I was just wondering if the nurses in the hospital have to verify an insulin dose to another nurse before giving it, maybe that should be done in school too. I know that most places only have one nurse, but the secretary can be trained to double check the dose. (As a former school nurse, I would have gladly done this.)
every time my father was hospitalized, his insulin was never verified by another nurse. I often gave him his insulin when he was in the hospital, and when on the pump, family came and ran it for them, they didnt want to mess with it. And when he was on an obscure drug, I even got to bring in his meds from home becouse the hospital couldnt get it in time. Almost unheard of.
Maybe it was just the hospital we were at, but it was their policy that the nurses has to verify all insulin given with another nurse. It was a policy that I really appreciated, especially being new to insulin and nervous about it.
Insulin is considered a high alert drug and every hospital I have worked at or been in the nurses have had to double check a dose before administering it to the patient. When I was younger and in school the nurse always double checked the does either with the second school nurse or the secretary. If it was the secretary she would work the math out loud saying something like "since Liz is eating 65 grams of carbs and she gets one unit for every 10 grams of food then she needs 6.5 units of insulin." Then she would have the secretary make sure that was correct before letting me give myself the shot. That is the safest practice and should be done each and every time a child is given insulin.
Ellen posted an article about a school nurse who was assigned to vaccinate some school staff for influenza and inadvertently injected them with a student's insulin (this was like a year or two ago)
Did your school nurse make a dosing error? I guess I think it would not be so good for the D child to have to wait for two busy adults to coordinate their time to get the second pair of eyes down to the nurse's office while the poor kid is waiting for their shot so that they can go eat lunch. I suppose it's different too, in that a school nurse only gives a few injections a day, while a nurse in a hospital could be doing hundreds and might be more prone to mistakes simply due to the volume. And too, since kids need only fast acting at school, nurses cannot make the #1 dosing screw up that parents make at home ... giving huge doses of fast-acting by accident, instead of Lantus.
At dx, DD was a pediatric unit run by (IMO) the best children's hospital in our area, but the insulin dosages were not double-checked. I don't believe our school nurse double checks and would not expect her too, though she frequently calls me when DD's reading seems "off" and we discuss adjustments to DD's dosage.
A friend who is in nursing school recently told me that there are just two drugs that must be double-checked when given in a hospital. One of them is insulin. Our school nurse always double-checks her calculations with her supervisor over the phone. When my husband and I are both at home, we tend to run our calculations past each other. It's so easy to make a mistake.
I send in the carb counts for lunch everyday with the insulin figured out - even though he is on the pump and it does it for her. It gives her something to compare it to prior to dosing.
I have worked in 2 hospitals in Massachusetts and one in Fl and at all 3 insulin was one of the drugs that was double checked with another RN.
As far as I know insulin in always double checked by another nurse. It's often done in the med room though not the patients room.
