Implementing self-administration of insulin in hospital: a journey of discovery and innovation. Part 2: Implementing change

Abstract

Offering patients the choice to manage their diabetes in hospital and supporting them to do so is best practice but is not routine. Hospital processes around storage and concerns about insulin misuse coupled with custom and practice have led to increasing numbers of delayed and missed doses. Audits demonstrated the case for change and highlighted that patients were self-administering without proper processes and support. This paper describes a guide developed to help trusts through the change process required to implement patient self-administration of insulin and the experience of doing so in one trust. Dedicated project management and trust-wide involvement are key to success, and innovations to embed self-administration of insulin included electronic documentation of risk assessment, patient assessment by pharmacy technicians and simple bedside storage.