Endocrine Abstracts

Introduction: An important part of diabetes management is maintaining high standards of in-patient care. A previous audit in the south of England demonstrated difficulties consistently achieving standards identified as good practice. This audit aimed to identify current standards of in-patient care provided to children with type 1 diabetes across the Yorkshire and Humber region.

Methods: The audit was conducted against in-patient care standards identified by the Children and Young Person’s Diabetes Implementation Support Group (CYPDISG). Questionnaires were sent to clinical leads of all paediatric diabetes units in the region, which serves 2599 children and young people with diabetes.

Results: Sixty-three per cent of units, consisting of two tertiary and eight secondary care units, responded. Nine out of ten units had paediatric nurses in areas where children were cared for, but only tertiary centres always had trained paediatric nurses in the emergency department (ED). Paediatric wards and EDs in all units had protocols for management of new diagnosis of diabetes, diabetic ketoacidosis (DKA), hypoglycaemia, and surgery. All units had regular education sessions for ward staff, although only 50% had education sessions for ED staff. A 24 h on-call service was only provided by 40% of the units. The diabetes team was usually contacted within 2 h of an admission in tertiary centres and within 24 h in secondary care units. All units actively involved paediatric diabetes specialist nurses in in-patient management. Only two units had insulin prescription charts and only tertiary centres routinely audited insulin prescription and administration errors.

Conclusions: This audit demonstrates on-going difficulties achieving current standards of in-patient care for children and young people with diabetes. There needs to be standardisation across the region and feasibility of implementation needs to be explored.