A recent report1 by the National Patient Safety team at NHS England reviewed insulin delivery using passive safety pen needles, highlighting concerns such as insulin pooling and potential for under-dosing. Using a passive safety needle requires steady pressure when touching the skin and throughout medication delivery. If the pressure drops, the safety mechanism activates, and contact with the patient is lost, which means undelivered medication could stay inside the device or end up on the patient’s skin. Early triggering of the safety mechanism on passive devices prevents the patient from receiving their insulin, mainly due to insufficient training in the correct use of these devices.
The study found a common issue in incident reports describing insulin pooling during administration, followed by steps like additional blood glucose monitoring to ensure safety. Some reports also mentioned unexpected high blood glucose readings and unexpected cases of diabetic ketoacidosis.
Recognizing that insulin is a vital medication, the report points out that active safety needles may pose less risk because of how they work and the reliability of insulin delivery. This is especially important where there is limited training on insulin delivery and a reliance on staff who may only be working temporarily. The article highlights the importance of training and education for both types of needles and suggests considering safety, ease of use, and dosing accuracy when choosing insulin delivery devices.
References
1. Jennings, S. (2023) ‘NHS England National Patient Safety Team PSI 115.2022. Summary for NAMDET: Insulin Pen Safety Needles’, National Patient Safety Team Updates, 6(2), pp. 30-31.