ABSTRACT
Background: In-hospital hypoglycaemia were identified by National Diabetes Inpatient Audit (NADIA) as a persistent challenge across UK hospitals over the last decade. NNUHFT is without exception: 1-in- 10 of our hospitalised people with diabetes experienced hypoglycaemia events. Insulin prescriptions have rocketed during the covid-19 pandemic, especially with Dexamethasone induced hyperglycaemia. We aimed to raise all clinical staff's hypoglycaemia knowledge to improve patient safety during this unprecedent period. Method: Quality improvement methodology were used. Hypoglycaemia event data, and occurrence location pattern, was collected at 'Planning' phase. At 'Doing' Phase, clinical staffs were divided into two learner groups, according to 'Planning' phase data: 1) nurses and healthcare assistants;2) junior doctors. Educational materials were tailored-made to each group's clinical role. Bitesize sessions were delivered via ward visits and online sessions during a three-month period (Mar-May 2021). Hypoglycaemia event data over this training period were compared to equivalent period before training began (t-test). Surveys were conducted to assess hypoglycaemia management knowledge, before and after training. Results: Majority of hypoglycaemia (81%) occurred outside endocrine care. 18 training sessions were delivered to group 1 (80 learners), 8 sessions to group 2 (48 learners). In-hospital hypoglycaemia events (blood glucose <4.0 mmol/L) were significantly reduced by 14%: 838±32 vs. 719 ±23 (mean ± s.e.m) episodes per month, p = 0.03. Hypoglycaemia knowledge survey's average score significantly improved: group 1, from 37% to 80%;group 2, from 71% to 85%. Differential preference of training delivery method was observed: face-to- face for group 1, online for group 2. Conclusion: We successfully demonstrated a tailor-made, flexible in-hospital diabetes safety quality improvement initiative was feasible, even in the midst of pandemic.