Approved to round DOWN to nearest whole unit if calculations result in dose in fractions.

Patients with orders for the hospital’s adult sliding scale insulin order set have orders to implement the hospital’s hypoglycemia orders. However, some patients have orders for scheduled or PRN insulin without use of the sliding scale insulin order set. These patients may not have PRN orders for treatment of hypoglycemia.

To improve safety with insulin use, the following policy has been approved by the P&T Committee:

1. Allow pharmacists to automatically implement the ADULT Hypoglycemia Orders, if not previously ordered, for adult patients receiving the following:
1. Scheduled insulin
2. PRN insulin
2. The pharmacist would enter the ADULT Hypoglycemia Orders into iCare, using the Per Protocol order mode, under the name of the provider who ordered the insulin.

Continuation of home therapy is approved for patients on the U-500 concentration of regular insulin. Patients are allowed to use their own supply of HumuLIN R KwikPen. If the patient home supply is unavailable then the hospital will supply the PEN form. If the patient is on the vial, then the order will be converted to the hosptial supplied pen form. The U-500 concentration in a VIAL is not to be used in the hospital.

Home Insulin Pump Pharmacist Flowchart with link to verification tip sheet

Reviewed: 25 Sept 2018 (U-500 pen and vial)

• Micromedex
• UpToDate
• Lippincott Advisor