The complexity of diabetes management, with advances in therapies and best practice, can be difficult for general ward staff to manage, leading to clinical risks, such as maladministration of insulin, clinical inertia and episodes of hypoglycaemia, often resulting in suboptimal care. With limited time and resources, inpatient diabetes specialist nurses (DSNs) are often unable to address all the issues. Locally a large number of medication errors and ‘near misses’ were identified on the wards. The diabetes inpatient team discussed ideas and looked for inspiration nationally but felt that a new approach was required. The project focused on upskilling inpatient clinical pharmacists through completing the advanced diabetes management course, followed by a new, collaborative-working initiative involving regular clinical supervision and support from the North East Essex Diabetes Service (NEEDS) inpatient DSNs. Previously, pharmacists had just performed medicine reconciliation advice on medication interactions and side effects while assisting with discharge planning. The project demonstrated that clinical pharmacists were expertly placed to improve medication safety through performing a medication review, highlighting and identifying any clinical risks, and optimising patient therapy. They gained the skills and confidence to support diabetes management at ward level, leading to improved patient safety, reduced DSN workload, plus greater diabetes awareness and knowledge within the hospital.
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