Main Line Health Insulin Pump Policy Statement


Submitted by Deebeanne M. Tavani D.O., Ph.D, FACE, System Chief – Division of Endocrinology


The Division of Endocrinology, Diabetes & Metabolism of MLH is launching an Administrative Patient Owned Insulin Pump Policy, effective July 19, 2016. The policy will be found in the Policy Manager. The order set is Continuous Subcutaneous Insulin Infusion (CSII-Insulin Pump) Orders (CPOE).


The policy consists of a Patient Agreement, a Skills Assessment, a bedside Glucose Log found in Invision and accessible through SmartChart in patient forms. An endocrine consult is required for the use of the CSII-Insulin Pump orders, inclusive of observational status. For off-hours consultation, if the provider of care deems it appropriate, the prescriber may enter an order for the patient to continue use of the insulin pump at current settings. An endocrinologist will see the patient within 24 hours.


If at any time the insulin pump is disconnected or suspended, the endocrinology service should be notified for an alternative form of insulin therapy. Staff should take precautions and remove the insulin pump from radiological exposure including X-rays, CT and PET scan, and MRI as per manufacturer advice.

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