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Administration of insulin by pen.
Things to consider.
Your school nurse or other licensed healthcare professional
must review the procedure with you to ensure that you have the skills
to perform insulin administration competently.
Because insulin doses depend on blood sugar, food intake,
and activity levels, it is critical to give the exact dose ordered.
It is best practice to have a second person double-check the dose
you dial in on the insulin pen before administering it to be sure it is correct.
Check with your school nurse or the student’s healthcare provider
if you are unsure if a double-check is needed.
Insulin is administered subcutaneously.
This is the tissue between the skin and muscle mass
typically known as the fat layer.
Insulin is best absorbed when injection sites are rotated.
The common injection sites are abdomen, upper arm,
upper buttock, and outer thigh.
Be sure to check with the student or the student’s parents
to discuss preferred injection sites and rotation of sites.
The insulin pen contains a clear vial with insulin inside the cartridge
and a clear protective cap with a cover that protects the needle.
If the student is old enough and has been trained in their diabetic care,
encourage them to assist to help the student learn self-care skills
according to the child’s care plan and the school nurse’s direction.
Remember to keep healthcare information confidential.
Procedure for medication administration.
Explain the procedure to the child at his or her level of understanding.
Assemble the needed supplies and place on a clean surface.
Review the student’s medication order
to ensure the proper dose of insulin is given.
If you have any questions regarding the insulin dose, do not give the medication.
Consult with the school nurse before giving insulin.
Determine where the injection will be given on the student,
with the student’s assistance as appropriate.
Check the insulin pen and the student’s medical order to ensure that it is . . .
Also check to ensure the medication has not expired.
Check the insulin pen to see if the insulin cartridge
is loaded into the insulin pen.
If not, load the insulin cartridge into the pen.
Wash your hands.
Put on gloves.
Re-check the insulin pen
and the student’s medical order to ensure that it is . . .
Also check to ensure the medication has not expired.
Wipe the top of the insulin pen with an alcohol swab if instructed to do so.
Attach the pen needle by twisting the needle onto the end of the insulin pen.
Pull off and remove the outer pen needle protective cap and cover.
Be sure not to touch the needle.
Prime the insulin pen by dialing two units.
Push the end of the pen to push out the two units.
A small drop of insulin should be visible.
If insulin does not appear, repeat.
Dial the ordered insulin dosage to be administered to the student.
Cleanse the injection site with soap and water
or an alcohol swab and allow it to air-dry.
Never fan or blow on the area cleansed with the swab.
Gently pinch the skin of the chosen injection site
and insert the pen needle at a 45- to 90-degree angle into the skin.
While pinching the skin, slowly push the button
at the end of the pen to inject all of the insulin.
Wait 5 to 10 seconds while keeping the insulin pen
and needle in place to ensure that the insulin dose is given.
Once 5 to 10 seconds have passed, release the skin
and remove the insulin pen with needle from the injection site.
Do not recap the needle.
Dispose of the needle in an approved sharps disposal container.
Remove gloves and wash hands.
Document insulin administration,
including date, time, dosage, and site of injection.
Return supplies to appropriate location.
Follow up with parent or guardian and healthcare provider as needed.