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Diabetes inpatient and hospital care

Around 15 per cent of all hospital beds in the UK are occupied by people with diabetes. People with diabetes who are admitted to hospital must be cared for by appropriately trained staff, provided with access to a specialist diabetes team and given the choice of self monitoring and managing their own insulin.

Use the following resources and tools to improve inpatient and hospital care for people with diabetes:


Upcoming Training Courses

This module covers diabetic emergencies, presentation and management and broader aspects of managing in-patients with diabetes. Learners will be able to critically appraise current research and national directives which support the clinical management for diabetes inpatient care.

It is particularly suitable for healthcare professionals with an interest in diabetes inpatient care such as specialist registrars, diabetes specialist nurses, consultant diabetologist, podiatrists, pharmacists and ward nurses.

Module Dates: 20, 21, 22, 23 March 2018 assessments 21 May 2018


Publications

This bright idea describes how the Royal Free Hospital created a foot risk assessment tool based on the Ipswich Touch Test. Since introduction of the tool, the percentage of people with diabetes who received a foot risk assessment on admission increased from 6.5 per cent in 2013 to 40 per cent in 2015. Download the tool featured in the bright idea (PDF, 42KB).


Essential reading for improving your inpatient diabetes service


Shared practice examples

Engaging and training frontline staff

Ruth Miller, Diabetes UK Clinical Champion, developed a training programme when she observed that many diabetes inpatients have their care delivered by non-specialists. Since introduction of the training at Poole Hospital, medication errors have reduced from 46.9 percent in 2015 to 26.7 percent in 2016.

DiAppbetes provides concise guidance notes that cover a wide variety of key themes. The app can be downloaded and edited for different hospitals.

Diabetes back to the floor involves periodic diabetes care quality review at ward level followed by formative feedback to staff.

INDIE forms the basis for a blended inpatient diabetes educational tool which includes a web based educational resource (including knowledge survey, links to educational material and guidance.)

Inpatient Diabetes Education through Animation – (IDEA) involves a series of short cartoons based on real life scenarios, developed by trainee doctor, Sowmya Gururaj.

E-learning training modules

Managing DKA and Hypoglycaemia

Dr Parijat De, Consultant in diabetes and endocrinology and Diabetes UK Clinical Champion, piloted a condensed version of the original DKA management and monitoring chart developed by the JBDS-IP committee.

This factsheet has been designed by Southampton Hospital for patients experiencing DKA.

The DICE (diabetes inpatient care and education) team optimised use of their blood glucose monitors to identify trends in hypoglycaemia and introduced new initiatives to reduce levels.

This article shows how 'hypo boxes' can improve the assessment and management of episodes of hypoglycaemia in inpatients with diabetes.

Pocket medic and Diabetes UK Clinical Champion, Dr Sam Rice, have created a video to help health care professionals recognise and treat hypoglycaemia.

Insulin safety, electronic prescribing and improving self administration

This guide supports Trusts through the process of setting up safe and robust arrangements for routine self-administration of insulin. Part 1 helps Trusts to make a case for change and Part 2 provides step by step guidance on how to implement and measure self-administration of insulin throughout a hospital.

A multi-disciplinary group was created to develop a programme of work to improve the safe use of insulin.

The Derby Insulin Safety Group introduced change at multiple levels to improve the standards of all aspects of diabetes care in the hospital.

To improve patient care and safety the diabetes team trialled a new way of working in the Clinical Decision Unit.

In Sheffield, the pharmacy team led a series of projects to increase the number of people able to self-manage in hospital. This resulted in a change of policy permitting patients to keep insulin in their possession and to continue self care

This guide developed by the Health Innovation Network (HIN) sets out recommendations using validated tools to help improve insulin safety on discharge

Useful resources

Seven day working

This case study describes how the East and North Herts Diabetes Outreach Team (DOT) introduced seven day a week access to diabetes specialists for inpatients.


Resources for creating a case for change

Making change happen in hospitals can be difficult. These resources will help you create a case for change and engage your team in improvement.

Engage your workforce in Quality Improvement

The Improve Well app

This app has been designed to enable students and staff to feedback and suggest improvements to services, breaking down typical levels of hierarchy and allowing the whole workforce to engage in improvement.

Using data to drive change

Use of National Diabetes Inpatient Audit (NaDIA) data (PDF)

This NaDIA benefits case study describes the service and pathway changes in inpatient diabetes care services that hospitals and trusts have initiated as a result of NaDIA findings.

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