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  • 1.  Multi dose insulin vials per floor

    Posted 05-12-2025 18:56

    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?  



  • 2.  RE: Multi dose insulin vials per floor

    Posted 05-13-2025 11:17

    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
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  • 3.  RE: Multi dose insulin vials per floor

    Posted 05-13-2025 11:36

    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. 




  • 4.  RE: Multi dose insulin vials per floor

    Posted 05-14-2025 10:47
    We still use a pen per patient for sliding scale insulin. For lantus, our pharmacists will draw up the dose, label and send to the floor. Those vials stay in the pharmacy. 

    Connie


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