Medication errors common in inpatient diabetes care

OVER a third of hospital inpatients with diabetes experienced a medication error during a five-day audit conducted by the Health and Social Care Information Centre.

The audit also found that 59 inpatients (0.5 per cent) in England were reported to have developed diabetic ketoacidosis (DKA) after their admission to hospital – a complication which is “entirely preventable”.

The findings are published in the National Diabetes Inpatient Audit (NaDIA) which examined data collected by hospital teams in England and Wales about inpatients with diabetes over a five-day period in September 2012. It involved 13,410 patients with diabetes in 136 trusts in England and six local health boards in Wales. Over this period, 15.3 per cent of inpatient beds were occupied by people with diabetes, the majority of whom were admitted for medical reasons other than diabetes.

Among other findings 20.4 per cent of patients in England and 20.7 per cent in Wales experienced a mild hypoglycaemic episode whilst in hospital and 10.5 per cent of patients in England and Wales experienced a severe episode. Just 59 per cent of the inpatients saw a specialist diabetes team and 32.2 per cent of sites in England and 47.1 per cent in Wales had no diabetes specialist nurse provision for inpatient care.

On the positive side the majority of inpatients in England (85.7 per cent) and Wales (84.8 per cent) stated they were very satisfied or satisfied with their diabetes care while in hospital with around one in five reporting active involvement in the design of their care plan.

Audit lead clinician Dr Gerry Rayman said: "The purpose of this annual audit is to drive improvements in care for inpatients with diabetes, so I am pleased to see there has been some progress on problems highlighted in previous years' reports, for instance around insulin prescribing. But staffing levels remain low, and it is of grave concern that some patients are developing DKA, which is a potentially life-threatening complication in hospital. This is due to their needs being neglected and should simply never happen."