A novel approach to safe insulin prescribing
by Imperial College Healthcare NHS Trust
Insulin prescribing and administration errors in hospital cause significant risk. The paediatric diabetes team worked together with the pharmacist and paediatric unit staff to design and produce an insulin prescription drug ‘insert’ for in-patients that can be attached to each individual’s existing drug chart. The aim of this was to aid the prescription and administration of insulin injections, ensuring they are given correctly and safely, thereby reducing insulin drug errors and improving patient safety. There has been a 50 per cent reduction in errors with the administration of the insulin, including no missed doses due to unprimed pens and no over corrections.
"This initiative demonstrated excellent patient engagement and empowerment and is something that could easily be adapted to adult services. Outstanding!"
A skills based structured education programme to support adults with diabetes in insulin management
by Leicester General Hospital
The team developed an interactive education programme on insulin management for people with existing type 2 diabetes and people with type 1 diabetes for whom DAFNE is unsuitable. The programmes are run by diabetes specialist nurses and specialist dietitians and take place over three sessions, and include practical sessions using food models and participants’ own blood glucose profiles. Participants are encouraged to problem solve with support from their peers rather than the HCP. At the end of each session participants form their own individual plan. Achievements so far include a reduction in the number of 1:1 consultations and a reduction in HbA1c levels of a complex population, which included 50 per cent people from an ethnic background.
Improving insulin safety at Royal Surrey County Hospital
by Royal Surrey County Hospital
Several new initiatives were introduced to address insulin-related medication errors – a significant source of adverse events for in-patients with diabetes. These comprised three areas: training, savings and waste of insulin, and safety. By January 2012, 40 per cent of qualified nurses had completed the NHS e-learning module and all foundation year doctors had attended a mandatory insulin training session. Single insulin devices were dispensed to wards on a named patient basis and a drive to increase isophane insulin in ward settings resulted in an annual saving of £16,050. The introduction of pre-prepared intravenous insulin syringes and changes to the insulin prescribing procedure resulted in a reduction of prescription errors by 6 per cent.