Best practices for safe use of insulin pen devices in hospitals: Recommendations from an expert panel Delphi consensus process

Purpose. A Delphi consensus development process was used to identify best practices for the safe use of insulin pen devices in hospitals. Methods. A panel of healthcare professionals with experience in patient safety activities and development of insulin-use guidelines was selected. In round 1 of a 4-round Delphi process, panelists were asked to identify key concepts and practices relating to safe use of insulin pen devices in hospitals. In round 2, panelists indicated their level of agreement with draft practice statements reflecting input received in round 1; statements with strong support were refined based on panelist suggestions. In round 3, the modified draft statements were rated for potential impact on patient safety. In round 4, panelists selected a final list of statements to recommend as best practices. Results. A 12-member interprofessional panel consisting of nurses, pharmacists, and physicians participated in the Delphi process. In round 1, panelists submitted more than 450 statements describing safe practices for insulin pen use. Based on that input, 125 draft practice statements were developed; among 98 statements receiving panelist support in round 2, 76 were judged in round 3 to be critical to patient safety or likely to have a positive impact on patient safety. In round 4, panelists unanimously affirmed a final list of 35 best-practice statements for the safe use of insulin pens in hospitals. Conclusion. A Delphi consensus development process yielded a list of rebommended best practices to help ensure the safe use of insulin pen devices in hospitals and health systems.