Endocrine Abstracts

Background: Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) are common diabetic emergencies. However, the associated morbidity and mortality remains substantial. Non-specialist trainee healthcare professionals (HCPs) are usually the first point of contact in managing these patients in the acute medical setting. It is therefore essential that these trainees are confident in the management of these emergencies.

Aims: Our aim was to use digital technology to establish how confident trainee HCPs felt in managing diabetic emergencies, DKA and HHS, at a large university hospital Trust accepting unselected emergency cases. Digital platforms were utilised to assess trainees’ understanding and access to national-based Trust guidelines for DKA and HHS.

Methods: An online survey was carried out between December 2022 and January 2023. A QR code was utilised to allow easy access to the survey. The code was disseminated via email, posters, and messaging platforms within our Trust.

Results: Data was gathered from 45 HCPs; 38% were foundation year 1 doctors, 42% were senior house officers, and the remainder were nursing staff, medical support workers or higher speciality trainees. 82% of the responders had managed DKA or HHS in the last 6 months. 91% of the HCPs knew where to access the online Trust guidelines and 85% of the responders regularly used these trust guidelines. However, the survey found that only 49% of responders felt confident in the management of DKA, and 31% felt confident in the management of HHS. With regards to insulin prescription, 31% did not follow guidelines in prescribing regular basal insulin alongside fixed-rate insulin in the management of DKA. Moreover, the vast majority (62%) were not confident at all with initiating basal insulin.

Conclusions: Digital technologies such as online surveys and QR codes allowed quick feedback to be gathered to assess the competency of non-specialist healthcare professionals in managing DKA and HHS. This survey showed that the majority of non-specialist trainee HCPs were aware of the guidelines for DKA and HHS, but were not confident in managing these diabetic emergencies. More than half of these trainees did not follow the guidelines especially in prescribing regular basal insulin. The results were used to improve the way guidelines are presented to non-specialist HCPs and to tailor teaching sessions for these trainees to improve their confidence in managing diabetic emergencies.