Diabetes Skills Standard Training Checklist Insulin Pump printable pdf download

Diabetes Skills Standard Training Checklist

Insulin Pump

An insulin pump looks somewhat like a pager and can be clipped to a belt or placed in small pouch around the waist or tucked into a

bra, shirt or pocket. The pump contains a cartridge or reservoir of insulin. An insulin pump connects to a narrow, flexible plastic tubing

that ends with a short plastic catheter inserted just under the skin in the abdomen, buttocks, or thigh. Users set the pump to give a

steady trickle or "basal" amount of insulin continuously throughout the day. Pumps release "bolus" doses of insulin (several units at a

time) to cover carbs and at times when blood glucose is too high based on the user’s programming.

See individual “Cheat sheets” for the Medtronic Revel, Animas Ping or Insulet Omnipod

Explanation/Return Demonstration

A. States purpose of procedure

B. The Individualized Student Health Plan (ISHP) is referenced for proper timing and dosing of insulin.

C. Identifies supplies - ISHP and Student Daily Diabetes Monitoring Log. Insulin pump attached to student. Specific insulin

pump instruction sheet.

D. Procedure:

1. Wash hands, Acquire blood glucose reading,

When recess is before lunch, insulin dosing should be based on the pre-lunch blood glucose reading,

not a pre-recess blood glucose reading.

2. Demonstrate how to correctly enter blood glucose result into pump. Some glucose meters radio frequency blood

glucose reading directly to the pump.

3. Demonstrate how to correctly enter carbs into the pump or handheld device.

4. Demonstrate how to correctly scroll through screens/menus to properly use bolus calculator.

5. Demonstrate how to give bolus using bolus calculator and verify that dose calculations are within parameters as

stated in the ISHP.

6. Demonstrate how to check bolus history.

7. Demonstrate how to disconnect pump at insertion site “by pulling site like a band-aid” in case of severe low blood

sugar.

8. Verbalizes understanding of need for increased monitoring of blood sugar when blood sugars are high as indicated in

the ISHP.

9. Verbalizes understanding of how to respond to pump alerts and alarms and when to contact parent and/or District RN

10. Documents interventions on Student Daily Diabetes Monitoring Log

#615

Colorado Kids with Diabetes Care and Prevention Collaborative

July 2013

Diabetes Skills Standard Training Checklist Insulin Pump