Legal issues The main problem is that pre-filling a syringe with insulin to be used at a later date is secondary dispensing, an unlicensed activity not covered by the Medicines Act. Secondary dispensing is where a non-pharmacist transfers medication from a pharmacy container eg, an insulin vial into a secondary container eg, an insulin syringe to give to the person requiring medication.
Legally, moving a drug to a secondary container forms a new medicine — ie equates to drug manufacture — and thus the pre-loaded insulin syringe itself becomes an unlicensed product. If something were to go wrong, the nurse who prepared the syringe would potentially be personally liable for the consequences. Further legal problems are created because the syringe is usually not clearly labelled with the proper dose instructions, Safety warnings or guidance on safe storage.
The NHS Outcome Framework clearly states that patients with long-term conditions should take charge of their care. Organisation-wide policy Employers are legally responsible for the actions that nurses carry out in the course of their work. This is known as vicarious liability, and employers will have insurance for this purpose. However, to be covered, an employee must only work within an area of assessed competence and within the responsibilities of their role and job description.
The essential contents of a policy have been detailed elsewhere, 2 and an example can also be found in the RCN guideline. Once a policy is ratified and in place, a database needs to be set up to keep track of the patients who are involved and ensure they are appropriately risk assessed for mental capacity and suitability for this activity every three months.
Will is a year-old man who has had type 1 diabetes for 30 years. He is partially sighted, has had a renal transplant, a below-knee amputation of his left leg, and a cardiovascular event which has caused a mild left-sided hemiplegia and dexterity problems. His diabetes has not been particularly well-controlled, but his glucose levels are stable and he has no episodes of hypoglycaemia.
A community nurse currently visits twice daily to administer his insulin. His dexterity issues leave him unable to use a pre-loaded pen, as he has difficulties selecting the dose size and pushing the dosing knob. On assessment, Will has full capacity, knows how his insulin works, doses and frequency and displayed a good injection technique with a syringe.
He could also describe how he would manage a hypo effectively. He takes 56 units of Humulin M3 before breakfast and 26 units before his evening meal. He is not confident about managing his injections without a community nurse, but would like to be independent and free for social activities, rather than waiting in for the nurse, and would like to not have set meal times. Medical Review: E. This information does not replace the advice of a doctor.
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Please turn on JavaScript and try again. Important Phone Numbers. Top of the page. Topic Overview Insulin can become damaged and ineffective if it is not stored properly. Unopened insulin that is packaged in small glass bottles vials should be stored in the refrigerator. A family member, friend, or health professional can prefill insulin syringes for you.
If you prefill syringes:. Author: Healthwise Staff. Medical Review: E. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.
Learn how we develop our content. To learn more about Healthwise, visit Healthwise. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Updated visitor guidelines. Top of the page. Storing Insulin and Prefilling Syringes. Topic Overview Insulin can become damaged and ineffective if it is not stored properly. Control-positive cultures were prepared by intentionally contaminating two vials of 0.
Insulin from syringes was tested, and no bacterial growth was detected by daily readings of cultures for one week. Of the contaminated control syringes, those containing sodium chloride injection produced positive cultures at each of the study weeks; the contaminated insulin samples, although positive at week 0, had become negative by week 3, confirming the bactericidal activity of one or more of the components of this insulin product.
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