Correct dosing of insulin is based not only on the patient’s blood glucose values, but also on the patient’s weight. A pre-printed sliding scale for insulin is a tool that staff can use to quickly select the appropriate dose of insulin based on both criteria. Since the doses for each blood glucose and weight range are printed on the scale, determining the correct dose for a patient requires only one calculation: The units of insulin per kilogram (total units of insulin in 24 hours divided by the patient’s weight in kilograms). Prescribers only need to order the use of the sliding scale, and subsequently all dosing will be determined by referring to that tool.

Tips

• Make sure that your organization has only one sliding scale. If there are several different versions, there is a greater chance that staff will make an error.
• Automate the sliding scale if there are computer systems available that can accommodate it. That way, staff can have the computer perform the calculation of insulin units per kilogram.
• In order to make it very clear, visually, which sliding scale to use, step number five in the protocol asks to either highlight the units/kg column to use for the individual patient at hand or to black out the sections that should not be used. 
• Obtain input from physicians in your organization who regularly prescribe insulin.  Modifications that fit your local environment may be necessary and will ensure that the scale is used successfully.

Download the file (Word document).  Once the prescriber orders the use of the sliding scale insulin protocol, staff can determine all dosing by referring to it.  In order to make it very clear, visually, which sliding scale to use, step number five in the protocol asks to either highlight the units/kg column to use for the individual patient at hand or to black out the sections that should not be used.  Obtain input from physicians in your organization who regularly prescribe insulin.  Modifications that fit your local environment may be necessary and will ensure that the scale is used successfully.