the team lead. We also send labels when we replace the insulin (which we charge as "floorstock") which are rubberbanded to the box so they can fill out the date opened and stick it to the vial.

 

[PharmDstudent]

I see hospitals using the insulin pens, which is one box kit per person.
It's sort of like unit dosing.

You can also charge the patient for an entire bottle, which the nurse gets to keep track of.

 

[J ROD]

I know we switched over to pens....mostly...

 

[drugdoc]

We used to pull up glargine syringes. Got rid of that and now use pens for everything that the nurses call on request when it runs out for a particular patient. We inject TPN insulin and other IVs in the pharmacy and send them up.

 

[J ROD]

We used to pull up glargine syringes. Got rid of that and now use pens for everything that the nurses call on request when it runs out for a particular patient. We inject TPN insulin and other IVs in the pharmacy and send them up.

we do the TPN and NS bags too.....

it must have cut down on costs because I have not heard it brought up in over a yr.