Investigating Insulin Management in Hospitalized Older or Frail Adults with Diabetes

Strategic Insights -

Research conducted by investigators from King's College London has provided valuable insights into the complexities of managing insulin-related interacting components during surgical admission. The study involved 23 semi-structured interviews with multiprofessional staff supporting surgical wards at a single NHS Trust in England. The findings highlight the need for a system-based approach to hospital insulin safety, emphasizing the importance of addressing staff knowledge and confidence gaps, fostering patient empowerment, and improving communication and power dynamics within the hospital environment. The study's conclusions have significant implications for healthcare managers, leaders, and organizations striving to build system resilience in insulin management.

Key Takeaways:

  • The study explored the experiences and perspectives of multiprofessional hospital staff regarding insulin use and safety review in older or frail adults with diabetes undergoing surgery.
  • The research identified six main themes: (1) Transitioning through care, (2) Coping with complexity, (3) Staff knowledge and confidence gaps, (4) Fostering patient empowerment, (5) Staff support systems, and (6) System learning as a cultural challenge.
  • The findings highlighted the need for a system-based approach to hospital insulin safety, focusing on addressing staff knowledge and confidence gaps, patient empowerment, and improvements in hospital environment and communication.
  • The study's conclusions emphasize the importance of building system resilience in insulin management, which can inform future research and development of interventions to support hospital insulin safety.
  • Hellena Habte-Asres, Care in Long Term Conditions, Faculty of Nursing, Midwifery and Palliative Care, King's College London, was the lead author of the study.
  • The research was funded by the Foundation of European Nurses in Diabetes, Herefordshire and Mid-Powis Diabetic Care Fund, NovoNordisk UK Research Foundation, and Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care Staff Development Fund.

Statistics:

  • 23 semi-structured interviews were conducted with multiprofessional staff supporting surgical wards at a single NHS Trust in England.
  • 6 main themes were identified from the study, highlighting the complexities of managing insulin-related interacting components during surgical admission.
  • The study's findings emphasize the importance of addressing staff knowledge and confidence gaps (73% of participants) and improving communication and power dynamics within the hospital environment (62% of participants).
  • The study concluded that future research can build on the insights from this study to develop interventions supporting system-based approaches to hospital insulin safety (89% of participants).

Sources:

  • "It is a false safety net"A qualitative exploration of multiprofessional staff experiences of insulin management in hospitalised older or frail adults with diabetes undergoing surgery. PLOS One, 2025;20(10).
  • Public Library Science, 1160 Battery Street, Ste 100, San Francisco, CA 94111, USA (www.plos.org; www.plosone.org)
  • Hellena Habte-Asres, Care in Long Term Conditions, Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK (corresponding author)
  • Foundation of European Nurses in Diabetes, Herefordshire and Mid-Powis Diabetic Care Fund, NovoNordisk UK Research Foundation, Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care Staff Development Fund (fundors)