Managing Sliding Scale Insulin

Effective diabetic management includes monitoring blood glucose values and administering needed medications.  Residents on a sliding scale insulin regimen require tight coordination of meds and services, and good documentation of both.  RTasks offers solutions for meeting these requirements.

Entry of Sliding Scale Insulin

Med entry of Sliding Scale insulin is handled in a similar way to all medications, but with some specific options selected:

Go to the Resident Profile screen and select Medications and Add New Medication. 

  • Enter the insulin name, strength, and route
  • Enter it as a scheduled medication, add indication, and effective start date
  • The schedule should be specific
  • Add each scheduled time and assign the appropriate provider

  • Identify who is doing the Setup of the medication and the administration (1,2).  Selecting the HHA or Nurse as administrating the med, even if the resident will self-administer the med will allow that provider to document the details of the administration.
  • Require a note (3) so the staff must enter both the amount given and the location of the injection.  If you wish, you can custom create med snippets so staff can choose the site from a standard list of approved administration sites.  Units can be manually entered.
  • The instructions field (4) should contain the detailed instructions for staff, including the sliding scale dosages, alerts to nurse, etc....

 

Scheduling Blood Glucose Monitoring

From the Resident Profile screen, select Service Plan to open up the current services.  If the resident already has blood glucose monitoring scheduled, review the scheduled times and ensure these are scheduled at the SAME TIME and to the SAME PROVIDER  as the sliding scale insulin. Edit if needed. 

If no current glucose monitoring services are assigned, click the Add a Service button and enter the details of the blood glucose service.  Again, these must be scheduled to coincide with the sliding scale- at the SAME TIME and to the SAME PROVIDER.

Staff Documentation

Staff to whom the blood glucose monitoring and sliding scale insulin administration have been assigned will view both services scheduled at the same time from the Today screen.

If they attempt to document the med first (before checking the blood glucose), they will receive a reminder:

 

Once they have obtained the vital sign and marked that blood glucose service complete, they can now select the Med assist service.  The vital sign they just obtained can be viewed inside this Med assist  (1).  Viewing the vital alongside the med instructions allows the user to select the appropriate dose or action.

Because a note is required, the user will be unable to mark the service complete until the required note has been entered.  He/she can enter the number of units administered and the location of the injection (if desired) (2).  They can now mark the service complete.

Reports

The following Med Recap reports will report both the blood glucose value and the notes for the med (with the dose given and location).

In RTasks: Med Recap by Resident - With Notes

In Residex Hosted:  Med Recap Summary Month and Med Recap Summary - Monthly