Authors (including presenting author) :
Chan OYS(2), Wong WKV(2), Leung SYS(2), Lee SL(3), Hui KC(2), Tang MKC(3), Yeung KNK(2), Kong SK(1), Yu LME(4)
Affiliation :
(1)Specialist Out-patient Clinic, (2)Department of Medicine and Geriatrics, (3)Central Nursing Division, (4)Clinical Research Centre, Princess Margaret Hospital
Introduction :
Insulin is the standard treatment for management of hyperglycemia in in-patient setting to improve patients’ outcomes. With increasing varieties of insulin preparations and injection devices, nurses may not familiar with the time-action profile and way of administration of new insulins. Several studies reported that insulin-related medication errors happened across steps. Strategies for empowerment of nurses on safe and appropriate use of insulin are utmost important.
Objectives :
To identify and evaluate the effectiveness of the best evidenced-based practice available and the key components of education for health care professions on safe hospital use of insulin.
Methodology :
The literature was searched from CINAHL(EBSCO), Nursing Reference Center Plus and Google Scholar from 2008 to 2019 to identify relevant studies for safe practice on insulin administration. Total 12 relevant studies were identified. Johns Hopkins Nursing Evidence-Based Practice Critical Appraisal Tools were used for evidence appraisal and evidence synthesis. Based on the recommendations of evidence synthesis, we developed a structural education program which included the Train-the-trainer workshop on safe use of insulin with pre-post 12-item knowledge assessment; designed a ‘Quick Guide’ on insulin information; and conducted post-workshop compliance assessment in 19 clinical wards in Department of Medicine and Geriatrics. Paired t-test and McNemar’s test were used to compare the pre- and post- test score. The injection checklists were used to evaluate the compliance on insulin administration by insulin syringe and insulin pen.
Result & Outcome :
Total 27 qualified nurses attended the Train-the-trainer workshop. The post-test score was significant greater than the pre-test score (11.15±0.86 vs 8.15±1.96; p < 0.001). Seven items demonstrated significant improvement (ps < 0.02), while the others were not significantly different.
The overall compliance with administration by using insulin syringe and insulin pen was 95.11% and 96.94%, respectively. The satisfaction survey on training materials showed positive feedback.
The results demonstrated that in-service training empowered nurses’ knowledge on insulin; the ‘Quick Guide’ on insulin enhanced an easily accessibility to useful information; and ongoing assessment ensured the compliance of safe practice. Nurses can contribute to the safe use of insulin through minimizing the likelihood of medication error in different steps.
