NICE (2017) has recently published a key therapeutic topic (KTT) summarising the evidence-base on safer insulin prescribing. A key therapeutic topic (KTT) is a summary of the evidence-base on a particular topic identified to support medicines optimisation, but it does not form part of formal NICE guidance.
The safer insulin prescribing KTT encourages clinicians to improve insulin safety by ensuring that people with diabetes who are receiving insulin therapy are given information about hypoglycaemia, “sick-day” rules and when it is appropriate to notify the Driver and Vehicle Licensing Agency (DVLA). It emphasises that clinicians should be aware of the different types of insulins available, and that people on insulin receive appropriate training on how to use their insulin and are issued with an Insulin Passport.
The document refers to the patient safety alert issued by NHS Improvement in November 2016 warning of the risk of severe harm and death if insulin is withdrawn directly from a pen device or pen cartridge using an insulin needle and syringe. In 2015, a position statement by the PCDS was published in this Journal on this dangerous practice.
According to NICE (2017), 56 incidents associated with withdrawing insulin from insulin pens or refill cartridges were reported to the National Reporting and Learning System (NRLS) between 1 January 2013 and 30 June 2016. In the patient safety alert, NHS Improvement (2016) highlighted the importance of training for healthcare professionals and this is reiterated in NICE’s latest publication. Both documents encourage all healthcare professionals who prescribe, manage or administer insulin to undertake the “Six Steps to Insulin Safety” e-learning module developed by PCDS in association with TREND-UK.
So far, over 10 000 healthcare professionals have accessed the training online. This free e-learning module is available to all healthcare professionals who manage people on insulin and can be accessed at: https://diabetesonthenet.com/cpd-modules/the-six-steps-to-insulin-safety/
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