Addenbrooke’s Hospital Rosie Hospital

Background According to NaDIA 2017 report, 18% of all hospital inpatients have

diabetes. The majority of these patients are admitted into hospital

for non-diabetes related reasons and therefore are cared for by

non-diabetes specialist teams. Suboptimal hospital management of

diabetes can lead to increased length of stay and has been linked to

increased morbidity and mortality. However, despite recently

transformation funding, 22% of hospitals still do not have dedicated

diabetes specialist inpatient nurses (NaDIA 2018).

It is recognised that there is a lack of knowledge among non-

diabetes specialist ward staff about insulin. Face-to-face training is

often poorly attended due to staffing and workload pressures.

Furthermore, insulin requirements of sick patients can change

rapidly. Staff can be faced with an array of different insulins and

delivery devices. Access to diabetes specialist advice is often

limited, especially at night or over weekends.

Diabetes UK’s 2018 “Making hospitals safer for people with

diabetes” reports that insulin errors are a common drug error

involving ±40% of insulin-treated patients in the previous year and

recommends making insulin safety training mandatory for all

healthcare staff (HCPs).

Aim To increase self-assessed insulin safety knowledge, confidence and

guideline familiarity amongst HCPs via standardised digital insulin

safety training on a large scale across the UK.

Method

CDEP collaborated with a number of UK-based diabetes experts

and PocketMedic to create a ‘bite-sized’ educational film and

competency-based e-learning topic designed to support ward staff

improve insulin safety skills and reduce insulin errors. Diabetes

UK’s Lead for Inpatient Care and Diabetes UK’s Head of Care

provided expert advice and guidance.

The “Safe use of Insulin in Hospital” training was tested by other

diabetes experts as well as the target audience to ensure it was fit

for purpose before its launch in May 2019.

Following the successful review of the acute hospital-focused

insulin safety training, a second film and topic was launched in

September 2019 to support staff working in the ambulatory setting

“Safe use of Insulin in the Community”. This topic is slightly shorter

as it does not include Variable Rate Intravenous Insulin Infusions

(VRIII).

Reach As of the 2nd March 2020, media tracking tools on the CDEP and

PocketMedic websites show that the insulin safety films have been

viewed 7283 times and downloaded 96 times to be used offline for

in-house staff training since their launch in May and September

2019 respectively.

Digital Insulin Safety Training via the Cambridge

Diabetes Education Programme (CDEP)

Ward C1, Cottrell C², Davenport K1 , Littlemore K³, Rayman G4, Rice S5 and Simmons D6 1Wolfson Centre for Diabetes and Endocrinology, Institute of Metabolic Science, Addenbrookes Hospital, Cambridge; 2Think Glucose DSN, Swansea Bay University Health Board; 3PocketMedic, eHealth Digital Media Ltd; 4Diabetes

and Endocrine Centre, The Ipswich Hospital, East Suffolk and North Essex NHS Foundation Trust;5Price Philip Hospital, Wales and 6School of Medicine, Western Sydney University, Campbelltown, Australia;

Scan the QR codes to find out more or

visit the website:

www.cdep.org.uk

Conclusion

Acknowledgments: We would like to thank all the people who have been part of the development of CDEP to date as well as the stakeholders who have endorsed or accredited CDEP such as College of Podiatry, CUHP, BAPO, BDA, Diabetes UK, RCGP, RCN and RCM.

Supporting busy staff to robustly improve their insulin

safety skills as well as promote confidence and guideline

familiarity is well received and possible on a large scale.

Quality improvement audits are being undertaken in various

hospital trusts to gather clinical evidence of the impact of

CDEP’s insulin safety training on insulin errors.

Results

In the first 10 months, following the launch of CDEP’s insulin safety training,

1115 HCPs have successfully completed the training (average 3.6 / day, 7

days a week). Another 979 are in the process of completing it. On average,

the training takes 30-60 minutes depending on the difficulty level and which

insulin safety topic is undertaken.

CDEP collects feedback on the impact of the training from 100% of HCPs

who completed the training. Feedback from the hospital (n=705) and

community (n=410) training topics are very similar and have been combined

in graph 1.

0%

20%

40%

60%

80%

100%

Competency Confidence Guideline Familiarity

0.1% 0.3% 0.0%

8.3% 9.7% 8.1%

91.6% 90.0% 91.9%

Worsened

Maintained

Improved

Self-reported impact of undertaking CDEP’s Insulin Safety Training (n=1115)

Graph 1

Source: CDEP’s google analytics reporting data

Qualitative verbatim user

feedback is also collected to

populate a reflection

document and inform

improvements to the training.

Feedback has been

overwhelmingly positive.

“An excellent learning package, having compared

numerous other packages, this stands out as

being up to date, in line with National Guidelines

and challenging/makes you think. All aspects of

safe insulin management are covered. I will be

encouraging ward staff across our Trust to

complete this training. Probably the best e-

learning I have completed!”

Reach cont. Uptake of CDEP e-learning is widespread as demonstrated by CDEP’s

analytics data.

References CDEP, an online competency-based diabetes healthcare staff learning platform – www.cdep.org.uk (access 02.03.2020)

Diabetes UK insulin safety news – https://www.diabetes.org.uk/about_us/news/insulin-safety-hospital (accessed 02.03.2020)

Diabetes UK’s 2018 report “Making Hospitals safer for People with Diabetes “ - https://www.diabetes.org.uk/resources-s3/2018-

10/Making%20Hospitals%20safe%20for%20people%20with%20diabetes_FINAL.pdf (accessed 02.03.2020)

NaDIA Report 2017 - https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-inpatient-audit/national-diabetes-inpatient-audit-nadia-2017 (accessed 02.03.2020)

NaDIA Report 2018 - https://digital.nhs.uk/data-and-information/publications/statistical/national-diabetes-inpatient-audit/2018 (access 02.03.2020)

PocketMedic, an ehealth digital communications company - https://pocketmedic.org/ (accessed 02.03.2020)

User location based on IP address

Since the launch of insulin safety

training (n=307 days, date

02.03.2020), CDEP has had:

• 29,695 individual UK-based users

visited the site (88% of all CDEP

users).

• These users undertook 62,796

sessions (active learning

engagement) across its range of

diabetes topics offered.

• Insulin safety accounted for 12.8%

of all topics (n=8,721) completed.