Insulin and self medication in hospital

[Bill_St]

https://www.hssib.org.uk/patient-sa...tings/investigation-report/#executive-summary

Investigation report​

Insulin: supporting safe administration in inpatient settings​

 

[Bill_St]

I would hope everyone has a “Go Bag” prepared in case of a hospital admission.

Perhaps worth having two preprepared letters in your Go bag ready to give one to any admission team, giving the reference to the above and asking if the hospital conforms to the recommendations, particularly mentioning self medication and bedside availability of insulin. The questions in section 3.1 are useful and asking for your letter to be included in your notes would also help disseminate more training into the NHS.

Having something in writing with a copy to show on a ward can help to concentrate the mind. Fear of legal consequences can work both ways and worth having at least one being to Our advantage. “reluctance of staff to allow patients to self-administer because they fear being blamed if things go wrong.”

A 40% mis-medication is not to be taken lightly.
“In 2020 it was reported that ‘as many as four in ten people who have diabetes experience an insulin error while in hospital’ (Getting It Right First Time, 2020). In addition, in 2017 ‘an estimated 9,600 people required rescue treatment having fallen into a coma after a hypoglycaemic attack [episode] in hospital’, ‘2,200 suffered from diabetic ketoacidosis (DKA) whilst in hospital due to undertreatment with insulin’, and ‘people with diabetes stay an average 1-3 days longer in hospital than the rest of the population and have a 6% higher mortality rate”

 

[Bill_St]

I would hope everyone has a “Go Bag” prepared in case of a hospital admission.

Perhaps worth having two preprepared letters in your Go bag ready to give one to any admission team, giving the reference to the above and asking if the hospital conforms to the recommendations, particularly mentioning self medication and bedside availability of insulin. The questions in section 3.1 are useful and asking for your letter to be included in your notes would also help disseminate more training into the NHS.

Having something in writing with a copy to show on a ward can help to concentrate the mind. Fear of legal consequences can work both ways and worth having at least one being to Our advantage. “reluctance of staff to allow patients to self-administer because they fear being blamed if things go wrong.”

A 40% mis-medication is not to be taken lightly.
“In 2020 it was reported that ‘as many as four in ten people who have diabetes experience an insulin error while in hospital’ (Getting It Right First Time, 2020). In addition, in 2017 ‘an estimated 9,600 people required rescue treatment having fallen into a coma after a hypoglycaemic attack [episode] in hospital’, ‘2,200 suffered from diabetic ketoacidosis (DKA) whilst in hospital due to undertreatment with insulin’, and ‘people with diabetes stay an average 1-3 days longer in hospital than the rest of the population and have a 6% higher mortality rate”

Section 3.1
HSSIB has identified local-level learning for NHS trusts

• Do you have a policy that supports patients to safely self-manage their diabetes and support self-administration of insulin?
• Is your policy clear, available, and does it enable clinicians to support safe self-management and self-administration?
• Are the timing and content of meals considered in support of patients self-managing their diabetes?
• Is safe bedside storage of insulin provided to support self-administration? If not, how could this be supported?
• Are clinicians aware of national guidance and the regulatory stance regarding promotion of safe self-management of diabetes and insulin administration?

 

[Hopeful34]

Thanks @Bill_St

I dread the thought of having to be admitted to hospital because of issues like this.

 

[EllieM]

I had two pregnancies, one appendix and one broken leg in UK hospitals (all pre 1999).

I self managed my insulin throughout, though the first pregnancy had me briefly on an insulin line after a hypo during a failed induction.

I found the NHS very supportive of T1s self managing their diabetes.

My T1 mother, back in 2011, found the hospital excellent while she was in intensive care, but useless when she came out. A lack of specialists over the weekend left her with the choice of omitting basal or bolus as she recovered and needed less insulim, because she needed reduced insulin doses and no one was able to authorise them.