NaDIA shows reduction in hospital medication errors and severe hypoglycaemia

By Editor
30th November 2020
Audits, Inpatient Type 1 diabetes Type 2 diabetes

Inpatient diabetes teams have reduced medication errors, severe hypoglycaemia episodes and hospital-acquired diabetic foot lesions, according to the National Diabetes Inpatient Audit (NaDIA) 2019. 

The annual report has shown that 75 per cent of those surveyed in 2019 were seen by the diabetes team where appropriate compared to only 54 per cent in 2010.

Inpatient diabetes teams have also reduced the proportion of inpatient drug charts found to contain medication errors by 15 percentage points since 2010 (from 45 to 30 per cent).

Severe hypoglycaemic episodes have also been reduced from 12 per cent to seven per cent in 2019 and the need for injectable rescue treatment for severe hypoglycaemia has been lowered from 2.4 per cent of inpatients during the last seven days of their hospital stay in 2010 to 1.4 per cent in 2019.

DKA and HHS are preventable and should not occur during a hospital admission Gerry Rayman, Clinical Lead for the National Diabetes Inpatient Audit

In addition, the number of people developing foot ulcers at any point during their hospital stay has gone down from 2.2 per cent of inpatients audited in 2010 to 1.1 per cent in 2019.

However, the occurrence of some important and life-threatening harms remain unchanged, including severe hypoglycaemic episodes in inpatients with type 1 diabetes,  hospital-acquired diabetic ketoacidosis (DKA)  and hospital-acquired hyperosmolar hyperglycaemic state (HHS).

Gerry Rayman, Clinical Lead for the National Diabetes Inpatient Audit, Diabetes UK lead for Inpatient Diabetes, GIRFT Co-lead, said: “DKA and HHS are preventable and should not occur during a hospital admission. In this respect it is of interest that all medication errors have reduced with the exception of one, the failure to increase insulin when the capillary blood glucose1 (CBG) is persistently above 11 mmol/L, suggesting that focusing on staff training in hyperglycaemic management and insulin dose adjustment may reduce these life threatening harms.

“It is important to recognise the hard work of diabetes teams and the almost one hundred per cent participation in this annual audit, without which we may not have realised these improvements nor identified where we need to redouble our efforts. No other healthcare service in the world has such comprehensive national data to evidence and direct change in inpatient care; a unique achievement for which we should be proud.

NaDIA measures the quality of diabetes care provided to people with diabetes while they are admitted to hospital whatever the cause, and aims to support quality improvement. Data is collected and submitted by hospital staff in England.

To read the report in full, click here.

Photo by Irwan iwe on Unsplash

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