Our health system currently has three standard insulin infusion concentrations: 1 unit/mL (adults), 0.5 unit/mL (peds), and 0.2 unit/mL (NICU). Our medication safety council has received a request to eliminate the use of the 0.5 unit/mL concentration for multiple reasons--reports of wrong concentration errors, decreasing compounding needs, facilities that we transfer pediatric patients to do not use 0.5 unit/mL so our pharmacists are manually manipulating orders resulting in potential errors, etc. This would also align with the current Standardize 4 Safety recommendations for pediatric insulin infusion concentrations. In addition, our health system has recently approved adding 16 units/mL for BB/CCB toxicity only. We would like to minimize the various concentrations of this high-risk medication.

What standard concentration(s) are your facilities utilizing for insulin infusions? Any cut off for transitioning pediatric patients from the one concentration to another (e.g., 0.2 units/mL for 10kg and under, 1 unit/mL for all others)? Any additional input would be appreciated.

Thanks in advance.