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Insulin sliding scale/correction bolus order split

28 Mar 2021

AC dose process improvements begin April 13

By: Matthew Tanner, pharmacy clinical coordinator


To reduce the frequency of giving the “AC” dose of insulin at bedtime (or vice versa), the AC (with meals) and HS orders will be separated into different orders.

What you need to know:

  • Starting April 13, 2021
  • When you order the sliding scale or correction bolus insulin, it will show up as two orders:two orders
  • The “AC scale” order can be changed to q4h or q6h, but CANNOT be changed to ACHS or to HS.

  • The HS order CANNOT be changed to AC (with meals).

  • If the scale needs to be changed (i.e. from mild to moderate), BOTH orders will need to be changed. If you try to discontinue only one, you may need to click the “show additional orders” button to make the other related meds appear:

    show additional orders

  • You can choose to use two different scales at different times (i.e. a moderate scale timed with meals and a mild scale for HS doses), but you may get a call to ensure that what you meant to do.

  • You can no longer modify the scale on the mild, moderate and severe scales. A custom scale is available if the pre-existing scales just won’t fit the needs of the patient.