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Great job on the doing the patient identification . However I did notice when you pricked the patient , you did not wipe the first blood sample. Wiping the first blood sample is more effective and more accurate. Great. Job. Though !
I see some of the confusion when watching this. The physician's orders have NPH at 12 units in the AM and 8 units in the PM, I am assuming this is AM because she drew up 12 units of air and injected it into the NPH vial, and then did 2 units of Regular insulin based on the BS level of 154 and the sliding scale. She then took out 2 units of Regular and then 12 units of NPH per orders. The confusing part is the voice over, saying 30 units for NPH and 10 units for regular, which if you look at the order's does not say that.
When disinfecting the vial, you should start from the center to edge by circles, not back and forth which is not aseptic technique. When operating the syringe, hands can't touch inside plunger. Or you contaminate the drug with its surface when pushing and pulling against the outer barrel. Remember the clean gloves don't mean sterile gloves; they protect you not patient.) Sterile field has also been contaminated when you put your hands above the sterile field. That might be the most of the reason of nosocomial infect. I saw many times nurses do this way which shocked me, but I am not an authority but an alien. Although I am nursing student in American, I will follow Chinese way.
Not all places require this. This definitely is a hospital preference. As long as you are a student nurse and you have registered nurse of professor (RN) by your side watching you, that’s fine. If you’re an RN working, you don’t always need someone’s approval if it is the correct dose.
Very thorough, but sloppy rolling technique for the NPH. You could still see residue on the bottom of the vial. You turn the vials and pens on the opposite site where the residue is on. If the residue is on the bottom of the vial, like here, you turn the vial on its side and roll.
@@thesunnyedge It's apparently pretty normal in most of the world, because it's cheap and effective. :) You can also buy many premixed insulins that have a fast acting mixed into the NPH. I think it's one of the cheapest ones you can get in the US (I'm not American, so I don't know). Another benefit of NPH is that it can be diluted with diluting fluid, in the case of infants and young children. The modern insulins are often much too potent for them, and they can't be diluted. :)
@@zaiidchakir8788 but he doesn't because he doesn't exist. If he really cared about his "children" we wouldn't have wars, starvation, homelessness, inequality, etc etc. We'd live in a peaceful world but we don't
@@vince3523 we that's how ppl work if we font like what some one says then we fight and start wars, I respect you and what you believe in but maybe if you want to try searching up the Quran in English and start readying maybe that will help you under stand the point of life and why life is not fair.
2 different alcohol swabs needed to clean both N and R bottles...by using one, you risk spreading contamination/germs from one to the other...not a good..should redo that part of the video..
As an RN. it is well known the patient washes hands before finger pricking and does not use alcohol wipes. If you are going to check ID at least check it matches your medication chart, not once did she look at this to compare she had the right chart to patient. UR numbers are far more accurate than birth dates, it is not unknown to have patient with same birth date and name.Sharp was not put in sharps receptacle either. She should have also used an new alcohol wipe for each vial when cleaning. No alcohol wipe should be used to wipe injection site, just needs to be clean. Alcohol dries and hardens skin which effect future use of that site. The arm is not the first choice for insulin, but the abdomen. The body sites eg arm, leg , abdomen are not rotatable as have different absorption rates, eg all similar insulin given at similar time she be given in the one area , in slightly different patch of skin. if you lift an arm like that it tenses muscles and potentially causes pain, much better to have arm relaxed eg down. If she is used to giving own insulin, the patient should be offered this option.
+Anna Stacey thank you for the explanation! but for pt who stays in the hospital temporarily the arms where they can't reach at home might be a better alternative to use. agree with wiping vials with two different wipes. also another nurse should confirm the amount was accurate.
When wiping the patients skin with the Alcohol swab you only pass it on the skin once... not 3 or 4 times because the skin can get contaminated if you do so... everything else that you did was good
Good video, although you do not swab the skin with an alcowipe :) As the alcohol can give misleading results in concerns to the BGL reading. (This is well defined in research, have a look) Swab with warm water instead :)
Shanique Downer I’m a nursing student and we were taught if you can pinch 2 inches of fat it’s 90 degrees but if you can only pinch 1 inch (thin patients) it’s 45 degree just to make sure you don’t hit a muscle!!
Presenter injected 30 units of air into the cloudy vial first = good. didn't infect 10 units of air into the clear = bad. didn't draw ten units of air into the empty syringe = bad didn't draw ten units of insulin into the viall didn't draw 30 units of cloudy into the syringe There should be a total of 10 + 30 units = 40 units of insulin in that syringe, and the video doesn't depict this. Poorly done!!
hi, every body.. My name is Hiep.dinh, I am 25 years old I was born in Vietnam, Now i am a Last year students (medical & phamarcy university) i am a nurse, I want learn masters nurse at american, after university graduation in vietnam can you help me?
I hope that we come up with a better process. I believe the health care industry should not subject patients to such a painfull form of treatment. I am not a fan of needle injections or finger prickings. We should have empathy & compassion & do our best to minimize or eliminate the pain for the patient. In my opinion, daily needles & finger pricking are not good therapy. God, please help us to do your will.
Michael's ML&ATG I know what you mean, doing blood sugars and pricking the same patient 2, 3 or even 4 times a day is definitely not pleasant for the pt. I feel so bad every time I have to pick them during my day because their fingers must feel so sore
