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How Cornwall is leading the way in diabetes care

How Cornwall is leading the way in diabetes care

Published by the Pirate FM News Teamat 7:38am 4th April 2018. (Updated at 11:33am 4th April 2018)

Cornwall is leading the way in diabetes care thanks to one group of nurses.

The team from the Duchy have developed training using a dummy that mimics having a hypo.

They came up with the idea after a so-called 'serious untoward incident', that ended in the death of a patient.

It comes as figures show the condition is common among 28,000 admitted to hospital in Cornwall.

How does the training work?

The nurses from Cornwall Partnership NHS Foundation Trust have developed point-of-care simulation training in response to ineffective traditional training methods.

It follows a serious untoward incident (SUI) involving hypoglycaemia mismanagement which proved to be fatal. 

Made up of Clinical Nurse Diabetes Specialists Kim Sleeman, Amanda Davis and Amanda Veall, a project was put together to deliver a real-life simulation (SIM) module to the ward where the SUI had occurred over three months and to evaluate its effectiveness.

With diabetes care increasing in complexity, developments in practice required an increased depth of knowledge and skills from healthcare professionals.

By using a human patient simulator that mimics a person experiencing hypoglycaemia, the ward team have to respond in real time with the resources available around them and in an environment that is safe not only for the clinician, but also the patient.

It was hoped the SIM training would eliminate incidences of mismanagement of hypoglycaemia and reduce unnecessary hospital stays.

The team’s SIM training was and still is delivered to the entire multidisciplinary team, including nurses, healthcare assistants and junior and senior ward doctors trust-wide as part of a rolling SIM programme.

What are the advantages?

As hypoglycaemia emergencies can occur at any time and place, and with bed-space being at a premium, SIM training has been given in bathrooms, corridors and day rooms, as well as in the wards.

  • Key aspects of patient safety can be identified;
  • Allows for actual teams to learn together in their usual working environment;
  • Allows for testing of logistics and systems;
  • Multidisciplinary team integration and training relevant to the workplace;
  • Enables the discovery of latent safety issues;
  • Identifies “system and process” errors in situ;
  • Time effective (takes one hour for scenario and debrief);
  • Increases staff engagement and motivation.

What do the nurses think?

Amanda Veall is a Clinical Nurse Specialist in Diabetes and said: "The Trust has recognised the importance of cultural changes at the coalface by introducing integrated point-of-care SIM training.

Kim Sleeman added: “Challenging human factors in the work environment allows the team to learn together and improve performance, with consequent delivery of safer patient care, better outcomes and improved productivity.

"Rehearsing situations increases confidence and skills, so that when they are encountered in clinical practice, they can be managed calmly and efficiently.

"SIM not only develops skills and knowledge, but it also improves situational awareness required for good team working".

What are the results?

Following the training there was a 100% reduction in hypoglycaemia incidents seen on the pilot ward and a 64% reduction in hypoglycaemia incidences and 100% reduction of SUIs throughout the Trust.

There were below average incidents of mild hypoglycaemia at 12.3%; the national average 18.5%

Patients reported that they were “satisfied” or “very satisfied” with the overall care of their diabetes while in hospital, which was above the national average by 6%

Kim continued “Ipswich Hospital NHS Trust has already replicated our hypoglycaemia SIM training following a consultation with us.

"It really is an innovative training tool. It was received exceptionally well and demonstrated a positive impact of diabetes inpatient mortality and a decrease in the length of stay in hospital".

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