** single-gpage.php **
** content-gpage.php **


Prescribing Support – Medicines Optimisation

  

Updates, information and newsletters from the Medicines Optimisation Team


Library of Resources

Click on links

July 2020 Newsletter

Needles for Pre-Filled and Reusable Injector Pens for Subcutaneous Injection of Diabetes Medicines October 2020

Needle Length

The recommended needle lengths for adults are 4mm, 5mm or 6mm.

For children 4mm or 5mm needles are usually recommended.

Using shorter pen needles helps to prevent lipodystrophy and avoid unpredictable blood sugar levels.

If needle length is changed, blood sugars should be monitored.

All needles are for single use only.

Needle Brand

First-line choice:          TriCare screw-on needles (Owen Mumford Ltd) (£3.95 for 100)

Second-line choice:     BD Viva screw-on needles (BD) (£3.59 for 90)

Available in 4mm/32G, 5mm/31G, 6mm/31G sizes.

Compatible with all major brands of insulin pens and GLP-1s.

Injection Technique

Injection technique should be taught when initiating a medication and checked at each diabetic review.

The key points are:

  • Use a new needle for each injection
  • For insulins, discharge a 2 unit ‘air shot’ before dialling dose for injection
  • (For GLP-1s, follow manufacturer’s instructions for preparing injection)
  • Inject at a 90-degree angle into the skin (A lifted skin fold may be needed for children or very slim adults)
  • Ensure that the full dose is injected, then leave the needle in the skin for 10 seconds before removing
  • The needle should be removed from the pen immediately after use and discarded in a sharps bin
  • Injection sites should be rotated as instructed by the patient’s healthcare professional
  • If a patient notices any lumps at an injection site, they should seek advice from a healthcare professional

Further information and a suggested checklist can be found in the Trend guidelines:

https://trend-uk.org/wp-content/uploads/2018/11/ITM-Guideline_v9-FINAL-251018.pdf

Safe Disposal of Sharps

Patients should be educated about the safe disposal of sharps before starting injections and advice reinforced at every opportunity.

Advice should include:

  • Dispose of sharps immediately after use in a designated sharps container. Do not bend or break needles before discarding them. Do not put sharps in household waste.
  • Place the sharps container at eye level on a steady surface and within arm’s reach to allow for easy disposal of sharps. Close the temporary closure lid following use.
  • Keep the sharps container in a safe place to avoid accidental injury to others. Once filled to the ‘fill’ line close and lock the sharps container and arrange for safe disposal.
  • A sharps container should be prescribed for all patients prescribed injectable medication or lancets. Sharps containers with capacity ranging from 1 litre to 9 litre can be prescribed on FP10.
  • GP practices should not accept sharps bins for disposal.

Local arrangements for sharps disposal are:

Coventry City Council Council will collect any size container from households on demand when they have a sufficient quantity to make the journey worthwhile

Contact: 024 7683 2255 or email wastesolutions@coventry.gov.uk

North Warwickshire Borough Council Council will collect any size container from households on demand when they have a sufficient quantity to make the journey worthwhile

Contact: 01827 715 341 or email customerservices@northwarks.gov.uk

Nuneaton and Bedworth Borough Council Council will collect any size container from households on demand when they have a sufficient quantity to make the journey worthwhile. Request via the council website:

https://www.nuneatonandbedworth.gov.uk/info/20006/clinical_waste/161/clinical_waste_collection or telephone 02476 6376376

Rugby Borough Council Patients are required to arrange to deliver their own clinical sharps waste to RBC Hunters Lane depot, any size clinical sharps waste container will be taken for safe disposal.

Contact: 01788 533 533 or email contact.centre@rugby.gov.uk

Stratford District Council Sharps boxes up to 1 litre can be taken to any pharmacy in Stratford District except Boots.

Contact: streetscenedutyofficer@stratford-dc.gov.uk

Warwick District Council Pharmacies listed on the council website will accept 1 litre and 5 litre sharps bins for disposal:

https://www.warwickdc.gov.uk/info/20465/rubbish_waste_and_recycling/287/clinical_waste/2

Contact: 01926 456128 or email contract.services@warwickdc.gov.uk

Sharpsafe devices

Safety needles and lancets may be needed in certain circumstances:

Patient group Needles to be obtained via: Recommended brand:
Children who have to administer insulin injections whilst at school GP to prescribe on FP10 Safety needles:

BD Autoshield Duo 5mm/30G(£30.41 for 100)

Safety lancets:

Not usually required as patients use FastClix drum.

Patients with a known blood borne virus (BBV) where a family member is administering their injections GP to prescribe on FP10 Safety needles:

Microdot Max Safety Pen needles 5mm/30G

(£12.89 for 100)

Safety lancets:

Unistik 3 Comfort 1.8mm/28G (£6.31 for 100)

Patients where an NHS-employed District Nurse is administering their injections GP to prescribe on FP10

 

Safety needles:

Microdot Max Safety Pen needles 5mm/30G

(£12.89 for 100)

Safety lancets:

Unistik 3 Comfort 1.8mm/28G (£6.31 for 100)

Patients resident in a nursing home where staff are administering injections Care home to provide appropriate devices

 

 

These devices are not for routine use and should only be prescribed in the circumstances described above. Under Health and Safety regulations, it is the employer’s responsibility to provide safe sharp devices for their staff.

These devices should not be prescribed for use by privately employed nurses or carers, including care home staff; safety devices should be provided by their employer.

Oral Nutritional Supplements (ONS) October 2020

Weigh patient + obtain height + obtain weight history over last 3-6 months

Calculate ‘Malnutrition Universal Screening Tool’ (MUST) score MUST Calculator 

If weighing not possible, use the Patient Association Nutrition Checklist to identify risk of malnutrition

 

Click here for ‘Food First 3-2-1’ Treatment

Click here for ‘Food First Homemade Supplements’ or click on links on right above

 

 

(Visited 40 times, 33 visits today)

Leave feedback

Pages