Ninewells Hospital

Ninewells Hospital wanted to improve awareness of and the risks associated with hypoglycaemia and to improve their hypoglycaemia resolution date. They decided to obtain blood glucose reports from all wards in NHS Tayside, which are available electronically via linkage of the COBAS IT (connected meters), TrakCare and SCI Diabetes (electronic diabetes record). Over 400 episodes of hypoglycaemia occur in NHS Tayside per month and their data reports identified that less than 50% were resolved within one hour. The diabetes specialist’s nurses visited acute wards to engage with staff utilising blood glucose data, hypoglycaemia information, a hypoglycaemia board game, and a staff questionnaire to identify strategies for improvement. A hypo box audit was carried out. During hypoglycaemia awareness week they launched a new structured DATIX category of ‘Adverse Medication Event – hypoglycaemia not resolved within one hour’, historically hypoglycaemia has been under reported.