Endocrine Abstracts

Diabetes mellitus is a common comorbidity in hospital inpatients. Type 1 diabetes clinical guidelines recommend, where possible during admission, continuing the existing insulin regimen, including Continuous Subcutaneous Insulin Infusion (CSII), enabling insulin self- administration. However, many non-diabetes healthcare staff are unfamiliar with CSII, which may lead to medication errors. We introduced a new CSII Kardex, supported by an educational video on CSII, aiming to prevent errors in the prescribing and administration of CSII. We audited the use and compliance with this new Kardex. 19 patients and 26 admissions using CSII were identified in 2023 and 2024. Three patients had multiple admissions which were audited separately. Records were unavailable for three admissions. Thus, 23 admissions and 18 patients’ records were retrospectively reviewed. Mean diabetes duration was 31.3 ± 15.1 years; mean HbA1c was 59.8 ± 9.7 mmol/l/mol, where available. CSII used were Medtronic MiniMed™(14), Tandem t:slimX2™(3) and Roche Accu-Chek® Spirit(1). CSII Kardexes were used in 86.9% of cases. Subcutaneous insulin Kardexes were used in 30.4% of cases and additional subcutaneous insulin was administered or incorrectly recorded in 17.4%. 78.3% of admissions using CSII were under non-Endocrinology teams. Of these, diabetes consults were requested in 61%. Diabetes nurse specialist input was requested in 82.6% of the total 23 admissions. Reference to insulin prescription was made in 65.2% of Kardexes and 56.5% of discharge summaries. This audit demonstrates good compliance with a new CSII Kardex and highlights the importance of continued education for non-diabetes healthcare staff and involvement of diabetes specialists.