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Hello, Team,

I worked the floor on Sunday and to my chagrin, the hospital has went to multi-dose insulin vials not for individual patients but for the whole floor.  One vial, locked in the pyxis.  When you need to give insulin you pull it out, draw up your insulin, and then put it back for the next nurse to use for her/his patient. I refused.  I felt this was not only putting my patient at risk, but also my license.  I pointed out that I was relying on everyone before me to have accessed the vial correctly and cleanly.  I was informed that the pharmacy director said it was okay because this is what all the other hospitals are doing.  Is this true? Am I losing my mind?  I feel this is a step backwards and nowhere near safe or recommended practice.  

Do any of your hospitals actually do this?  

Oh my goodness, this is a tough one.  I can say that I haven't worked the floor, but have been visiting hospitals for IPC support and have not seen multi dose vials in hospitals or even SNFs in quite some time.  Patient specific insulin pens are the safest and the facility is supposed to opt for the safest method possible.  That being said, if the pens are not available or some other extenuating circumstance is at play, the multi dose vials could be used, with other safety measures in place like education to staff about the safest use and policy updates about the proper use and labeling.  

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Elizabeth Johnson
OSWAPIC President
MDRO Infection Preventionist
Oregon Health Authority
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Thanks, Elizabeth.  I talked to my friend in Portland and two of the larger facilities apparently have gone to this also.  Apparently the pens have become too expensive and they are switching to vials to save money.  I don't understand how cost effectiveness now trumps safety, but I guess times are changing.  Sad how much insulin is in the US when it's free or inexpensive everywhere else. 

Original Message:
Sent: 05-13-2025 11:17
From: Elizabeth Johnson
Subject: Multi dose insulin vials per floor

Oh my goodness, this is a tough one.  I can say that I haven't worked the floor, but have been visiting hospitals for IPC support and have not seen multi dose vials in hospitals or even SNFs in quite some time.  Patient specific insulin pens are the safest and the facility is supposed to opt for the safest method possible.  That being said, if the pens are not available or some other extenuating circumstance is at play, the multi dose vials could be used, with other safety measures in place like education to staff about the safest use and policy updates about the proper use and labeling.  

------------------------------
Elizabeth Johnson
OSWAPIC President
MDRO Infection Preventionist
Oregon Health Authority
------------------------------

Original Message:
Sent: 5/13/2025 11:36:00 AM
From: Amy Walter
Subject: RE: Multi dose insulin vials per floor

Thanks, Elizabeth.  I talked to my friend in Portland and two of the larger facilities apparently have gone to this also.  Apparently the pens have become too expensive and they are switching to vials to save money.  I don't understand how cost effectiveness now trumps safety, but I guess times are changing.  Sad how much insulin is in the US when it's free or inexpensive everywhere else.