Inpatient Management of Diabetes Mellitus
Building Capability in Inpatient Diabetes Management
The Diabetes and Endocrine network has developed a capability program to support junior medical officers and nursing staff care for people with diabetes in hospital. In particular, those people requiring insulin. In doing so, the program aims to improve outcomes and experience of hospitalisation, as well as reduce clinical variation and complications secondary to poor glycaemic control (hyper and hypoglycaemia).
Clinicians will have access to:
- a clinical decision support app ‘Thinksulin’ to support point of care decision making
- an eLearning program on My Health Leading with three learning modules will be available in the first phase
Why has the program been developed?
Glycaemic instability is commonly observed amongst inpatients with diabetes. Patients with diabetes are frequently admitted to hospital for treatment of conditions other than the diabetes. Therefore, insulin orders, administration and glycaemia management is the responsibility of general ward clinicians (including nursing staff and junior medical officers), not just endocrinologists or in-hospital diabetes services.
In addition, insulin is a high risk medication1. Error rates with insulin are not necessarily higher than with other medicines, but when problems do occur the consequences can be severe. The ACI Endocrine Network’s NSW Adult Subcutaneous Insulin Prescribing Chart aims to enable standardisation of insulin management across NSW. However, a 2015 evaluation of the chart in four local health districts showed a 'lack of awareness and understanding about components of current best practice in the management of people with diabetes outside of specialist endocrinology units', suggesting that best practice insulin management is not occurring in NSW hospitals2.
Components
Thinksulin - A Clinical Decision Support App
What is it?
A point of care app that will provide information and decision support on blood glucose level targets, hypoglycaemia management, blood glucose monitoring, basal-bolus calculations, and charting and reviewing doses.
Who is it for?
Targeted towards Junior Medical Officers and nursing staff (without specialist skills/knowledge in diabetes management); although it can be used by any clinician responsible for the prescription and administration of insulin.
How can you access it?
The App 'Thinksulin' is available for free on
Apple Store (https://apps.apple.com/au/app/thinksulin/id1359457527) and
Google Play (https://play.google.com/store/apps/details?id=au.com.medapps.diabetes) .
eLearning Modules
What is it?
A series of videos and online learning modules found on My Health Learning. Topics include: insulin basics; managing hypoglycaemia, and safely prescribing and administering insulin. Each module takes 15-20 minutes to complete.
Who is it for?
Targeted toward Junior Medical Officers and nursing staff; can be used by any clinician responsible for the prescription and administration of insulin.
How can you access it?
NSW Health Staff can access the modules via My Health Learning:
- Learning Path - Inpatient Management of Diabetes Mellitus for Junior Medical Officers (Course code194419823)
- Learning Path - Inpatient Management of Diabetes Mellitus (Course code194607998)
To access Learning Path - Inpatient Management of Diabetes Mellitus, please follow the steps below:
- Select Learning path – this will Log you into My Health Learning and take you to Learning Path - Inpatient Management of Diabetes Mellitus .
- Select Basics of blood glucose levels and insulin (course code 186680842). Once complete return to Learning Path by selecting your back arrow on your browser.
- Select Preventing and managing hypoglycaemia (course code 186681277). Once complete return to Learning Path by selecting your back arrow on your browser.
- Select Safely prescribing and administering insulin (course code 194502204). Once complete return to Learning Path by selecting your back arrow on your browser.
- Select Non-insulin agents in a hospital setting (course code 275744506). Once complete return to Learning Path by selecting your back arrow on your browser.
- Select Managing blood glucose levels in the perioperative period (course code 275744325). Once complete return to Learning Path by selecting your back arrow on your browser.
- Select Preventing and managing glucocorticoid induced hyperglycemia (course code 275744015). Once complete return to Learning Path by selecting your back arrow on your browser.
Non-NSW Health can access the modules staff via the ACI website:
References
- Clinical Excellence Commission, Medication Safety and Quality: High Risk Medications. Available at: http://cec.health.nsw.gov.au/patient-safety-programs/medication-safety/high-risk-medicines. Accessed (16 January 2016).
- O’Connell Advisory (2015), Agency for Clinical Innovation Evaluation of the Subcutaneous Insulin Prescribing Chart in Four Local Health Districts, Final Report.
Diabetes and Endocrine Network
Contact
Marina Sarkis
Diabetes and Endocrine Network Manager
Recently Added
Centre for International Blood and Marrow Transplant Research: Publicly available datasets
Added: 23 March 2023
Type: Webpage
American Society for Transplantation and Cellular Therapy: Practice guidelines
Added: 23 March 2023
Type: Webpage