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Royal Bolton Hospital

The National Diabetes Inpatient Audit ( NADIA) in 2015/16 concluded that patients at the Royal Bolton Hospital have, on average, more severe hypoglycaemic episodes when compared to the national average. Research suggested that the highest proportion of inpatient hypoglycaemia episodes took place overnight.

To try to tackle the problem they took data analysis of all readings recorded < 4 mmols over a month timeframe. They were obtained via the Trust’s blood glucose system, UNIPOC to analyse the time of the hypoglycaemia episode, the ward area and whether there was a relationship causal effect for some areas of meal times.

They identified the Royal Bolton Hospital occurrence of hypoglycaemic events occurs predominantly at 6-7 am. They also found there was an association of early mealtime and mid-morning hypoglycaemia in some areas. Timing of medication in relation to meals was also critical in preventing occurrence.

They were also able to identify ward areas that have a higher occurrence of hypoglycaemic events compared to others. As a result for some patients that are high risk, they advised to test earlier in the morning. We have also commenced work on a new capillary blood glucose chart with best practice guidelines and hypoglycaemia stickers for the patient’s notes.