Evaluation of an implemented new insulin chart to improve quality and safety of diabetes care in a large university hospital: a follow-up study

Abstract

Objectives To evaluate structure, documentation, treatment quality of a new implemented standardised insulin chart in adult medical inpatient wards at a university hospital. Design A before–after study (3 to 5 months after implementation) was used to compare the quality of old versus new insulin charts. Setting University Hospital Graz, Austria. Participants Healthcare professionals (n=237) were questioned regarding structure quality of blank insulin charts. Interventions A new standardised insulin chart was implemented and healthcare professionals were trained regarding features of this chart. Data from insulinised inpatients were evaluated regarding documentation and treatment quality of filled-in insulin charts (n=108 old insulin charts vs n=100 new insulin charts). Main outcomes and measures The primary endpoint was documentation error for insulin administration. Results Healthcare professionals reported an improved structure quality of the new insulin chart with a Likert type response scale increase in all nine items. Documentation errors for insulin administration (primary endpoint) occurred more often on old than new insulin charts (77% vs 5%, pConclusions The implementation of a structured documentation form together with training measures for healthcare professionals led to less documentation errors and safe management of glycaemic control in hospitalised patients in a short time follow-up. A rollout at further medical wards is recommended, and sustainability in the long-term has to be demonstrated.