SDE: Clinical Guidelines Ch7N

Clinical Procedure Guidelines for Connecticut School NursesPrintable version | Back to Contents
7
Specialized Health Care Procedures

N. Insulin Pump Management

Definition

The insulin pump is a small, battery-operated device, worn on a belt or in a pocket, which delivers a constant infusion of insulin. It is also used to administer a bolus of insulin to provide coverage for the ingestion of carbohydrates. The insulin is infused subcutaneously via a catheter or needle placed in the abdomen, hip, or thigh (National Diabetes Information Clearinghouse, 2009).

Purpose

Insulin pumps replace the need for periodic injections by delivering rapid acting insulin continuously throughout the day. The use of an insulin pump allows the user to match insulin administration to their lifestyle, rather than adjusting their lifestyle to the administration of insulin. Insulin pumps allow a more “natural” level of insulin in the body.

Equipment

Insulin pump, infusion sets, insulin (ordered by authorized prescriber), adhesive tape or Tegaderm; extra batteries; and gloves (for infusion set change.)

Procedure

  1. Programming insulin pump:
    1. Follow manufacturer’s instructions.
    2. Follow prescriber’s orders for basal rate as well as for bolus infusions:
      1. Make sure instructions are available for types of pumps in use in your schools.
  2. Changing an infusion set:
    1. Check with manufacturer’s instructions for changing infusion sets. There are many different types. Some sets are inserted at an angle, some at 90 degrees. Some sets have separate cannulas and insertion devices; some are an all-in-one device.

Delegation Considerations

Only a school nurse, RN, or LPN may program an insulin pump, administer a bolus or change an infusion set. Unlicensed assistive personnel may be trained to assist a capable student to administer a bolus by checking the student’s calculations and numbers. A student specific IHCP and emergency care plan (ECP) should be in place.

Select Nursing Considerations

There are many different manufacturers of insulin pumps. The school nurse needs to be familiar with each particular type he or she handles. Most insulin pump companies provide manuals for their pumps, instructional videos, and in-person training, if requested. Hospitals are another resource that will provide training to school nurses for the consistent care and management of their patients’ diabetes.

In case of an insulin pump malfunction or failure, an emergency plan must be in place for administration of insulin to the student (such as an insulin pen).

Reference

National Diabetes Information Clearinghouse (2009). Alternative devices for taking insulin. Retrieved January 19, 2012.

 




Content Last Modified on 7/23/2014 1:29:11 PM