Randomized controlled evaluation of an insulin pen storage policy

Area of Science:

• Healthcare Quality Improvement
• Patient Safety
• Medication Error Prevention

Background:

• Wrong-pen-to-patient insulin pen errors pose a risk to patient safety.
• Current insulin pen storage policies often lack effective safeguards.
• Secure bedside storage solutions are needed to enhance medication safety.

Purpose of the Study:

• To evaluate the effectiveness of secure bedside insulin pen storage in improving adherence to storage policies.
• To assess the impact of a revised policy allowing lock box storage on preventing insulin pen errors.
• To compare the efficacy of policy change plus education versus education alone.

Main Methods:

• A cluster-randomized controlled evaluation was conducted at an academic medical center.
• Policy adherence was assessed via direct observation before and after implementing lock boxes and education.
• Eight patient care units were divided into intervention (lock boxes) and control groups.

Main Results:

• Adherence to insulin pen storage policy improved significantly in intervention units (59% to 89%, p=0.005).
• Control units showed no significant change in adherence (49% to 67%, p=0.26).
• Common nonadherence included unsecured pens or storage in nurses' pockets.

Conclusions:

• Permitting secure bedside storage of insulin pens, alongside nurse education, substantially increased adherence.
• This intervention proved more effective than education alone in enhancing insulin pen storage practices.
• The findings support policy changes for improved point-of-care medication safety.