Nurses and doctors at University Hospital Southampton NHS Foundation Trust are pioneering a set of standards to ensure all patients with diabetes get the specialist care they need in hospital.
The initiative, led by the trust’s lead consultant in diabetes Dr Mayank Patel, provides guidance for all nursing and medical staff on meeting diabetic patients’ needs.
“Clear minimum standards of care… will give clinicians and their patients the best foundation”
While some patients may have been admitted as a direct result of diabetes, others may be being treated for unrelated health problems and cared for staff without specialist knowledge of the condition.
Nurses and others are reminded to “think glucose” by a logo used on patient status boards to identify anyone with diabetes.
Under the standards, they must ensure a foot disease assessment is carried out within 24 hours of admission and insulin or oral diabetes medication is given at or before mealtimes.
Clinicians are also expected to know what action to take to manage hypoglycaemia and hyperglycaemia, including referring patients to the inpatient diabetes team.
As part of the scheme, the trust’s diabetes team, which includes five specialist nurses, is responsible for reviewing patients, devising discharge plans when needed and providing educational material to staff, patients and families.
The team also investigates incidents and shares lessons with staff, and reviews re-admissions due to uncontrolled diabetes with community practitioners.
As well as raising awareness among clinicians, the standards encourage patients to inform staff if they have diabetes and need any support.
Clinicians pioneer standards for inpatient diabetes
“We know almost a quarter of all adult patients in UK hospitals have diabetes at any one time and patients can spend anywhere between an additional three to five days in hospital if their condition is neglected,” said Dr Patel.
“The introduction of simple and clear minimum standards of care for all adult patients with diabetes will give clinicians and their patients the best foundation to provide the right care for the duration of a hospital admission,” he said.
He also highlighted the role technology can play in assisting nurses and doctors to provide the best care.
Together with critical care consultant Dr Sanjay Gupta, he has developed an app – DiAppBetes – that can be accessed via smartphone and tablet devices to help non-specialist clinicians when treating patients with diabetes.