Vanessa Briones

Pico Question
Nursing Informatics 2016
P: Elderly population within a nursing home
I: Insulin Pens
C: Insulin Vials/ Needles
O: Prevention of medical errors

Question: Do the use of insulin pens verses insulin

needles prevent medical errors from occurring more
often?
I chose this question because at the nursing home I am currently working at
we are beginning this transition from insulin vials that we draw up to insulin
pens. I wanted to take this time to research the information behind this
change we are going through instead of just not questioning something or
knowing the information behind it.

Your evaluation:

Having filled in the flowchart, what conclusion have you reached? Is this a
good source for your research project?
Does the author or organization have the proper experience and
qualifications to provide this information? Yes the author is a licensed
individual who is an Advanced Nurse Practitioner, Certified Diabetes
Educator, and has a Masters Degree in the Science of Nursing.
If written by an organization, is the organization well known and trusted?
This Article was written on the American Diabetes Association website so I
would say yes, his is well known.
Does the organization have a positive (altruistic) purpose in providing this
information? Yes, their purpose is to educate on Diabetes.
Does the source contain a bibliography or other references to show the
source of the information? Yes
Has this source been through a formal publication process? Has it been
edited or reviewed? Yes

 Does the site contain any bias? If so, can you find a way to balance the
bias with information from other sources? No bias is seen here, it gives
information to educate on Diabetes and the use of insulin pens verses insulin
needles, gives both pros and cons.
Finally, is it up to date? Is this important for your topic? Yes it is up to
date, it is important for the topic because the most up to date information is
needed for the best evidence based practice.
Summary (What is your overall evaluation, based on the checklist and your
flowchart? Is this a suitable source for your academic research? What
evidence supports your decision?)
This article is great for my question because it gives information on what I
was asking. It answered my questions as to why insulin pens are being used
versus insulin vials and needles. It comes from a good source, and it is also a
publicized journal. The article is up to date and is written by a qualified
individual. Some of the advantages that insulin pens are greater patient
acceptability and compliance. It is important for the patient to feel
comfortably when using needles or injections because this is a very
intimidating thing, with insulin pens they are easy to use, making patients
feel more comfortable with them. Insulin pens improve health-related quality
of life, because there are studies that show they are less painful then regular
insulin needles. Also there is a greater dosing accuracy with the use of pens
instead of needles and vials. Older population is the largest population
receiving diabetic treatment, and they are at higher risk for both
hypoglycemia and hyperglycemia. Insulin pens improved adherence to
therapy compared to vials and syringes, costs were lower with pens rather
than vials and needles.

Source information:
Title: Improved Disposable Insulin Pen Devices Provide an Alternative to
Vials and Syringes for Insulin Administration
Author (if listed): Geralyn R. Spolett MSN, ANP-CS, CDE
Organization (if provided): American Diabetes Association
URL (if provided): http://spectrum.diabetesjournals.org/content/25/2/117.full
Other information useful for finding this source again or for citing it later:
Diabetes Spectrum Journal

Your evaluation:
Having filled in the flowchart, what conclusion have you reached? Is this a
good source for your research project?
Does the author or organization have the proper experience and
qualifications to provide this information? Yes, article writer is a Pharm D,
and also an RPh.
If written by an organization, is the organization well known and trusted?
It is written by an organization called Pharmacy Times, pharmacists write
articles about the most recent EBP on medications.
Does the organization have a positive (altruistic) purpose in providing this
information? Yes
Does the source contain a bibliography or other references to show the
source of the information? Yes
Has this source been through a formal publication process? Has it been
edited or reviewed? It was published and has many sources listed for its
information.
Does the site contain any bias? If so, can you find a way to balance the
bias with information from other sources? I dont believe that any bias is in
this article the Pharmacist is writing about studies and things that have
proved the information that he has found. Also they are just reporting the
most recent medical updates to other pharmacists/ healthcare providers.
Finally, is it up to date? Is this important for your topic? Yes it is up to
date, it was published May 19, 2015. This is important to have because the
most up to date information is what nurses can base their practice off of, and
what is the safest practice at that.
Summary (What is your overall evaluation, based on the checklist and your
flowchart? Is this a suitable source for your academic research? What
evidence supports your decision?)
I believe that this is a suitable article because it has information based on my
question that I formed and it also has up to date information that has sources
to back up that information. It states in this article that insulin pens are
convenient for patient use, and for nursing use. There was a study to show
how easy use of pens and harder for patients to use syringes, pens make it
easier for patients to see the dosage they are getting as opposed to syringes
where it is more difficult to read. Pens have a shorter, thinner needed
reducing the pain of injections. There was also a study that showed patients

using pen needles experienced significantly greater reduction in glycosylated

hemoglobin levels. There is a less waste of insulin related to saving money.

Source information:
Title: Insulin Pens: Improving Adherence and Reducing Costs
Author (if listed): Michael R. Page Pharm D RPh
Organization (if provided): Pharmacy Times
URL (if provided): http://www.pharmacytimes.com/publications/directions-inpharmacy/2015/may2015/insulin-pens-improving-adherence-and-reducingcosts
Other information useful for finding this source again or for citing it later:
Pharmacies and Healthcare Communications LLC.

Your evaluation:
Having filled in the flowchart, what conclusion have you reached? Is this a
good source for your research project?
Does the author or organization have the proper experience and
qualifications to provide this information? Yes both authors are Doctors of
Pharmacy.
If written by an organization, is the organization well known and trusted?
Annals of Long-Term Care our journal articles published online for long-term
care facilities and health care providers.
Does the organization have a positive (altruistic) purpose in providing this
information? Yes, there are studies that support their evidence that they
researched.
Does the source contain a bibliography or other references to show the
source of the information? Yes.
Has this source been through a formal publication process? Has it been
edited or reviewed? Yes it was published on January 14, 2016.
Does the site contain any bias? If so, can you find a way to balance the
bias with information from other sources? No evidence of bias in this article,
there was studies done to both support and not support my question.

Finally, is it up to date? Is this important for your topic? Yes this article is
up to date was published in January 14, 2016.
Summary (What is your overall evaluation, based on the checklist and your
flowchart? Is this a suitable source for your academic research? What
evidence supports your decision?)
This article broke down the use of insulin pens and vials within long term
care facilities. They took surveys of long term care facilities usage of pen
needles and the pros and cons of the usage. Although there has been errors
using the pens, her is evidence that supports that insulin pens can be used
safely, and reduce costs within the long term care facility. The article
concluded that more studies needed to be done to see exactly how useful
insulin pen needles are and if they are safer than insulin vials and syringes.
Source information:
Title: Utilization of Insulin Pens in Long-Term Care
Author (if listed): John B. Hertig PharmD; Katelyn Brown PharmD
Organization (if provided): Annals of Long-Term Care
URL (if provided): http://www.annalsoflongtermcare.com/article/utilizationinsulin-pens-long-term-care
Other information useful for finding this source again or for citing it later:
Issue Number:
Volume 24 - Issue 1 - January 2016

Conclusion: I came to the conclusion through my research that there are

great advantages to using insulin pen needles. The cost of them is higher on
average but there is little to no waste with them in turn making them less
expensive over time. Using pen needles is less painful to the patient which is
always a great outcome. Also when nurses uses insulin pens there is less of
a chance of either overdosing or under dosing a patient. Elderly patients are
at more risk for either becoming hyper or hypoglycemic, if we can minimize
these risks that is greater quality of life for the patient. There is also more
research that I can do to dig a little deeper into the topic, but what I have
found so far answers my question to yes, using insulin pens is safer overall
for elderly patients when treating their diabetes.