Self‐management of diabetes in hospital: a guideline from the Joint British Diabetes Societies (<scp>JBDS</scp>) for Inpatient Care group

Flanagan, Daniel; Dhatariya, Ketan; Kilvert, Anne; Scott, A.; Roberts, Alison; Allan, Belinda; Walton, Chris; Stanisstreet, Debbie; Rayman, Gerry; McKnight, J.; Thow, Jonathan; James, Jo; Richie, Kelly; Stuart, Louise; Hammersley, Maggie Sinclair; Savage, Matthew W.; Winocour, Peter; Malik, Ranjeeta; Hillson, Rowan

doi:10.1111/dme.13677

Cited by 21 publications

(15 citation statements)

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“…Notably, there was a lack of involvement of people with diabetes in both the design and target of interventions reported. The current drive for people with diabetes to self‐administer and/or self‐manage their insulin in hospital would be further supported by evidence linking this practice to reductions in prescribing errors . Although arguably resource‐intensive, routine use of the NaDIA in the UK can provide organizations with valuable data with which to monitor and benchmark their performance with respect to insulin prescribing errors and individual experience.…”

Section: Discussionmentioning

confidence: 99%

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

2019

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Aim To conduct a systematic review of literature to identify interventions that are effective in improving insulin prescribing for people with diabetes in the hospital setting. Methods Computerized bibliographic databases were searched for studies published in English that described the effectiveness of interventions to improve insulin prescribing within the hospital setting. Studies were eligible for inclusion if they reported data that compared insulin prescribing practice after an intervention or compared with a control group. Studies were not excluded on the basis of publication date, geographical location or risk of bias assessment. Results We identified 35 studies for inclusion in the review, including two cluster randomized controlled trials, two cohort studies, and 31 uncontrolled before–after studies. Studies reported a variety of interventions that aimed to increase insulin prescribing accuracy or completeness or decrease the use of discouraged subcutaneous sliding scale insulin regimens. Differences in definition of insulin prescribing error, terminology and common practice based on geographical location was evident, and quality issues with respect to study design and reporting somewhat limited the interpretation of conclusions. Conclusions Implementing strategies that are sensitive to local context and designed to increase adherence to insulin prescribing guidelines are associated with a reduction in prescribing errors. Future implementation should build on effective approaches including multifaceted interventions involving multiple stakeholders at various institutional levels. Future studies in insulin prescribing errors would benefit from the use of standardized approaches, terminology and outcome measures to enable greater comparison.

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Section: Discussionmentioning

confidence: 99%

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

2019

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“…У разі розвитку декомпенсації вуглеводного обміну моніторинг і лікування повинно бути особливо ретельним. Рекомендується використовувати сучасні Настанови з лікування гіперглікемічних кризів, наприклад, Рекомендації Американської асоціації клінічних ендокринологів та Американського коледжу ендокринологів (AACE/ACE), Настанови від Об'єднаного британського діабетичного товариства (JBDS) для групи стаціонарної допомоги та клінічні огляди [50][51][52].…”

Section: ïðàêòè×í² ðåêîìåíäàö²сunclassified

Почему Больные Сахарным Диабетом Имеют Худшие Результаты В Лечении COVID-19? (Аналитический Обзор И Практические Рекомендации)

Mankovsky¹,

Halushko²

2021

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Актуальность. Всемирная организация здравоохранения 11 марта 2020 объявила коронавирусную болезнь 2019 (COVID-19) пандемией. По состоянию на 15 мая 2020 в целом по всему миру было зарегистрировано 4539401 случай COVID-19 и зарегистрировано 303551 случаев смерти. В Украине коронавирусная инфекция COVID-19 впервые была диагностирована 3 марта 2020 в Черновцах, и уже 13 марта был зафиксирован первый летальный случай в результате коронавирусной инфекции. На 15 мая 2020 в Украине насчитывалось 17 330 случаев заболевания, из них 476 летальных (летальность - 2,7 %), выздоровели - 4473 пациентов (25,8 % от заболевших). В Украине, как и в целом в мире, во время распространения тяжелого острого респираторного синдрома коронавирус-2 постоянно публикуются данные о том, что определенные группы пациентов имеют больший риск заразиться COVID-19. Сюда входят пациенты с гипертонической болезнью, сердечными заболеваниями и сахарным диабетом (СД). Цель: проанализировать причины негативного влияния сахарного диабета на течение коронаровирусной болезни (COVID-19) и сформулировать рекомендации по профилактике и лечению для больных СД и их врачей. Материалы и методы. Для решения поставленной задачи был проведен поиск публикаций с помощью поисковых систем PubMed и Google Scholar. Поисковыми терминами были: COVID-19, сахарный диабет, гипергликемия, гипогликемия, осложнения. В результате проведенного поиска по указанным терминам в целом было выявлено 267 публикаций, которые были обнародованы с начала эпидемии с декабря 2019 года по 14 мая 2020. Результаты. Основными факторами риска развития и тяжелого течения COVID-19 считают преклонный возраст, артериальную гипертензию, сахарный диабет (СД), сердечно-сосудистые и цереброваскулярные заболевания. На основе анализа профильных публикаций в поисковых системах PubMed и Google Scholar установлены причины негативного влияния СД на течение и результаты лечения COVID-19, сформулированы рекомендации по профилактике и лечению больных в случае сочетания коронаровирусной болезни с сопутствующим СД. Выводы. Считаем целесообразным сформулировать рекомендации по менеджменту больных СД в условиях пандемии COVID- 19, созданных на основе проведенного анализа публикаций и современных международных рекомендаций.

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“…The team decided if self-administration status was included as a ‘free-text’ prescription item as part of the medicines reconciliation process on admission, staff would be clearly informed from the point of admission. As others have shown, this should prompt consideration of self-management during admission and promoting insulin safety,30 and allow early referral to the diabetes specialist nurse if district nurse input was required for insulin administration at home. As a result of this small adjustment to the medicines reconciliation process on admission, compliance with the overall guidance increased by a further 20%.…”

Section: Strategymentioning

confidence: 99%

Improving the quality of insulin prescribing for people with diabetes being discharged from hospital

Bain¹,

Silcock

Kavanagh

et al. 2019

BMJ Open Qual

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Medication errors involving insulin in hospital are common, and may be particularly problematic at the point of transfer of care. Our aim was to improve the safety of insulin prescribing on discharge from hospital using a continuous improvement methodology involving cycles of iterative change. A multidisciplinary project team formulated locally tailored insulin discharge prescribing guidance. After baseline data collection, three ‘plan-do-study-act’ cycles were undertaken over a 3-week period (September/October 2018) to introduce the guidelines and improve the quality of discharge prescriptions from one diabetes ward at the hospital. Discharge prescriptions involving insulin from the ward during Monday to Friday of each week were examined, and their adherence to the guidance measured. After the introduction of the guidelines in the form of a poster, and later a checklist, the adherence to guidelines rose from an average of 50% to 99%. Qualitative data suggested that although it took pharmacists slightly longer to clinically verify discharge prescriptions, the interventions resulted in a clear and helpful reminder to help improve discharge quality for the benefit of patient safety. This project highlights that small iterative changes made by a multidisciplinary project team can result in improvement of insulin discharge prescription quality. The sustainability and scale of the intervention may be improved by its integration into the electronic prescribing system so that all users may access and refer to the guidance when prescribing insulin for patients at the point of discharge.

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Self‐management of diabetes in hospital: a guideline from the Joint British Diabetes Societies (JBDS) for Inpatient Care group

Cited by 21 publications

References 1 publication

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

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

Почему Больные Сахарным Диабетом Имеют Худшие Результаты В Лечении COVID-19? (Аналитический Обзор И Практические Рекомендации)

Improving the quality of insulin prescribing for people with diabetes being discharged from hospital

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