This guide will walk you through Instinct’s thought process on ordering Insulin on the treatment sheet as well as making treatment groups.
Table of Contents
We all know there are many different types of diabetics that may be in your hospital. This article covers everything from a stable diabetic boarder to a complicated DKA patient.
Standard Vital Instinct
All hospitals will have a standard insulin product as an option to order on the treatment sheet called ‘Insulin – Ask Dr. (Note Type)’. Other options can be made based on your hospital needs.
Note that the Quantity the doctor orders is just how many times this order is going to be completed (each). This is not the number of units of insulin which could be changing. The order allows you to write exactly what insulin type you want in the ‘Order Notes’ and select the route and frequency. This is usually what we recommend with diabetics receiving different doses or types of insulin and varying frequencies and the nurse will read the ‘Order Notes’ to get more information.
Stable Diabetes
For stable patients, normally the insulin is going to be the same at 12 hour intervals. Insulin orders can be made for all the specific types and routes of insulin and additional orders should be written in the ‘Order Notes’ box.
💡 Please note: The quantity the doctor orders is going to be the units of insulin, which has to be consistent.
Sick Diabetic Receiving Injections
There may be a diabetic patient who is sick or not eating and the insulin needs may change based on their blood glucose level or appetite. The insulin amount or frequency may be inconsistent and the nurse needs to alert the doctor. We recommend using the standard order for these situations so the doctor is not forced to order the specific type or units of insulin, and so the nurse does not just complete the treatment without reading the ‘Order Notes’.
Another scenario is a patient receiving consistent intermittent regular insulin injections. You are always using the same insulin, but the amount of insulin changes based on the blood glucose. You could set up a pre-made option using the regular insulin with default notes regarding the instructions.
💡 Please note: The above example has a quantity of ‘each’ and your hospital set up may be displayed differently.
Sick Diabetics on Insulin CRIs
There are a lot of different options to make insulin CRI orders to your specific wants and needs. The Insulin CRI vital sign should have been set up already during your hospital’s implementation if you plan to use it, but if it is not set up, you can always email us at support@instinct.vet. Most hospitals choose mL/hr, but you can also choose rates based on units per kilogram.
Another popular option is to have a total combined fluid rate, as the insulin rate is always changing based on the blood glucose, but fluids are adjusted so the total rate is always the same. Our team can also set that up as a vital sign to trend if needed. An order could be made to make the insulin CRI bag with instructions on how much insulin to what size bag. There could also be an order for using a specific line or catheter for the CRI. Here is an example of an insulin CRI group:
In the ‘CRI – Insulin’ order notes, you can already have one or multiple options of how you want to adjust your CRI.
💡 ProTip: You could also add this group to a group you already have (ie. DKA group/Sick diabetic group). The possibilities for personalization are endless!