Endocrine Abstracts

Parents of children with adrenal insufficiency are taught to administer a hydrocortisone intramuscular (IM) injection in an adrenal crisis. This involves assembling a needle and syringe and drawing up a dose from a vial. It is known that parents report high confidence levels in administration of the injection but at the time of acute illness actual administration is poor. This study set out to see if introducing a planned refresher session for families would impact confidence levels, and increase the likelihood of parents administering the IM injection when needed, whilst also ensuring safety nets are up to date. The study consisted of three parts: A pre and post-questionnaire to assess parents understanding and confidence. Families were chosen at random filled out a pre-refresher questionnaire. Then asked to fill in a post-questionnaire 3-6 months afterwards. Emergency admissions were audited retrospectively to see if families who had attended a refresher were more likely to give the injection when indicated than families who had not attended a refresher. Audit of whether all safety nets were in place. 30 families completed the pre-questionnaire, and 16 of these families then completed the post-questionnaire. The refresher session demonstrated improved knowledge, and confidence levels remained increased 3-6 months afterwards. 100% of parents felt more likely to be able to give the injection. All parents wanted the opportunity to re-attend session. This was further demonstrated in hospital admissions, families were two times more likely give the IM injection appropriately after attending a refresher compared to those that did not. Safety nets were not up to date prior to the session, 44% of families did not have any hydrocortisone for injection and 50% needed needles and syringes. This study shows that refresher sessions improved the confidence and knowledge levels of families around when to give the IM injection, and increased the likelihood of them administering it when needed. It ensured the correct safety netting was in place. Going forward, patients will be offered 2 yearly refresher sessions. To improve the efficiency of the refresher sessions a Microsoft app has been developed to minimise administrative work associated with each session.