Guidelines for Optimizing Safe Subcutaneous Insulin Use in Adults

The ISMP Guidelines for Optimizing Safe Subcutaneous Insulin Use in Adults were developed to help healthcare facilities prevent insulin errors and improve patient outcomes by addressing the at-risk behaviors and unsafe practices associated with subcutaneous insulin use in the inpatient setting and during transitions of care.

The consensus statements presented in this guidance document are based on the proceedings from a summit held by ISMP in November 2015 of key stakeholders, as well as feedback received through public comment. Agreement was reached regarding common risks associated with subcutaneous insulin use and best practice recommendations for the safe use of subcutaneous insulin in the hospital and during transitions of care. Evidence-based research and regulatory evidence were also used, as available, to support the development of the guidance statements.

The guidelines outline the risks associated with subcutaneous insulin use in the following processes:

• Prescribing, dispensing, preparing, and administering subcutaneous insulin
• Using insulin pens and vials
• Monitoring patients on subcutaneous insulin
• Educating patients on subcutaneous insulin

The recommendations contained within the safe practice guidelines focus on the following processes:

• Prescribing of subcutaneous insulin
• Pharmacy management and distribution of subcutaneous insulin
• Administration and monitoring of subcutaneous insulin
• Safe transitions of care for patients receiving subcutaneous insulin

The guidance document also addresses evolving practices and technologies that aim to enhance the safety of insulin use, such as with concentrated insulin and insulin pen devices.

The summit and this guidance document have been made possible through funding from BD.

_{How to cite: Institute for Safe Medication Practices (ISMP). ISMP Guidelines for Optimizing Safe Subcutaneous Insulin Use in Adults. ISMP; 2017. https://www.ismp.org/guidelines/subcutaneous-insulin.}