National Diabetes Inpatient Audit England, 2019

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Isn't impressive, or partic reassuring, is it? Quite a lot of things seemed to have deteriorated in 2019 against 2017. And that was before Covid - difficult to envisage how good or poor it might be now.
 
Isn't impressive, or partic reassuring, is it? Quite a lot of things seemed to have deteriorated in 2019 against 2017. And that was before Covid - difficult to envisage how good or poor it might be now.
I agree. Given the findings, if I had the choice, I'd go for self management if I ever ended up in hospital.

It's no wonder people come to this forum for advice!

Executive summary pg 5:

On the day of the audit in 2019, NaDIA found high levels of:

Medication errors – almost 1 in 3 of the inpatient drug charts surveyed had at least one medication error.

Insulin errors – two fifths of inpatient drug charts for insulin-treated inpatients had one or more insulin error.

Hospital-acquired diabetic ketoacidosis (DKA): on the day of the audit, 3.6 per cent of inpatients with type 1 diabetes had developed in-hospital DKA at any point during their hospital stay.

Capillary blood glucose1(CBG) levels not being recorded at all recommended stages of the perioperative pathway2
 
Last one's interesting - we're located between 2 hospitals the Geo Elliot near Nuneaton, and UHCW in Coventry. The latter is much larger and has used 'smart' BG meters which record Obs electronically, cos Pete was an inpatient several times in there in recent years so I've been visiting him when his Obs were done several times. Meanwhile back at the ranch I opted to go to GEH A&E when I hurt my knee and discovered I'd broken my patella which needed pinning and wiring once they'd opened it up and done the jigsaw which did actually go OK BUT they absolutely didn't have their BG meter recording results electronically. Also had my cataracts done there too, same comment. No idea whether they've upgraded by now or not.
 
I’ve only been admitted to hospital once while living in England. And that was for DKA, so maybe that doesn’t count. I was soon back on my regime while in hospital, and had no complaints. Living in Scotland I was only admitted once for multiple investigations into my neurological problem ( to save me 8 ferry trips). Nobody took over my diabetes therapy, and let me sort it out for myself. Apart from one male nurse who spotted me munching wine gums. When I said I was a tad hypo, he gave me a lecture on empty calories (they weren’t empty to me) and promptly gave me a butty and a glass of milk, which are full calories, so I had to take a sneaky correction in the night.

I slept through next day’s lumbar puncture, never been seen before apparently.

The different experiences in Scotland, inluding cataract surgery x2 and a couple of colonoscopies, are probably due to every single ward in every Scottish hospital has a checklist on how to treat T1 patients, at least those who are compos mentis, and situations where referral rather than self management might be necessary. This was trialled some years back in a couple of hospitals in the North East of Scotland, and was such a success it went nationwide.

It’s such a good and effective idea that NHS England has ignored it, kicked the ball into the long grass and decided to have a good look at what goes wrong. Nothing, of course, will improve.
 
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