Introducing a diabetes e‐learning module: a means of improving junior doctors' confidence and ability in managing inpatients with diabetes

Abstract

The aims of this study were to determine whether the introduction of a diabetes management e‐module can increase junior doctors' confidence in managing inpatients with diabetes and contribute to improvements in patient care.A diabetes e‐module was introduced at Barnet and Chase Farm Hospitals NHS Trust in October 2010. Junior doctors completed it and undertook an online exam at the end. Junior doctors were surveyed once, six to eight months after completing the e‐module, and retrospectively ranked their confidence and knowledge levels in managing inpatients with diabetes before and after completing the e‐module. Patient care was assessed by comparing the National Diabetes Inpatient Audit (NaDIA) findings at Barnet Hospital before and at two time points after the introduction of the e‐module.After undertaking the e‐module there were statistically significant increases in the self‐ranked confidence and knowledge levels of junior doctors regarding diabetes management. This included improvements in identifying different types of insulin, making insulin dose adjustments for hypoglycaemia/hyperglycaemia and a reduction in reported prescription errors. The results from the NaDIA also suggest an improvement in ‘good diabetes days’ for insulin‐treated patients with diabetes and a pattern of reduction in prescription and management errors.This study demonstrates that an inpatient diabetes management e‐module increases junior doctors' knowledge and confidence in managing diabetes. A multi‐centre study would be needed to confirm whether this translates into better management of inpatients with diabetes. E‐modules may be used to cover further topics in diabetes, and to support nursing and patient education. Copyright © 2013 John Wiley & Sons. Practical Diabetes 2013; 30(3): 122–127

Interventions to improve insulin prescribing practice for people with diabetes in hospital: a systematic review

“…The types of intervention varied, as well as the implementation strategies, and measures of improvement between studies (see Table ). Although three studies used the UK's National Inpatient Diabetes Audit (NaDIA) methodology and data collection tool, the follow‐up period, interventions, implementation and the data reported were varied, hence it was difficult to pool data or make meaningful comparisons .…”

“…The types of intervention varied, as well as the implementation strategies, and measures of improvement between studies (see Table S4). Although three studies [19] x Courtenay 2007 [17] x x Donihi 2006 [26] x x Dooley 2011 [28] x Donsa 2016 [27] x x Doyle 2014 [54] x x x x Ena 2009 [41] x x Gomez-Huelgas 2014 [55] x x Guerra 2010 [43] x x x Hamilton 2013 [18] x Harbin 2015 [36] x x Helmle 2017 [37] x x x x x x x Horton 2015 [44] x Kowiatek 2001 [29] x x x x Lehnbom 2009 [35] x x Mamillapalli 2012 [38] x Maynard 2009 [45] x x x McIver 2009 [30] x x x Mulla 2015 [39] x x x Newsom 2018 [15] x x x x Noschese 2008m [46] x x Rushmer 2008 [31] x x x Schnipper 2009 [47] x x x Schnipper 2010 [48] x Taylor 2012 [32] x Thompson 2009 [49] x x x Trujillo 2008 [50] x x Tully 2018 [33] x x x Vaidya 2012 [56] x Valgardson 2015 [52] x x Wesorick 2010 [34] x x Wexler 2010 [52] x Wong 2016 [40] x x Yeung 2018 [53] x x ª 2019 Diabetes UK used the UK's National Inpatient Diabetes Audit (NaDIA) methodology and data collection tool, the follow-up period, interventions, implementation and the data reported were varied, hence it was difficult to pool data or make meaningful comparisons [18,19,32]. The introduction of simple, small focused interventions led to an improvement in the completeness and accuracy of insulin prescribing, particularly when they involved 'hard stops' (such as pre-printi...…”

“…All were uncontrolled before-after studies. Four studies were multisite [19,28,30,32], seven involved teaching or tertiary hospitals [26][27][28][29][30][31]33] and three studies involved district general hospitals [18,19,25].…”

“…There was a lack of consistency with respect to the methodology and outcome measures used in the studies. Seven studies measured the reduction in insulin prescribing errors [18,19,[25][26][27][28]32], three measured the accuracy, clarity and completeness of prescriptions [29,31,33], and one study measured opportunity for error as a result of unclear prescribing [30]. The types of intervention varied, as well as the implementation strategies, and measures of improvement between studies (see Table S4).…”

“…Both Taylor et al and Al-Yassin et al describe the impact of a single educational intervention involving junior doctors [19,32]. NaDIA-reported errors reduced from 15.4% to 7.8% (P < 0.05) and from 32% to 17% (P > 0.05), respectively.…”