Insulin chart improves prescribing in hospitals

Use of an insulin chart has been shown to improve routine, supplemental and sliding scale insulin prescribing in hospitals.

The National Subcutaneous Insulin Chart for Acute Hospitals chart, which was piloted in six public and private hospitals over the last two years, was found to improve clarity around the dose of insulin prescribed and route and frequency of administration.

The proportion of doses that were missing in orders decreased, as did the use of unapproved abbreviations.

According to an evaluation report by the Australian Commission on Safety and Quality in Health Care (ACSQHC), the proportion of blood glucose levels in the recommended range increased significantly with use of the chart.

The number of days that blood glucose levels were recorded as requested and the accuracy of those records also increased significantly.

“The results support the hypotheses that using a standardised chart for prescribing and administering subcutaneous insulin and recording BGLs, when combined with planned implementation and education:

  • Reduces errors in subcutaneous insulin prescribing and administration
  • Does not result in inferior blood glucose control.”

The report found that while the proportion of orders where the prescribers name was clear increased, there were remaining concerns about orders not being signed or not initialled after the dose had been administered.

Improvement was still required in stat or phone orders for insulin, the report also said.

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