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.
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. :)
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.
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
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!!
@@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.
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 :)
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!!
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
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?
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 have T1 Diabetes, and I have to say if I have to go to a hospital as a in patient I hope I get a nurse who's as competent and kind as she is
I'm a nursing student and we were actually told not to swab before giving the pricj as the alcohol and change the reading.
I also thought about the same thing
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.
so when pulling up
regular(clear) first then Nph (cloudy)= RN (just a quick way to remember what gets pulled up first)
My school has taught us Nancy(nph) Reagan(regular), R(regular) N(nph). Air, air, draw, draw
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.
Julia Petty there is no sterile field when giving an inzulin shot
People administer their own insulin every day. Don’t make it harder than it actually is. 🤦🏽♀️
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.
Lemonz1989 didn’t even know they still use NPH 😳
@@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. :)
I love the PR of this nurse❣️❤️
i could have sworn they did not show that you need to have another licensed staff to check and confirm the drawn up insulin is correct.
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.
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.
+Anna Stacey So she had 10 units and 30 units to give so in all she gave 40 units ?
ok keyboard warrior, hurry up and make your own video and let us comment if you did it correctly.
Alexander Lagarteja Her comment is helpful. Errors should be pointed out, particularily in a nursing "educational/informational" video.
Clover Clov er
i like to help someone someday, AMEN.
In my hospital always i get no battery charge what can i do. So i have to take twice
What about meal
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
thought subcutaneous injunction is 45 degrees
90 degrees for normal size patients, but 45 degrees for thin patients
also they are using insulin syringe
I learnt 45 to 90 depending on location. Deltoid would be 45 and abdomen would be 90 regardless of patient size.
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!!
Is it painful or not
What's an insulin pen
I'm 15 and I have to do all of this to my diabetic aunt
***** 2 BAD THAT'S NOT POSSIBLE THIER IS NO CURE 4 IT YET
what is your question lyrics blah blah blah blah sorry sorry I love you I love you so much more because I love you 100 words for
🤓👍 the same like my mum..my Allah recovering all the patients🙏
god cant cure diabetes
@@keyboardwarrior5332 yea he could if he wanted to,he made the Universe and your questioning him if he could cure a little disease
Ameen
@@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.
merci pour ces lecons
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 :)
Add
How to give insulin via IV
Hello 👋 , how're you doing, I hope you are doing fine. I'm David from Houston, Texas. Where are you from? You seems like a real Country girl😊🌹
Perfect!!
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!!
This needs to be refined to about 1 minute or less for a hospital.
The GovNer Qashqai mmmm asa aaja asa aanoalluu
"rolling the vile between your hands" ... didn't anyone proofread the subtitles?
it's great
i agree with Neilsing.
Thank
very helpful! thank you
Is it something new for. Her then
Good process
Very helpful! Thank you.
Hello Tiffany, how're you doing, I hope you are doing fine. I'm David from Houston, Texas. Where are you from? You seems like a real Country girl😊🌹
they did that james.
Thanks mam
net for plse satish
your suppose to wipe the first drop of blood.
Lammy you dont wipe the first drop of blood if it is for glucose only.
Is it scary
wrong, she forgot to wipe the first blood
FIRST BLOOD!!!
@@TheMightyKinkle ???
@@richardx4456 it was a Mortal Combat reference
@@TheMightyKinkle Oh nice man!
fantastic video
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
Michael's ML&ATG i totally agree with you, i have the same thinking. but what can we do !
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 hate diabtese really i hate too much its big stone in my path everytime or its my career or to go somewhere or to eat really hate my badluck
rất hay
your suppose to wipe the first drop of blood.
net for plse satish
🎅💔👑
mD