Hypoglycaemia management in some hospitals is inadequate
Insulin considered appropriate therapy for hypoglycaemia by some
nurses |
Treatment of hypoglycaemia in hospital is inadequate and haphazard, according to several research groups presenting their work at the Diabetes
UK annual professional conference held in Birmingham last week.
Pharmacists at Guy’s and St Thomas’ NHS Foundation Trust,
London, found that routine stock for treating hypoglycaemia was inadequate.
In 33 adult wards evaluated, Lucozade was located on one ward and glucose
tablets on none. They also found that nurses’ knowledge about hypoglycaemia
was lacking. In 27 questionnaire-based interviews, four nurses considered
insulin to be an appropriate treatment for hypoglycaemia and two recommended
oral products for patients who could not swallow.
The pharmacists found that of 54 patients with blood glucose readings
less than 4mmol/L, 15 received sub-optimal treatment (inadequate intake
of carbohydrate) and 38 received inappropriate treatment (no treatment
or no carbohydrate). Self-contained treatment packs will now be issued
to all wards and outpatient clinics and a treatment algorithm will be
displayed on wards, say the researchers.
Researchers from the John Radcliffe Hospital, Oxford, say that the management
of hypoglycaemia in hospital is often haphazard, with resources disorganised
and difficult to access. They have developed a portable kit for wards,
which contains all necessary first-line treatment and a trust guideline
as an algorithm. Evaluation of the kit has prompted risk reducing and
cost-effective changes, they say.
Researchers from the Royal Gwent Hospital, Newport, conducted an audit
of 46 junior doctors, which highlighted gaps in the doctors’ knowledge.
For example, about 72 per cent did not know what capillary blood value
indicated hypoglycaemia and 25 per cent did not name intramuscular glucagon
as a treatment option for hypoglycaemia. The researchers conclude that
the questionnaire-styled audit raised awareness of trust guidelines and
is a useful educational tool. |
The
Pharmaceutical Journal
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