David Cousins, Head of Patient Safety, Medicines and Medical Devices visited Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham on 25th November 2010. He met with Dr Philip Dyer, Consultant Diabetologist and Physician, Catherine Homes, Diabetic Specialist Nurse for Inpatients and Natasha Jacques, Principal Pharmacist in the newly built (£12 million) Diabetes and Endocrinology Centre in Heartlands Hospital.
The team have been undertaking a range of activities to improve the treatment of diabetes for inpatients:
- New design glucose blood monitoring chart with clear guidance on escalating action
- Introduction of ‘hypo boxes’ to better treat inpatient's with hypoglycaemia
- IV sliding scale packs with information and equipment to make these procedures easier and safer
- An inpatient ‘Think Glucose’ training course. The course is mandatory for all nurses and available to other professions That covers four main topics: managing glucose and other monitoring hyperglycaemia, hypoglycaemia and insulin safety including the use of insulin pen devices
The team are planning to introduce self administration of insulin by inpatients in the Trust. This has required a complete revision of the Trust Self Administration Policy for all medicines including new sections for insulin self administration. The policy has developed includes a tool to aid staff to assess the mental capacity of patients, to determine if it is safe for them to self monitor and self administer insulin.
The Trust is planning to produce two podcasts to be made available on the hospital intranet to be freely accessed by staff. The first will cover the general topic of self administration of medicines by patients and the second podcast will cover the more specific topic of insulin self administration.
Group members have been accessing and taking part in the NPSA Insulin Safety Forum and have found shared materials such as inpatient chart design and discussions concerning bedside storage of insulin helpful.
They plan to pilot the new insulin self administration procedures in one ward early in 2011.