1. Insulin Administration by Syringe 8/17/20151

2. This PowerPoint covers basic procedures for administering insulin by syringe. There are different kinds of syringes, and variations in directions for different students. Demonstration, skills observation, consultation, and ongoing supervision by the school nurse or parent will be important for accurate and safe medication administration. 8/17/20153

3. Competency checklist are available at: http://dpi.wi.gov/sspw_schlnurse.html http://dpi.wi.gov/sspw_schlnurse.html Products used were for demonstration purposes and are not an endorsement of the products. 8/17/20158

4. What topic will be discussed? What is diabetes? What is the prevalence of diabetes? What is the difference between type 1 and 2 diabetes? What is insulin? What are some important facts regarding insulin? What are the supplies needed? What are the parts of an insulin syringe? What is the insulin administration procedure? 8/17/20154

5. What is Diabetes? Chronic Disease Two major types – Type 1 and Type 2 Type 1 Diabetes – Pancreas produces no or small amounts of insulin. Type 2 Diabetes – Pancreas does not produces enough insulin and/or it does not work as it should (sensitivity) Both types require balancing food, exercise and insulin to keep blood sugar as close to the normal range (80-120 mg/dl) as possible. 8/17/20155

6. What is the prevalence of type 1 and 2 diabetes? 151,00 students with type 1 diabetes under the age of 20 (CDC, 2011) 1.7 per every 1,000 students 1-19 years has been diagnosed with type 1 diabetes. http://www.cdc.gov/diabetes/projects/cda2.htm 7.2 per every 100,000 student has been diagnosed with type 2 diabetes (CDC, 2011) http://www.cdc.gov/diabetes/projects/cda2.htm 8/17/20156

7. What is the difference between type 1 and 2 diabetes? Type 1 diabetes is a chronic disease where the pancreas produces no or little insulin needed to control blood sugars in the blood. Treated with insulin, monitoring blood glucose levels, exercise and healthy foods. Type 2 diabetes is a chronic disease where the pancreas does not produces enough insulin and/or the body is not able to use the insulin properly. Treated with healthy foods, exercise, oral medication and/or insulin. 8/17/20157

8. What is insulin? Hormone produced by the pancreas Regulates blood sugar levels in the body Used to treat diabetes Given by syringe, pen or pump 8/17/20158

9. What are some important facts regarding insulin? Check expiration date. Immediately after opening, place date on vial. Do not shake. Stored in a vial, which is effective for 28 days for after opening for fast-acting insulin. Stored at room temperature without exposure to sunlight. Measured in units. Administered in the subcutaneous tissue or the tissue between the skin and firm muscle mass. 8/17/20159

10. What is needed prior to administration of insulin by syringe? Medical provider and parent authorization Syringe Vial of insulin Gloves Alcohol swab(s) Authorized Sharps disposal container Glucose monitor 8/17/201510

11. What are the parts of a insulin syringe? NeedleBarrelPlunger Insulin Syringe 8/17/201511

12. What are the five rights? Right student Right medication Right dosage Right time Right route or method of administration Right to documentation 5 Rs + 2 Right Reason 8/17/201512

13. What is the procedure for administration of insulin? 1.Gather supplies. 2.Check the rights. 3.Wash hands and apply gloves. 4. Check the insulin vial to make sure you have the correct type of insulin and it is has not expired. 5. Recheck the rights. 6. If the vial is new, remove lid. 7. Wipe stopper with alcohol swab. 8. Remove cap from insulin syringe without touching needle. 8/17/201513

14. Procedure cont. 9. Pull air into syringe by pulling back on plunger until the black bar is even with the line showing the exact units of insulin needed. 10. Push needle through rubber top of vial at a 90° angle. 11. Push plunger so that air goes from syringe into vial. 8/17/201514

15. Procedure cont. 12. Turn vial upside down. Pull insulin into syringe by slowly pulling back on plunger until top of its black bar is even with the line showing units of insulin needed. If present, remove all air bubbles (See demonstration of two methods). 8/17/201520

16. Procedure cont. 13. Select an injection site with the assistance of the student as appropriate. Insulin is most effective when sites are rotated. The most common places to inject insulin are the:  abdomen,  upper arm,  upper buttock, and  outer thighs. 14. Cleanse skin with alcohol swab (optional) and allow skin to dry. Never fan or blow on area cleansed with swab. 8/17/201515

17. Procedure cont. 15. Gently pinch skin of chosen injection site. Hold syringe at a 45-90° angle to skin, and push needle all the way in. 16. Let go of pinched skin and slowly push plunger to inject all of the insulin. 17. Wait 5 seconds before pulling out the needle. 18. Never recap needle. Place used needle in approved sharps disposal container. 19. Remove gloves and wash hands. 20. Document medication administration. 8/17/201516

18. Demonstration 8/17/201517

19. Questions Any comments regarding this webcast? Any suggestions on future school nursing topics? Contact: WI Dept. of Public Instruction School Nursing Consultant (608) 266-8857 8/17/201518