Friday, August 13, 2010

big blue for insulin

Impact of an Interactive Online Nursing Educational Module on Insulin Errors in Hospitalized Pediatric Patients

  1. Mary M. Sullivan, RN, DNP, ANP-BC, CDE1,
  2. Colette R. O'Brien, RN, MS, C-PNP, CDE2,
  3. Stephen E. Gitelman, MD2,
  4. Susan E. Shapiro, RN, PHD1 and
  5. Robert J. Rushakoff, MD3

+ Author Affiliations

  1. 1Department of Nursing, University of California, San Francisco, California;
  2. 2Division of Pediatric Endocrinology, University of California, San Francisco, California;
  3. 3Division of Endocrinology and Metabolism, University of California, San Francisco, California.
  1. Corresponding author: Mary M. Sullivan,


OBJECTIVE To determine the effectiveness of an online module for reducing insulin administration errors by nurses caring for hospitalized pediatric patients.

RESEARCH DESIGN AND METHODS Pediatric nursing staff completed a mandatory online educational module teaching insulin pharmacokinetics and the insulin order form, using diluted insulin and finishing with 15 interactive cases. A chart audit to determine all possible insulin errors of patients receiving insulin was done before and 2–6 months after the educational module.

RESULTS All of the medical center's 283 pediatric nurses successfully completed the educational module. A total of 24 charts were audited in the preintervention phase and 22 in the postintervention phase. The preintervention insulin error rate was 14.8%, reduced to 1.7% (P < 0.001) postintervention. Improvement occurred in correct insulin dosing and type, timing of administration, and timely blood glucose monitoring and documentation.

CONCLUSIONS An interactive online educational module can be an effective strategy for reducing pediatric nurses' insulin administration errors.

Dr. Wei-An Andy Lee
Clinical Endocrinologist
Assistant Professor of Clinical Medicine
Keck School of Medicine
University of Southern California

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