Let them Pump: Insulin Pump in Labor

Let them Pump: Utilizing Insulin Pumps in Labor
A steady increase in continuous subcutaneous insulin infusion (CSII) or insulin pump use challenged a level III obstetrical unit to organize a multidisciplinary team and develop appropriate insulin pump guidelines for the hospitalized pregnant diabetic patient. Studies suggest that near normal glycemic control prevents or delays complications of diabetes. With slightly better glycemic control during insulin pump therapy versus multiple injections a noticeable increase number of patients using insulin pump therapy has been observed within the child - bearing population.  Patients who use an insulin pump prior to pregnancy are usually highly motivated individuals and continuation of the insulin pump during labor becomes an issue of patient satisfaction.
The presentation will include the guidelines developed to promote safe continuation of insulin pump therapy for the hospitalized pregnant diabetic and meet JCAHO medication administration guidelines.  Supporting the patient to continue insulin pump therapy through the labor and delivery process promotes patient self-care and an effective participant of the healthcare team.  A responsibility of the entire healthcare team includes optimum communication among healthcare providers to provide safe care and maintain euglycemia during the antenatal, intrapartum and postpartum period. Included in the presentation are viable communication tools developed by the team to improve communication among all healthcare providers.