Supporting patients to administer their own insulin when in hospital will facilitate self care, improve patient experience and should reduce errors and delayed doses. Around 50% of people with diabetes who are admitted to hospital require Insulin. We have found that it is a complex change and have developed a Guide to the Implementation of Self Administration of Insulin which can be downloaded and freely used by Trusts (see resources).
We have been working with University Hospital Southampton, Salisbury Hospital and Hampshire Hospitals on this work. Audits in all 3 trusts showed significant wastage of insulin which is left in ward fridges when patients are discharged, delays in administration of insulin in relation to mealtimes and that over 50% of patients were self administering their insulin. However the processes to support patients who were self administering insulin were variable.
There is evidence that patients with diabetes are more likely to have worse control of their disease when they are in hospital than at home. In Wessex, around 17% experienced a medication error in hospital. Poor diabetes control or an insulin error can mean up to 3 more days in hospital than would be expected.
University Hospitals Southampton are further ahead in their work than the other Trusts, and some examples of innovations that they have implemented to support patients to administer their own insulin are:
Diabetes UK have signposted the Implementation Guide from their website (professional best practice resources) and we are delighted that this work was shortlisted in the Medicine Safety Category of the HSJ Patient Safety Awards 2017, and in the Long Term Conditions and Patient Safety Categories of the Nursing Times Awards 2017. The short video below shows the project nurse and a patient talking about the work and how it has made a difference.
We are keen to share our work and resources. Please do get in touch if you are interested in finding out more: