The Variable Rate Intravenous Insulin Infusion Protocol.

Area of Science:

• Clinical Pharmacy
• Endocrinology
• Patient Safety

Background:

• High insulin use in inpatients is linked to frequent and severe medication errors.
• Baseline audits revealed significant variability in intravenous insulin prescription practices, including fluid choice, electrolyte monitoring, and prescription clarity.
• Existing practices led to inconsistent glycaemic management and potential patient harm.

Purpose of the Study:

• To standardize intravenous insulin prescription for inpatients across the trust.
• To evaluate the uptake and effectiveness of a new Variable Rate Intravenous Insulin Infusion (VRIII) protocol.
• To reduce medication errors and improve glycaemic and electrolyte control.

Main Methods:

• Implementation of a trust-wide Variable Rate Intravenous Insulin Infusion (VRIII) protocol.
• Making the protocol accessible via the intranet and providing staff education.
• Monitoring protocol uptake, medication errors, and patient glucose and electrolyte levels.

Main Results:

• Successful routine use of the VRIII protocol throughout the trust.
• Observed decrease in prescribing and administrative errors associated with insulin administration.
• Demonstrated good glucose and electrolyte control in patients managed with the protocol.

Conclusions:

• Standardized protocols, like the VRIII, effectively reduce medication errors in insulin prescribing.
• The protocol ensures good glycaemic control and electrolyte balance.
• Continuous education of clinical staff is essential for sustained protocol efficacy and patient safety.