Standardising practices through form design and education improves insulin management.
Diabetes is common in hospitalised patients and insulin is frequently required for management. Insulin is a high-risk drug, accounting for about 15% of reported medication-related incidents. Despite its complexity, insulin management in hospitals is often undertaken by junior and non-specialist staff. Improving insulin management requires addressing safe prescribing and administration as well as quality use of insulin. Common errors in insulin use are well documented and can be addressed through form design and enhancing decision support. We undertook to improve insulin management using a locally proven improvement methodology. New forms were developed for intravenous and subcutaneous insulin and blood glucose management. Audited pilot studies in four hospitals confirmed improved insulin management without adversely impacting on overall diabetes management as assessed using Glucometrics. Subsequently, the forms have been introduced to 70% of Queensland public hospitals with roll-out to remaining hospitals continuing. Large-scale standardisation of insulin management is feasible.
McIver
Fiona B
FB
Safe Medication Practice Unit, Queensland Health, Brisbane, QLD, Australia.
Mitchell
Charles A
CA
Finn
Carmel P
CP
Kamp
Maarten C
MC
D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D007003:Hypoglycemia / Q000188:drug therapy*; D007004:Hypoglycemic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008485:Medical Audit; D008499:Medical Records / Q000592:standards*; D008508:Medication Errors / Q000517:prevention & control; D017410:Practice Guidelines as Topic / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000458:organization & administration*; D011793:Queensland
D007004:Hypoglycemic Agents; D007328:Insulin