Insulin
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What you will learn
This module promotes the safe management of insulin, a commonly used high risk medicine.
Learning outcomes
On completion of this module you will be able to:
- identify the different types of insulin, their therapeutic action times and available devices
- identify common errors occurring in the prescribing, dispensing and administration of insulin
- identify risk factors and vulnerabilities of using insulin that can contribute to errors
- identify strategies and governance structures that can minimise the risk of errors and harm.
Scope of module
This module focuses on the use of subcutaneous insulin, with intravenous insulin falling outside its scope.
It is recommended that all clinicians who are involved with intravenous insulin review their state or local health service policies and clarify any ambiguities with their diabetes service.
Unlike subcutaneous insulin, the indications for the use of intravenous insulin do not only include hyperglycaemia. The specific equipment, procedures, clinical targets, monitoring and therapeutic endpoints do not fall within the scope of this module to address the associated risks and potential errors that can occur.
About this module
Relevance
This module is intended for all health care staff involved in the management of insulin particularly in hospital, aged care and home care settings.
Duration
The module is designed to take around an hour to complete.
Certificate
On successful completion of the assessments you can download a certificate of completion.
Compliance
This module aligns with the National Safety and Quality Health Service Standards, Second Edition – Standards 1, 2, 4 & 6.
Disclaimer
This module content was developed by the Australian Commission on Safety and Quality in Health Care and is protected by copyright under a Creative Commons Attribution-Non-Commercial-Share Alike (BY-NC-ND) 4.0 International License.
The content is provided in good faith by the Commission for information purposes. It is not a substitute for, and is not intended to replace, any specific policies, guidelines or requirements for your local health network or health service.
The Commission does not accept any legal liability or responsibility for any injury, loss or damage incurred by the use of, or reliance on, this information.
Course release dates
| Date | |
|---|---|
| March 2025 | Updated to include new case studies and changes to current practice, policies and standards. |
| March 2015 | First released. |
Resources
General resources
- APINCHS classification of high risk medicines – Australian Commission on Safety and Quality in Health Care (ACSQHC)
- Diabetes data snapshots – National Diabetes Services Scheme
- Brayfield A (ed). Martindale: The Complete Drug Reference [internet]. London: Pharmaceutical Press 2017.
- Management of type 2 diabetes: A handbook for general practice – The Royal Australian College of General Practitioners, 2020.
- NPS MedicineWise
- Diabetes Australia
- Li J, Jayasekara R. Reducing insulin administration errors in inpatients from a Nursing perspective: A literature review. Am J Biomed Sci & Res. 2019;6(2).
- Diabetes: Australian facts, Hospitalisations – Australian Institute of Health and Welfare
- High Risk Medicine Standard: Insulin – Clinical Excellence Commission, NSW Government
Insulin types
High concentration insulin products
- Safety Alert: High Concentration Insulin – Department of Health, Government of Western Australia
- Safety Brief: U-500 insulin – Queensland Health, Queensland Government
- Insulin safety: High strength insulin glargine 300 units/mL – SA Health, Government of South Australia
Other resources
- Australian Medicines Handbook
- Know your insulins September 2020 – Government of Western Australia, South Metropolitan Health service, Fiona Stanley Fremantle Hospitals Group
- MIMS Online
- Diabetes – Therapeutic Guidelines
- Know Your Insulins (March 2022) – NSW Therapeutic Advisory Group
- High Risk Medicine Standard – Clinical Excellence Commission, NSW Government
Insulin devices
- Safe administration of medication pen devices, information for health care providers – Clinical Excellence Commission, NSW Government
- Fact Sheet: Continuous glucose monitoring – National Diabetes Services Scheme
- All about insulin pumps – Baker Heart and Diabetes Institute
- Severe hyperglycemia in patients incorrectly using insulin pens at home – Institute for Safe Medication Practices.
Manufacturers instructions
Other sites
- Insulin Part 1: Understanding insulin – Diabetes Australia
- Insulin pens – Drugs.com
- How to use an insulin pen – Learning About Diabetes
- KwikPen Pre-filled insulin pen – Electronic Medicines Compendium (emc)
Insulin errors
- Institute for Safe Medication Practices (ISMP)
- Institute for Safe Medication Practices (ISMP) Canada
- Pennsylvania Patient Safety Authority
- Insulin Safety Week Australia
- Cousins D, Rosario C, Scarpello J. Insulin, hospitals and harm: a review of patient safety incidents reported to the National Patient Safety Agency. Clin Med. 2011; 11(1):28–30.
- Medication errors with the dosing of insulin: problems across the continuum – Pennsylvania Patient Safety Authority
- Guiding principles to achieve continuity in medication management – Department of Health and Aged Care, Australian Government
- Cohen MR. Check Up – Tip for insulin-dependent diabetics with poor vision – The Philadelphia Enquirer
Safe prescribing
National Subcutaneous Insulin Medication Charts
- National Subcutaneous Insulin Charts – ACSQHC
- National Subcutaneous Insulin Chart for acute hospitals – ACSQHC
- National Subcutaneous Insulin Chart for non-acute hospitals – ACSQHC
Other resources
- Safer Insulin Prescribing: Guidance for Australian pharmacists – ACSQHC
- Recommendations for terminology, abbreviations and symbols used in medicines documentation – ACSQHC
- Get it right! Taking a Best Possible Medication History (eLearning module) – NPS MedicineWise
- National Medication Management Plan – ACSQHC
- Safer insulin prescribing. Guidance for Australian prescribers – ACSQHC
Safe storage and selection
- National Mixed-Case Lettering List – ACSQHC
- Brayfield A (ed). Martindale: The Complete Drug Reference [internet]. London: Pharmaceutical Press; 2017.
Safe dispensing and administration
- The Australian Diabetes Educators Association (ADEA)
- Considerations for Blood Glucose Monitoring and Insulin Administration – Centers for Disease Control and Prevention
- Double-checking medication administration – ACSQHC
- The Factsheet: Identification of neural route medicines, fluids and lines – ACSQHC
User-applied labelling of injectable medicines, fluids and lines
- National standard for user-applied labelling of injectable medicines, fluids and lines – ACSQHC
- Labelling medicines. SA Health, Government of South Australia.
- Northern Territory: Health Policy Guidelines Centre (PGC). Issuing and administering Medicines PHC Remote Guideline
Safe monitoring and responding
Managing hypoglycaemia and hypoglycaemia
- Fact Sheet: Managing hypoglycaemia – National Diabetes Services Scheme
- Fact Sheet: Hypoglycaemia – Baker Heart and Diabetes Institute
Other resources and references
- Diabetes management in aged care: Fast facts for care workers – National Diabetes Services Scheme
- Diabetes management in aged care: A practical handbook – National Diabetes Services Scheme
- The McKellar Guidelines for Managing Older People with Diabetes in Residential and Other Care Settings – Centre for Nursing and Allied Health, Deakin University and Barwon Health
Engaging with consumers
- NPS MedicineWise
- Diabetes Australia
- Diabetes insulin self-administration assessment – Northern Health, Victoria
Acknowledgements
Content team
Michelle Robins, Nurse Practitioner Diabetes, Northern Health, Melbourne.
Northern Health Insulin Working Group.
