Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

An Initial four week audit of six sub-acute units identified poor compliance to the hypoglycaemia policy. Three quarters of hypoglycaemic episodes were incorrectly managed including the initial and follow-up treatment and documentation. In addition, inpatient hypoglycaemic episodes were often associated with the use of a supplementary insulin regimen (SIR) and limited adjustment or cessation of these medication orders.
A multi facet strategy was implemented in all units with the aim of reducing the number of hypoglycaemic episodes, improve the detection, increase policy compliance and promote sound clinical medication decision making.
The intervention strategy included: a) monthly training sessions b) laminated treatment flow charts placed prominently in all clinical areas c) recruitment of ten diabetes link nurses to mentor colleagues in the treatment of hypoglycaemia d) presenting an education package to all junior medical staff e) timely inpatient medication prescribing intervention by the nurse practitioner diabetes f) screening of all inpatients with diabetes by the diabetes educator to identify risk of hypoglycaemia .
The follow-up four week audit, nearly one year after strategy implementation has shown a 50% reduction in the number of hypoglycaemic events and 75% compliance with the policy. It should be noted that three quarters of hypoglycaemic events were asymptomatic.

Reduction of inpatient hypoglycaemic episodes and improved compliance to policy can occur when several strategies are implemented together with commitment of time, resources and surveillance. To assist in sustainability of these strategies, it is hoped to incorporate electronic educational aids and programs for nursing and medical staff.