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NSW adult Subcutaneous Insulin Chart

What is it?

adult subcutaneous insulin prescribing chart
Download the chart

In March 2018, the NSW Agency for Clinical Innovation Endocrine Network endorsed changes to the NSW Adult Subcutaneous Insulin Prescribing Chart (the Chart) for use in NSW public hospitals. The original chart was released in 2010 and has been used by clinicians extensively across NSW.

As part of implementation, a consultation process was undertaken to collect feedback on the Chart and a number of opportunities to enhance the Chart were identified. The incorporated changes aim to further support standardisation of best practice insulin management across NSW.

The chart combines subcutaneous insulin prescription and administration with blood glucose, ketone monitoring and glycaemic management guidelines.

It is designed to minimise delays in management decisions and provide clinicians with clear guidelines for:

  • Insulin prescription
  • Insulin administration
  • Hypoglycaemic and hyperglycaemic management
  • Safe supplemental insulin use

Overview of the changes made to the Chart

Detailed changes made to the Chart

When should you use it?

The chart is intended for use in acute adult inpatient areas.

How do you use it?

As part of the review, ACI will be updating the below instruction guides and training resources.

Download these resources to help you:

NSW Health staff can watch this video via HealthShare.

Why do we need it?

  • Insulin errors are one of the most frequent forms of prescription errors in hospitals. The aim of standardising a subcutaneous insulin chart is to minimise these errors.
  • A standardised chart supports less experienced front line clinicians through the provision of guidelines and advice as close to the point of care as possible.
  • The inclusion of daily blood glucose and ketone monitoring results in parallel to the prescribing chart, allows staff to refer to recent readings more easily when prescribing and administering insulin doses. Doses supplied by telephone order, supplemental doses and one-off orders are all recordable in this single document.

Who developed it?

The chart was developed by the ACI Endocrine Network following an extensive review of charts across the state and nationally. It involved widespread input from rural and metropolitan clinicians.

The chart has been successfully piloted and refined following feedback from key staff across the state.

What about local policies?

The guidelines do not take the place of local policies, or override the treatment plans of individual patients. They may be of use in areas where local policies do not exist or are difficult to access by front line or after hours staff.

Who do I contact for more information?

Marina Davis Network Manager, Diabetes and Endocrine Network
Care Across the Lifestyle and Society | Agency for Clinical Innovation
Level 4, 67 Albert Avenue, Chatswood NSW 2067
PO Box 699, Chatswood NSW 2057
Phone (02) 9464 4621 | Fax (02) 9464 4728
marina.davis@health.nsw.gov.au

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