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dc.contributor.authorBain, A.
dc.contributor.authorSilcock, Jonathan
dc.contributor.authorKavanagh, S.
dc.contributor.authorQuinn, Gemma L.
dc.contributor.authorFonseca, I.
dc.date.accessioned2019-11-07T12:26:38Z
dc.date.accessioned2019-11-25T11:24:33Z
dc.date.available2019-11-07T12:26:38Z
dc.date.available2019-11-25T11:24:33Z
dc.date.issued2019-08
dc.identifier.citationBain A, Silcock J, Kavanagh S et al (2019) Improving the quality of insulin prescribing for people with diabetes being discharged from hospital. BMJ Open Quality. 8(3): e000655.
dc.identifier.urihttp://hdl.handle.net/10454/17500
dc.descriptionYes
dc.description.abstractMedication errors involving insulin in hospital are common, and may be particularly problematic at the point of transfer of care. Our aim was to improve the safety of insulin prescribing on discharge from hospital using a continuous improvement methodology involving cycles of iterative change. A multidisciplinary project team formulated locally tailored insulin discharge prescribing guidance. After baseline data collection, three ‘plan-do-study-act’ cycles were undertaken over a 3-week period (September/ October 2018) to introduce the guidelines and improve the quality of discharge prescriptions from one diabetes ward at the hospital. Discharge prescriptions involving insulin from the ward during Monday to Friday of each week were examined, and their adherence to the guidance measured. After the introduction of the guidelines in the form of a poster, and later a checklist, the adherence to guidelines rose from an average of 50% to 99%. Qualitative data suggested that although it took pharmacists slightly longer to clinically verify discharge prescriptions, the interventions resulted in a clear and helpful reminder to help improve discharge quality for the benefit of patient safety. This project highlights that small iterative changes made by a multidisciplinary project team can result in improvement of insulin discharge prescription quality. The sustainability and scale of the intervention may be improved by its integration into the electronic prescribing system so that all users may access and refer to the guidance when prescribing insulin for patients at the point of discharge.
dc.language.isoen
dc.rights© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
dc.subjectInsulin prescribing
dc.subjectDiabetes
dc.subjectInsulin discharge prescribing guidance
dc.subjectDischarge prescriptions
dc.titleImproving the quality of insulin prescribing for people with diabetes being discharged from hospital
dc.status.refereedYes
dc.date.Accepted2019-08-06
dc.date.application2019-08-24
dc.typeArticle
dc.type.versionPublished version
dc.identifier.doihttps://doi.org/10.1136/bmjoq-2019-000655
dc.rights.licenseCC-BY-NC
dc.date.updated2019-11-07T12:26:46Z
refterms.dateFOA2019-11-25T11:24:54Z
dc.openaccess.statusopenAccess


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