Insulin errors too common

24 November 2010

A REPORT on inpatients with diabetes in England and Wales has shown insulin prescribing errors in nearly one in five cases.

The summary report from the National Patient Safety Agency was published recently in the BMJ and highlights knowledge gaps among non-specialist staff in hospitals and in community settings. It involved a national audit of over 14,000 inpatients with diabetes in England and Wales and reported prescribing errors in 19.5 per cent of cases.

The authors point out that errors relating to insulin arise because of the drug's narrow therapeutic range and the need for precise dose adjustments with careful administration and monitoring. Over 20 different types of insulin are in use, in various strengths and forms, and with a range of delivery devices, including insulin syringes, prefilled or reusable insulin pens and infusion pumps.

"Staff may not be familiar with the safe use of different devices or the complex range of products now available."

To reduce errors the study cites an NPSA report urging changes, such as ensuring access to appropriate equipment (insulin syringes) and training programmes for staff. It also gives specific advice on prescribing and adminstering insulin such as never to use abbreviations (u or iu) for the term units or international units as these can lead to "10-fold" errors, for example "5u" being interpreted as 50 units.

See BMJ 2010; 341:c5269