Improving preparedness of junior doctors to manage patients with diabetes: a pilot educational programme from ward-based pharmacists
Keywords:Clinical pharmacy, inter-professional education, Northern Ireland, patient safety, quality improvement, ward-based teaching, insulin prescribing
Background: Diabetes is a complex condition and junior doctors can feel underprepared when tasked with safely prescribing insulin. Hyperglycaemia is known to increase mortality and morbidity, yet a British study in 2008 demonstrated that a quarter of doctors responding to the survey did not feel confident enough to take the main initiative to control blood glucose for a patient under their care in hospital. Diabetes learning resources are widely available, yet few offer the opportunity to link undergraduate theory with practical prescribing tasks. Clinical pharmacists can play an important role in providing this type of practical support and in the formative development of safe prescribing for junior doctors. This paper describes an initiative from a hospital pharmacy team to support Foundation Year doctors (FY1s) with safe insulin prescribing.
Methods: The team from the Belfast Trust designed a ward-based teaching session which could be used by clinical pharmacists to help newly qualified doctors on their wards. These sessions, known as SIPS (Safe Insulin Prescribing Sessions), focused on three key areas: documentation, insulin product range and resources. The aim was to assess if SIPS had an impact on confidence levels for different aspects of insulin prescribing. This pilot educational intervention was carried out with 19 junior doctors. After the session each doctor was contacted to complete a short online questionnaire ranking their confidence and knowledge levels in managing inpatients prescribed insulin before and after the pharmacist SIPS.
Results: After completing the ward-based teaching there were statistically significant increases in the self-ranked confidence and knowledge levels of junior doctors regarding insulin prescribing.
Conclusions: This pilot demonstrates that ward-based teaching from a pharmacist can support junior doctors in managing diabetes. A larger study would be needed to confirm whether this translates into better management of inpatients with diabetes.
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