Determinants of nurse satisfaction using insulin pen devices with safety needles: an exploratory factor analysis
Open accessAbstract
BACKGROUND: A paucity of data exists to examine nurses' satisfaction with the use of insulin pens with safety needles in hospitalized patients with diabetes. We investigated major determinants of nurses' preference of the method of insulin administration in the context of a General Hospital in Northern Italy. METHODS: Consecutive patients admitted to three hospital units of different care intensity requiring insulin received insulin therapy through either the vial/syringe method (October to December 2012) or pen/safety needles with dual-ended protection method (January to March 2013). Before the implementation of insulin pens, floor nurses received a specific training program for proper insulin pen injection technique including individual testing of the devices (pen/safety needles). At the end of the study, nurses completed the Nursing Satisfaction Survey Questionnaire. Cronbach's alpha was used to determine the internal consistency and reliability of the questionnaire. Major determinants of satisfaction were investigated through an exploratory factor analysis. The association between each retained factor and time spent to teach patients how to self-inject insulin with pen devices was also investigated. RESULTS: Fifty-three out of 60 nurses (mean age ± SD 36.2 ± 8.5 years, 85 % women, 57 % with 10+ years of working experience) returned the questionnaire. Internal consistency of the questionnaire was satisfactory (Cronbach's alpha > 0.9). Three months after their introduction, about 92 % of nurses considered pen devices an "improvement" over the vial/syringe method. Two factors explained 85 % of nurses' satisfaction, one related to convenience and ease of use, and the other to satisfaction/time spent for dose preparation and administration. The latter factor was inversely correlated with time spent on patients' training tasks. CONCLUSIONS: Nurses' satisfaction with pen devices was higher than previously reported, possibly reinforced by safety needles with dual-ended protection. Perceived workload was a major determinant of nurse satisfaction using pen devices with safety needles. To facilitate the introduction of insulin pens in the hospital setting, it should be specifically addressed during training programs in the switch-over period.
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Several reports indicate that inpatient use of insulin pens is safe and may improve nurse satisfaction when safety protocols, including nursing education and bar code scanning procedures, are in place to guarantee single-person use.
“Several reports indicate that inpatient use of insulin pens is safe and may improve nurse satisfaction when safety protocols, including nursing education and bar code scanning procedures, are in place to guarantee single-person use (70-73).”
From 16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026 (2026) · cites this paper as [70]
The Discussion reports that about 92% of nurses considered pens with safety needles an improvement, and that no needlestick injuries occurred during the three-month pen-use period. The Methods describe nurse training, but the paper does not report bar-code scanning or a procedure guaranteeing single-person use; its Background also describes inpatient adoption as controversial because of contamination risks. (LLM, conf=0.88)
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- [2]Molife C Lee LJ Shi L Sawhney M Lenox SM Assessment of patient-reported outcomes of insulin pen devices versus conventional vial and syringe Diabetes Technol Ther 2009 11 8 529 38 10.1089/dia.2009.0007 19698067 · DOI
- [3]Perfetti R Reusable and disposable insulin pens for the treatment of diabetes: understanding the global differences in user preference and an evaluation of inpatient insulin pen use Diabetes Technol Ther 2010 12 Suppl 1 S79 85 20515312
- [4]Cornell S Managing diabetes-related costs and quality of life issues: Value of insulin analogs and pens for inpatient use Health Policy 2010 96 3 191 9 10.1016/j.healthpol.2010.02.006 20226560 · DOI
- [5]Davis EM Christensen CM Nystrom KK Foral PA Destache C Patient satisfaction and costs associated with insulin administered by pen device or syringe during hospitalization Am J Health Syst Pharm 2008 65 14 1347 57 10.2146/ajhp070636 18593681 · DOI
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16. Diabetes Care in the Hospital: Standards of Care in Diabetes—2026
American Diabetes Association Professional Practice Committee for Diabetes*, Bajaj, M., McCoy, R. G., Balapattabi, K., Bannuru, R. R., Bellini, N. J., Bennett, A. K., Beverly, E. A., Briggs Early, K., ChallaSivaKanaka, S., et al. (2026) · Diabetes Care · doi:10.2337/dc26-s016 · Cited by 80 · see citing works
- Authors
- Veronesi, G., Poerio, C. S., Braus, A., Destro, M., Gilberti, L., Meroni, G., Davis, E. M., & Bossi, A. C.
- Affiliations
- University of Insubria (IT)
- Azienda Ospedaliera Treviglio (IT)
- Creighton University (US)
- Corresponding author
- Bossi, Antonio C.
- Venue
- Clinical Diabetes and Endocrinology
- Published
- 2015-11-09
- Volume
- 1
- Issue
- 1
- Pages
- 15-15
- ISSN
- 2055-8260 (ISSN-L)
- PMC
- PMC5471734
- OpenAlex
- W2162815165
- Cited by
- 19
- References
- 0
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 1 · 2015: 1
- FWCI
- 3.45
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Clinical Diabetes and Endocrinology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IrInSubria (University of Insubria) (submittedVersion)
- Topics
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- insulin pens, safety needles, nursing satisfaction, insulin administration, hospitalized diabetes patients, perceived workload, nurse training, self-injection training
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