Endocrine Abstracts

Acute and long-term complications attributable to diabetes are regrettably still common. To monitor for the development of such complications NICE recommend regular measurement of certain criteria to enable early intervention. A previous audit performed in our hospital looked at the adherence of paediatric diabetic reviews to NICE guidelines. As a consequence of this audit a detailed pro-forma to be used at all paediatric diabetic reviews was introduced.

This poster presents the results of a closed loop audit that has resulted in our service offering improved clinical care. Patients were selected randomly from a local database of paediatric diabetic patients and the notes reviewed retrospectively for evidence of meeting the NICE criteria.

It was found that thyroid and coeliac screening improved to 100% from an initial 86% and 87.5% respectively. Improvement was also noted in the documentation of foot reviews (up 29% from 0%), growth charting at every visit (up 40% to 50%) and blood pressure monitoring (up 50% to 75%).

The pro-forma allows individual targeted changes to be made or added with ease if areas for improvement are identified during the audit process. In this last audit it was identified that dental reviews continued to be poorly documented and therefore a designated space to document these has now been included; this will hopefully trigger a similar level of improvement as shown in other areas over the last year.

Other changes included a tick box for “growth chart plotted” and a line to state definitively whether microalbuminuria was present on urine dip (rather than just whether urine was checked).

In conclusion the introduction and use of a pro-forma can facilitate an improvement in the care of paediatric diabetic patients working toward standardised national targets. The resultant pro-forma has the potential to be used at a national level.