Insulin Dosage Preparation and Administration: Prefilled Pens versus Syringes

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Abstract

Background:

Insulin delivery systems are continually evolving and today syringes or prefilled pens predominate. An efficient insulin delivery system may recover time, improve safety and reduce healthcare costs.

Aim:

To quantify the time required to prepare and administer insulin doses using prefilled pens or syringes.

Method:

An insulin delivery simulating protocol was followed. Insulin preparation and administration was timed from the receipt of the medication order until the end of administration. A 2:1 syringe to pen allocation ratio was used; syringes were the control. Two operators were each assigned 58 pen and 116 syringe doses; total of 348 insulin doses.

Results:

Randomisation distributed doses uniformly by device and operator. The mean (SD) dose delivered by syringe was 30.4 ± 17 units and 30.3 ± 17.7 units by pen (p = 1.0). Mean dose (p = 0.3) and administration time (p = 0.6) between operators were also similar. Mean administration time for doses delivered by syringe was 71 ± 10.9 seconds and 52.1 ± 9 seconds by pen. Mean time difference between devices was 18.9 seconds (95%CI 17-21; p ≤ 0.0001). Operators prepared and administered doses more quickly over time.

Conclusion:

There was a 27% reduction in preparation and administration time when prefilled insulin pens were used. A consistent training effect occurred, which was similar between operators and independent of volume. As product features and operator training influence insulin delivery efficiency, institutions should consider these factors along with efficacy, safety and acquisition costs when selecting prefilled pens or syringes.

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