Endocrine Abstracts

Introduction: Across the North West England, following a survey across all Children and Young People’s Diabetes Units, a large number of paediatric diabetes specialist nurses (PDSNs) adjust insulin doses of children and young people with diabetes without a non-medical prescribing qualification (NMP). The majority have no Standard Operating Procedure (SOP) in place, which is essential for their indemnity. In the meantime, PDSNs who were waiting to commence the NMP (v300) course could utilise the SOP.

Objectives: To ensure that all nurses practising in children and young people’s diabetes without a NMP, have a local SOP in place.

Methods: A working group comprising the Network Manager, a Paediatric Diabetes Advanced Specialist Practitioner and the two Network Lead PDSNs was created. The group worked from an SOP originally designed by the Advanced Specialist Practitioner. The draft version was shared across all of the PDSNs within the Children and Young People’s North West Diabetes Network for peer review and amendments made accordingly. The final version was endorsed by the Network’s Steering Group.

Results: Following a survey on the awareness and implementation of the SOP across 20 paediatric diabetes units and the results are as follows:

Diabetes Nurses now have clear prescribing boundaries:

• Age: 2-18 years

• an allowance of 10% dose adjustment of current prescription;

• exclusion criteria:

• out of expertise of the PDSN;

• parents and carers who specifically request a team member with prescribing qualifications.

Conclusions: By designing a generic Insulin Dose Adjustment SOP, all teams can utilise the SOP and adapt accordingly for local ratification processes by the individual Trust’s/organisation’s Medicines Management Group. PDSNs across the Network who have a ratified SOP now have indemnity to adjust insulin doses safely within structured boundaries. Further advantages include records of competencies and Trust/organisation oversight of nurses adjusting doses. The SOP has been shared nationally and is recognised as an official document by the National Children and Young People’s Network, which can be accessed via the Network’s website.