People with diabetes account for 15 per cent of inpatients in England, according to an audit published today by NHS Diabetes. Analysing clinical data of over 12,000 inpatients with diabetes from 206 hospitals as well as nearly 5,000 patient questionnaires, the ‘National Diabetes Inpatient Audit (NaDIA) 2010 (England)’ also found that at the time of the audit people with diabetes had been in hospital for an average of eight days, approximately three days longer than all inpatients. Nearly all (86.7 per cent) were admitted as an emergency.
The audit also discovered that over one third (37.1 per cent) of inpatients with diabetes experienced at least one medication error, a quarter (26.0 per cent) of their charts had prescription errors and a fifth (20.0 per cent) had one or more medication management errors. Insulin overdoses can result in potentially fatal hypoglycaemic episodes (‘hypos’)1 and insufficient insulin can lead to diabetic ketoacidosis (DKA)2 which, if left untreated, can also prove fatal. The audit found that patients with medication errors had twice the rate of severe hypoglycaemia (18.1 vs 7.9 per cent). Of further concern, whilst in hospital 44 people (0.4 per cent) developed DKA and 266 (2.4 per cent) had hypoglycaemia severe enough to require injectable treatment.
Other findings from the results, which were analysed by data experts at Diabetes Health Intelligence, a strategic programme of Yorkshire and Humber Public Health Observatory, found:
- 31.0 per cent of sites had no inpatient diabetes specialist nurses.
- 69.4 per cent of inpatients with diabetes had not been seen by a member of the diabetes team.
- 54.4 per cent of those with a diabetes management problem had seen the diabetes team.
- Only 27.5 per cent of patients had their feet examined at any time during admission.
- 2.2 per cent developed a new foot complication during their hospital stay but 49.6 per cent of these had no input from a Multi-Disciplinary Footcare Team (MDFT)
- 27.2 per cent reported that choice, and 22.7 per cent timing, of meals was only sometimes or rarely suitable for managing their diabetes effectively. People who reported poor choice and timing of food were more likely to have a severe hypoglycaemic episode whilst in hospital.
http://www.diabetes.nhs.uk/news.php?id=387
Issues in this article may affect your organisation or your employees or colleagues. Healthcare e-Academy courses may provide some background information or training on related subjects. A course which is specific to the above issues is our Safe Use of Insulin course, created by the Healthcare e-Academy in collaboration with NHS Diabetes. This course is FREE. If you are interested in registering for this course, then please visit http://www.healthcareea.co.uk/nhsdiabetes or contact info@healthcareea.co.uk
