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PS-014 An observational review and audit of the treatment of hypoglycaemic events in a university teaching hospital
  1. S Molony1,
  2. L McCabe2,
  3. S Mcquaid3,
  4. M Kieran4,
  5. C Meegan4
  1. 1Mater Misericordiae University Hospital, Dublin, Ireland
  2. 2Mater Misericordiae University Hospital, Pharmacy Department, Dublin, Ireland
  3. 3Mater Misericordiae University Hospital, Department of Endocrinology, Dublin, Ireland
  4. 4Mater Misericordiae University Hospital, Pharmacy, Dublin, Ireland

Abstract

Background Hypoglycaemic events may have grave implications for patients with diabetes mellitus, and is defined as a blood glucose (BG) level of <4 mmol/L. Anecdotally, it has been reported that events were not treated as per evidence base in the hospital setting.

Purpose This study aimed to conduct a baseline audit and review of the treatment of hypoglycaemic events among diabetic inpatients in a university teaching hospital. Quality improvement methods and a reaudit were also planned.

Material and methods Baseline adherence to the hypoglycaemic hospital protocol was determined in an audit undertaken on 148 retrospective hypoglycaemic events, by clinical pharmacists, over a 5 week period. Data were analysed and quality improvement initiatives were implemented by the pharmacy department in conjunction with the endocrinology department. The efforts employed included the development and launch of a new hypoglycaemia protocol, the provision of educational material in the form of a quiz, a medication safety alert, and informal and formal education. A reaudit was undertaken over a 5 week period on 151 hypoglycaemic events.

Results 72.9% (n=108) of hypoglycaemic events in the baseline audit were treated with short acting carbohydrate, which increased to 81.4% (n=123) in the reaudit (p>0.05). Lucozade was the predominant short acting carbohydrate used to treat hypoglycaemic events throughout the study. Of those events treated with Lucozade, 33.3% were treated with the recommended amount in the baseline audit, increasing to 70.6% in the reaudit (p<0.05). There was limited compliance with retesting of BG within 15 min in the baseline audit (repeated within 15 min in 9.5%; within 30 min in 24.8%). The time to retest was significantly reduced (p<0.05) in the reaudit (BG repeated within 15 min in 30.5%; within 30 min in 63.5% of events).

Conclusion We established the baseline incidence of hypoglycaemic events. With the provision of a clear, colour coded evidence based hypoglycaemia protocol and a multifaceted educational drive, it was possible to improve the management of these hypoglycaemic events to improve patient safety.

References and/or acknowledgements 1. Joint British Society for Diabetes. The hospital management of hypoglycaemia in adults with diabetes mellitus. cited 14 Sep 2014. Available at https://www.diabetes.org.uk/

No conflict of interest

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