scholarly journals Assessment of Insulin Injection Practice of Nurses Working in a Tertiary Healthcare Center of Nepal

2018 ◽  
Vol 2018 ◽  
pp. 1-6
Author(s):  
Shital Adhikari ◽  
Ramesh Sharma Poudel ◽  
Laxmi Rajbanshi ◽  
Shakti Shrestha

Introduction.Sound knowledge and good practice on insulin injection technique are essential for nurses in order to administer insulin correctly and to educate patients or their relatives adequately. This study aimed to assess the insulin injection practice through the use of insulin pen among nurses working in a tertiary healthcare center of Nepal.Materials and Methods.A cross-sectional descriptive study was conducted among 67 nurses working in one of the tertiary healthcare centers of Nepal. Demographic information and insulin injection practice of nurses through the use of insulin pen were assessed using self-administered questionnaire. Each correct practice was scored “1” and incorrect practice was scored “0.”Results.The median (IQR) insulin injection practice score of nurses was 11 (9-12) out of 16. Thirty-seven (55.2%) nurses store insulin pen filled with insulin cartridge at room temperature while 57 (85.1%) nurses store unopened cartridge at refrigerator (2-8°C). The practice of hand washing and injection site cleaning was mentioned by 92.5% and 82.1% of the nurses, respectively. However, just over half of the nurses mix the premix (cloudy) insulin and prime insulin pen before each injection. Thirty-four (50.7%) nurses do not lift skin during injection and more than half of the nurses keep needle beneath the skin for less than 5 seconds after completely injecting the required dose of insulin. One out of ten nurses massage injection site after injecting insulin. Most of the nurses (86.6%) use single needle more than once and the median (IQR) frequency of needle reuse was 6 (3-12). Similarly, systematic site rotation was performed by 59 (88.1%) nurses and twenty (29.9%) nurses claim that they use single insulin pen for two different cartridges.Conclusion.The insulin injection practice of nurses assessed through the use of insulin pen was suboptimal and highlights the need for urgent educational intervention.

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Ramesh Sharma Poudel ◽  
Shakti Shrestha ◽  
Rano Mal Piryani ◽  
Bijaya Basyal ◽  
Kalpana Kaucha ◽  
...  

Introduction. Proper insulin injection practice is essential for better diabetic control. This study aims to assess the insulin injection practice of patients with diabetes. Materials and Methods. A cross-sectional study was conducted at Chitwan Medical College Teaching Hospital, Bharatpur, Nepal, from February 2017 to May 2017. Patients injecting insulin through insulin pens (n=43) for a minimum of 4 weeks were consecutively recruited. Patients’ baseline characteristics, current insulin injection technique, insulin transportation practice, complications of insulin injection, disposal practice of used needle, and acceptability of insulin were recorded. Descriptive statistics were performed using IBM-SPSS 20.0. Results. The insulin injection technique of patients and their relatives was inadequate. The majority of patients and their relatives (25, 58.1%) mentioned that they transport their insulin cartridge without maintaining cold chain. Thirteen patients (30.2%, n=43) reported complications of insulin injection and the most common complication among those patients was bruising (10, 76.9%, n=13). Almost all patients disposed the used needle improperly, and the common method was disposing the needle in a dustbin and then transferring to municipal waste disposal vehicle. Insulin was accepted by just 16 (37.2%) patients. Conclusion. There was a significant gap between the insulin delivery recommendation through insulin pen and current insulin injection practice.


2016 ◽  
Vol 23 (05) ◽  
pp. 576-582
Author(s):  
Rizwana Kitchlew ◽  
Inayat Thaver ◽  
Shehryar Pervez ◽  
Ikram ul Haq

Objective: To determine the trends in insulin injection technique and associatedcomplications in the local diabetic patients. Study Design: Cross-Sectional Descriptive study.Place and Duration of Study: This study was conducted in Department of Medicine at FatimaMemorial College & Hospital Lahore from 25th May 2015 to 25th October 2015. Patientsand Method: Three hundred patients above 18 years of age who presented in outdoor andindoor department of the hospital, gave consent were enrolled. The data was collected throughinterview and relevant physical examination; data was analyzed by using SPSS 20.0 version.Results: 300 diabetics were enrolled; 108 (36%) male and 192 (64%) female. Mean age inmales was 52.8±13.7 and in females was 52.2±11.8. Duration of insulin use was less than5 years in 175 (58%) and 5 years or more in 125 (42%). Insulin syringe of 8 mm gauge wasbeing used by 263 (87%). Abdomen was the injection site in 202 (67%); however, 279 (93%)rotated the injection site. The angle of injection was kept at 90 degrees by 254 (85%). Theneedle was reused for five or more times by 187 (52%) and 216 (72%) were self-injecting. Localcomplications were seen in 105 (35%); out of those pain was most commonly (35 %) reported.Among age groups significant association (p<0.05) was seen in site of insulin delivery, in agemore than 60 years more injected in abdomen. In gender groups more males (83%) wereself-injecting. Significant association (p<0.05) was seen in duration of insulin use and localcomplications. Majority, 126(72%) of those who were on insulin for less than 5 years did nothave complications. Conclusion: Majority of our patients had adopted reasonable techniquehowever repeated reinforcement can further improve appropriate insulin delivery, less wastageof insulin and better glycemic control with less chance of complications.


Author(s):  
B. M. Sindhu ◽  
B. M. Rashmi ◽  
G. Prashanth ◽  
M. R. Nagendra Gowda

Background: Diabetes mellitus has emerged as a global health problem. Insulin is the essential treatment modality for significant number of diabetic patients. Nearly 4 out of 10 patients with T2DM in India are using insulin, either alone or in combination with oral hypoglycemic drugs (OADs). The present study was conducted with the objectives to assess the knowledge and insulin injection practices, risk factors of sharps injury among diabetic patients who are on insulin treatment.Methods: Cross sectional study was conducted at a Basaveshwara hospital, Chitradurga, among diabetic patients on insulin treatment for minimum of past 6 months. Insulin injection technique questionnaire (ITQ) was administered to study participants and proforma was filled by interview technique.Results: 100 patients participated in the study. Syringe and needle device and 6 mm needle are most commonly used devices. 5-10 seconds was the most common duration of time (54%) for which the patients continued to keep the needle inserted in injection site after insulin injection. A 26% patients had lip hypertrophy at injection sites. Among households of the insulin users, a high percentage of children (41%) and house keeper/waste collectors (32%) were at risk of sharps injury. A majority of 55% of the insulin users reported that they didn’t have appropriate disposal containers for the used sharps.Conclusions: A 29% of participants did not practice proper rotation of injection site. Reuse of insulin needles was common practice. Pain/tenderness, lipo-hypertrophy and leakage of insulin after injection were noted at injection site. 10 seconds dwell time was reportedly practiced by only 23%, about half of patients skipped insulin injections and didn’t follow appropriate disposal of used sharps, thereby exposing both family members and waste collectors/handlers to higher risks of sharps injuries.


Author(s):  
Animesh Choudhary ◽  
Jitendra Chouhan ◽  
Sanjeev Gulati ◽  
Jogesh Kumar Vishandasani

Background:  Correct injection technique used by the patient can determine the outcomes with insulin therapy in type 2 diabetes mellitus, however most patients on insulin remain unaware of the proper insulin injection techniques. The purpose of this study was to assess the current practice of insulin administration among diabetes patients.Methods: This cross-sectional study was conducted in 3 tertiary care centers delivering specialized diabetes care in central India from November 2019 to February 2020. The study included patients (n=150) using insulin for at least three months by either syringe or pen. All of them answered a survey questionnaire which focused on key insulin injection parameters.Results: Abdomen was the most common (53.33%) site of insulin injection. About 95.33% of subjects were following the injection site rotation instructions. The practice of hand washing, and cleaning of the injection site was practiced by 120 (80%) and 112 (74.66%) respondents respectively. Needle reuse was a common practice, and 146 (97.33%) subjects were using the same needle more than once. Around 73.33% were storing insulin at proper temperature, while 54.66 % reported having pain at the injection site and 14.66% had noticed persistent swelling at their injection sites. Conclusions: There is a significant gap between the insulin administration guidelines and current insulin injection practice. Education and counseling about proper insulin injection techniques should be provided to all persons with diabetes to ensure optimal usage of the drug to achieve the desired glycemic control.


2019 ◽  
Author(s):  
Adeladlew Kassie Netere ◽  
Eyayaw Ashete ◽  
Eyob Alemayehu Gebreyohannes ◽  
Sewunet Admasu Belachew

Abstract Background: Diabetes mellitus is a group of metabolic disorders and resulting from deficits in insulin secretion, insulin action, or both. Insulin therapy is primarily required to attain the recommended goal of blood sugar. The primary aim of this study was to evaluate the knowledge, skills and practices of insulin storage and injection technique of patients. Methods : An interview based cross-sectional study was conducted in conveniently selected participants in Northwest Ethiopian primary hospitals from March, 1, 2019 to May, 30, 2019. Knowledge and practice were measured by administering structured questionnaire with a Likert scale of 1–5 through face-to-face interviews and skills were assessed by five observational (demonstration) techniques from a total of 166 clients. Results: Of the total 166 participants, 54.8% were males and the mean age was 38.46±13.8 years . The overall knowledge (65.4%.) and practice (53.89%) rate on insulin storage and handling techniques were showed moderate knowledge and fair practices. About 94.6% of participants correctly shown insulin injection sites. One-way ANOVA showed that the level of education [F (3, 162) = 7.283, p<0.001], ways of instruction of insulin injection [F (2, 163) =3.32, p = 0.039], insulin therapy duration [F (3,162) = 3.59, p= 0.015] and assessing insulin storage [F (2,163) = 4.45, p = 0.013] had a significant effect on level of knowledge. Similarly, knowledge level [F (2,163) = 14.17, p < 0.001], educational status [F (3,162) = 10.57, p <0.001], occupation type [F (4,161) = 5.43, p <0.001], time since insulin therapy [F (3, 162) = 5.46, p = 0.001] and diagnosis [F (3,162) = 3.36, p= 0.02] had a significant effect on patients’ insulin storage and administration practices. Conclusion: Patient had marginal knowledge and practices on insulin storage and administration techniques. The patients’ skills on the important and critical steps of administrations are poor. The engagements of healthcare professionals and stakeholders should be in developments of instructions and guidelines are very crucial in addition to focusing on educating and changing their wrong perceptions, believes and attitudes towards storage and administering techniques.


2020 ◽  
Author(s):  
Katharine D. Barnard-Kelly ◽  
Edward Mahoney ◽  
Leah Baccari ◽  
Teresa Oliveria ◽  
Stanislav Glezer ◽  
...  

Approximately 200 million people worldwide use injectable therapies as part of diabetes management. There appears to be a significant gap between insulin injection technique recommendations and injection practice for many. We aimed to develop and validate a novel, brief, self-administered injection technique assessment questionnaire.


2020 ◽  
Author(s):  
Adeladlew Kassie Netere ◽  
Eyayaw Ashete ◽  
Eyob Alemayehu Gebreyohannes ◽  
Sewunet Admasu Belachew

Abstract Background: Insulin is an effective therapeutic agent in the management of diabetes but it is also sensitive to external environment. Consequently, diabetic patients’ adherence to insulin delivery recommendations is critical to its effectiveness. Lack of knowledge, skill, and irrational practices on appropriate insulin delivery techniques can result in therapeutic failure and increased costs of therapy. The aim of this study was to evaluate the knowledge, skills, and practices of insulin storage and injection technique of patients. Methods : An interview-based cross-sectional study was conducted in conveniently selected participants in Northwest Ethiopian primary hospitals from March 1 to May 30, 2019. Knowledge levels were assessed with right or wrong responses and practice was measured by administering a 4-point Likert scale structured questionnaire through face-to-face interviews. Finally, a five-point observational (demonstration) techniques checklist assessed patients’ skills. Results: Among 194 patients approached, 166 participants completed the survey with a response rate of 85.6 %. From these participants, 54.8% were males and the mean age was 38.46±13.8 years . The overall patients’ median knowledge and practice levels on insulin storage and handling techniques were moderately adequate (64.3%) and fair (55.4%), respectively. In patients’ skill assessments, 94.6% showed injection sites, 70% indicated injection site rotations, and 60.75% practiced injection site rotations. Education (p<0.001), duration of insulin therapy (p=0.008) and duration of diabetes (p=0.014) had a significant effect on patients’ knowledge level. Education (p<0.001), occupation (p<0.001), duration of insulin therapy (p=0.001), duration of diabetes (p=0.036) and patients’ knowledge levels (p<0.001) were found to have a significant effects on the patients’ practice level. A Mann-Whitney U test also disclosed that residency, ways to get insulin and mocked injection technique during first training had significant effects on patients’ knowledge levels. Conclusion: The current study revealed that patients had moderately adequate knowledge and fair practice levels on insulin storage and handling techniques. Moreover, patients missed important insulin administration skills. Healthcare professionals and stakeholders can play important roles in educating patients thereby improving the knowledge, practice, and administration techniques of patients.


2020 ◽  
Vol 16 (1) ◽  
pp. 41 ◽  
Author(s):  
ABM Kamrul-Hasan ◽  
Ajit Kumar Paul ◽  
Mohammad Nurul Amin ◽  
Md Abu Jar Gaffar ◽  
Md Asaduzzaman ◽  
...  


2020 ◽  
Author(s):  
Adeladlew Kassie Netere ◽  
Eyayaw Ashete ◽  
Eyob Alemayehu Gebreyohannes ◽  
Sewunet Admasu Belachew

Abstract Background: Insulin is an effective therapeutic agent in the management of diabetes, but also sensitive to the external environment. Consequently, diabetic patients’ adherence to insulin delivery recommendations is critical for better effectiveness. Patients’ lack of knowledge, skill and irrational practices towards appropriate insulin delivery techniques may end up in therapeutic failure and increase costs of therapy. The aim of this study was to evaluate patients’ knowledge, skills and practices of insulin storage and injection techniques. Methods : An interview-based cross-sectional study was conducted through purposive selection of participants in Northwest Ethiopian primary hospitals from March 1 to May 30, 2019. Levels of knowledge were assessed with right or wrong responses, while practice was measured by using a 4-point Likert scale structured questionnaire collected via face-to-face interviews. Likewise, a five-point observational (demonstration) techniques checklist employed to assess patients’ skills. Results: Among 194 patients approached, 166 participants completed the survey giving a response rate of 85.6 %. More than half of the respondents (54.8%) were males and the mean age (±SD) was 38.5±13.8 years. The overall patients’ median knowledge and practice levels on insulin storage and handling techniques were moderately adequate (64.3%) and fair (55.4%), respectively. In patients’ skill assessments, 94.6% correctly showed injection sites, 70% indicated injection site rotations, and 60.75% practiced injection site rotations. Education (P<0.001 ), duration of insulin therapy (P=0.008), and duration of diabetes (P=0.014) had significant impact on knowledge level. Education (P <0.001), occupation (P<0.001), duration of insulin therapy (P=0.001), duration of diabetes (P =0.036) and patients’ knowledge level (P<0.001) were found to have a significant effects on the patients’ practice levels. A Mann-Whitney U test also disclosed that residency, ways to get insulin and mocked injection technique during the first training had significant effects on patients’ knowledge levels. Conclusion: The current study revealed that patients had moderately adequate knowledge and fair practice levels on insulin storage and handling techniques. However, patients missed important insulin administration skills. This study highlights the need of regular public health education so as to enhance the patients’ knowledge, skill and practice levels on insulin handling techniques.


Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 402
Author(s):  
Yuko Yoshida ◽  
Masuko Sumikawa ◽  
Hiroyuki Sugimori ◽  
Rika Yano

In Japan, skin disinfection is typically considered necessary before an insulin injection to prevent infection at the injection site. This cross-sectional study evaluated factors that influenced symptoms of injection site infection among 238 Japanese patients who self-injected insulin for diabetes between October 2015 and January 2016. A structured questionnaire was used to collect data regarding skin disinfection practices, infection symptoms at the injection site, frequency of injections, environment at the time of injection, and hygiene habits. The majority of patients (83.2%) performed skin disinfection before the self-injection. Logistic regression analysis revealed that infection at the injection site was positively associated with skin disinfection before injection, age, and performing injections outside home. It was speculated that omitting skin disinfection before administering subcutaneous insulin injection was not the factor that affected the symptoms of injection site infection. The greatest contributor to infection symptoms was injections performed outside the home. Future studies focusing on the environment, in which patients administer insulin injections, to assess its influence on symptoms of injection site infections are warranted.


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