Endocrine Abstracts

Insulin is a life-saving drug but can be life threatening if not prescribed properly. A prospective, consecutive audit of insulin prescription was carried out on all medical and surgical patients admitted to South Tipperary General Hospital with types 1 and 2 diabetes mellitus in November 2013. The practice was compared with hospital guidelines which are consistent with other hospitals nationally. Three prescribing practices were audited: i) the prescription of insulin on insulin prescription sheets (as per hospital policy) or drug kardex; ii) the adjustment of insulin doses on insulin prescription sheets as per blood sugar levels; and iii) the prescription of insulin on discharge prescription. Twenty consecutive patients were audited. 65% had insulin charted on insulin prescription sheet, 15% on drug kardex alone and 20% on both. 80% of patients had their insulin dosage corrected as per blood glucose readings on insulin prescription sheet, 10% on both and 10% did not need insulin dose correction. 60% of patients had insulin prescribed on discharge prescription whereas 40% did not and the reasons for this were analysed. As a result of these findings a new insulin prescription sheet was recommended and introduced with regular and supplementary insulin sections. Educational sessions on insulin prescription were also organised. A re-audit of a further twenty patients was performed in June 2014 to look at the above three prescribing practices. It showed 100% compliance in terms of insulin prescription. 90% compliance was observed in terms of insulin dose adjustment as per blood glucose readings. The remaining 10% did not require correction of insulin dose. 65% of patients had insulin prescribed on discharge, 10% did not require insulin on discharge, 10% died and 15% were still inpatients at time of re-audit. The re-audit showed an improvement in the practice of insulin prescribing and therefore improved patient safety.