Home Health Blogger

Managing the Home Health Patient on Insulin

Posted by Joy Joan E. De Castro, RN, MSN on Mar 23, 2021

Home health patient teaching for insulin therapy include the following MyHomecareBiz objectives: 

1. Provide the evidence-based, best practice methods for self-managing insulin injections,
2. Ensure the patient/caregiver successfully recalls and demonstrates insulin self-injection independently, safely and effectively.

Know the Different Types of Insulin

  • Rapid-acting: Usually taken before a meal to cover the blood glucose elevation from eating.  This type of insulin is used with longer-acting insulin.
  • Short-acting: Usually taken about 30 minutes before a meal to cover the blood glucose elevation from eating. This type of insulin is used with longer-acting insulin.

    Download Patient Teaching for Insulin Administration

  • Intermediate-acting: Covers the blood glucose elevations when rapid-acting insulins stop working. This type of insulin is often combined with rapid- or short-acting insulin and is usually taken twice a day.
  • Long-acting: This type of insulin is often combined, when needed, with rapid- or short-acting insulin. It lowers blood glucose levels when rapid-acting insulins stop working. It is taken once or twice a day.

img-Insulin-table.png

Patient Recall Items for Insulin Administration & Management...

Discuss the process of insulin management with the patient; encourage the patient to have a family member present if they so desire.

  • Pre-filling the syringe
  • Proper handwashing
  • Gather your supplies
  • Check the color of your insulin. If your insulin does not have the appropriate color, DO NOT USE.
  • Safely prefill the syringe using sterile technique.
  • Rotation of injection sites
  • Self-injection of the insulin
  • How to perform and record blood glucose reading with their glucometer in the office and record on the glucose log sheet
  • Correct disposal of sharps
  • Correct storage of insulin
  • How meal times affect insulin administration schedule 
  • Signs of and treatment of hypoglycemia
  • Signs of and treatment of hyperglycemia
  • Reasons why insulin and dose adjustment may be necessary

Additional Teaching Items

The patient may need an increase in insulin dose under the following circumstances:

• Sickness and/or an infection
• Reduction in activity
• Weight gain
• Certain prescribed medications: Prednisone
• Emotional stress
• Pregnancy

The patient may need a decrease in insulin dose under the following circumstances:

• Activity increase
• Weight loss
• Kidney function issues

Tips for Storing Insulin

• Keep opened vials at room temp
• Discard opened vials after one month.
• Refrigerate unopened vials not in use between 36-46 degrees F. The expiration date applies to unopened, refrigerated insulin.
• For some pens and other dosing devices the storage life is less. Read the label.
• Durable pens and dosing devices should NOT be refrigerated once in use.

General Tips for Medications...

• Do not miss any doses of insulin. Contact the doctor to discuss specific instructions in the case of a missed dose of insulin.
• Try to use only one pharmacy so all medicines are managed in one place (to reduce risk of duplicating medicines and harmful drug interactions).

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