PICOT Statement

PICOT Statement Paper

The focus of this paper is the management of uncontrolled diabetes using the insulin pen for the older patients who suffer from the disease. Research indicates that an insulin pen is better than the traditional insulin treatment, especially for the elderly patient. Therefore, administration of insulin using the pen results in better management of the disease and also preserves patients’ independence.  It is also a safer alternative for this population.

PICOT Statement

Statistics from the American Diabetes Association indicate that at least 11 million Americans above the age of 65 live with diabetes mellitus. Related to these statistics is the relationship between aging and the risk of developing diabetes. Those who have uncontrolled diabetes may require insulin therapy to manage the condition (Akhrass et al., 2010). Due to many diabetes-related comorbidities among the elderly such as neuropathy, dementia, and vision loss, many elderly patients are at risk of dosage errors associated with insulin administration. These factors can impact negatively on the ability of an old patient to inject themselves with insulin. In fact, this increases their dependability on caregivers. For this population, simplification of the administration of insulin can lead to better management of the disease and also helps these elderly patients to enjoy their independence. Administration of insulin through an insulin pen instead of the traditional insulin is a more convenient and safer alternative for the elderly.

Evidence-Based Solution

There are many barriers associated with the traditional methods of administration of insulin using the syringe and the vial. However, advances in insulin delivery are effective in dealing with mechanical obstacles that can help in meeting the needs of some populations such as the elderly diabetes patients suffering from dexterity and visual issues. Many barriers related to administration of insulin are associated with the mode of administration. Holding of the syringe in the right manner or having visual acuity is essential in the self-administration insulin using the traditional methods. However, decreased manual dexterity and visual impairment can affect self-administration using the conventional techniques.  Evidence from several studies indicates that an insulin pen can be useful in dealing with the problems associated with the traditional methods of insulin administration. 

Nursing Intervention

Elderly patients with disabilities emanating from diabetes such as neuropathy and visual problems can safely self-administer insulin using the pen because the pen prevents the occurrence of issues such as inaccurate dosing. The pen also provides them with a more prominent visual display and also has an audible feature with clicking sounds. These sounds can be heard during dosage selection and completion of an injection. This element is essential for patients with visual impairments.  In his review of insulin pens, Akhrass et al. (2010) illustrate the different pen devices that are available in the market today and the advantages these pens have for older adults with diabetes. The review compares the pen device with the traditional insulin administration methods.  First, he reports that the insulin pen device reduces the number of steps followed during the self-administration of insulin and prevents the elderly patients from injecting air. It also draws the right dosage into the syringe and also visually validates the right dose.

Patient Care

Simplifying the process of administration of insulin by using the insulin pen can lead to better management of the disease. It can also help these elderly patients to enjoy their independence (Akhrass et al., 2010). Administration of insulin through an insulin pen instead of the traditional insulin is a more convenient and safer alternative for the elderly. Elimination of issues related to traditional administration methods such as improper dosage can improve the quality of life for the patients.  

Health Care Agency

This intervention does not require a healthcare setting since self-administration of insulin takes place at home. However, education of elderly patients on how to self-administer insulin can take place at care facilities for the elderly.

Nursing Practice

This improvement will have an impact on nurses whose practice involves dealing with older adults with diabetes. First, it will make their work easier since the increased independence of the elderly patients afforded by the insulin pen means fewer mistakes and fewer follow-ups by nurses. Secondly, it reduces the adverse health effects of improper dosage that is common with traditional methods of insulin administration.


Nurses should help patients choose the correct method of insulin delivery. They should ensure the technique fits their lifestyle and needs. They can intervene by helping patients to choose the type of insulin therapy that suits them and also help them explore barriers to the effective use of the pen device. Patient barriers belong to several definable categories. These include the refusal to use insulin, negative conceptions about insulin, insulin use complexities, weight gain, and fear of injections. Using a systematic approach, nurses can identify diverse patient obstacles, clarify them, and then deal with them.  Ideally, nurses play a pivotal role in educating elderly patients about the correct methods of insulin administration and encourage them to use the pen device because of its safety and convenience.


Akhrass, F., Skinner, N., Boswell, K., & Travis, L. B. (2010). Evolving trends in insulin delivery: In pursuit of improvements in diabetes management. American Health & Drug Benefits, 3(2), 117-122.

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