Authors (including presenting author) :
Chan WY(1),Ko WY(1), Choy CK(1), Leung SMJ(2), Hung SY(1), Chan YL(1), Chow WPA(1), Cheung PH(1), Cheung YHK(1), Wong MSM(1), Wong MYM(1)
Affiliation :
(1)Department of Family Medicine and Primary Healthcare, Hong Kong East Cluster (2)Patient Support Call Centre
Introduction :
Insulin therapy is commonly prescribed for diabetes in primary care clinics. Proper insulin injection practice is essential for a better glycemic control. As time goes by, knowledge and skill fade away. As such, a pilot study focusing on self-injection technique of Type 2 Diabetes has been designed to review on their competency
Objectives :
a. To arouse patients’ awareness on their compliance on insulin-injection technique, clarify misconception and empower their chronic disease management. b. To arouse staff’s awareness on the possibility of patients’ skill deviation.
Methodology :
PLAN: Type 2 Diabetes, communicable with self-injecting insulin being followed up in general outpatient clinics was invited to complete “Questionnaire on Technique of Insulin Injection”. DO: Nurses identified non-compliance group, demonstrated proper technique with return demonstration on the non-complied item(s), patient received "Take-Home Pamphlet". CHECK: Nurse scheduled a phone follow-up contacted the patient to review on the non-complied item(s). A patient satisfaction survey was conducted to evaluate service. ACT: Identical program would be recommended to carry out from May to August annually to empower insulin self-injected patients for self-reliance.
Result & Outcome :
34 targeted patients were recruited. Findings showed all of the participants’ insulin compliance was good and delivered entire dose of insulin. However, 64% failed tipping of insulin adequately. 29% did not keep pen in-situ for at least 10 seconds. 15% did not screw on a new pen needle before each injection. 9% failed to assess and rotate injection sites every time. 6% did not prime insulin pen every time. Nurses delivered patient education individually and phone follow-up to them, those suboptimal self-injection items had marked improvement. The situation of inadequate tipping of insulin had improved and 90% of patients can keep pen in-situ for at least 10 seconds after injection. All patients could screw a new pen needle per injection, willing to assess and rotate injection sites and prime the insulin pen correctively. Patients rated good level of understanding after this review and expressed that their injection technique had been enhanced. In long run, patients are more confident in insulin self-injection and they are empowered to have better blood glucose control.
