National subcutaneous insulin charts
The Commission has produced national subcutaneous insulin charts for acute and sub-acute hospitals and mental health facilities. These support the delivery of appropriate care and improve the management of blood glucose levels (BGLs) in these different groups of patients.
Design features of national subcutaneous insulin charts
The charts are designed to:
- Link the prescribing of subcutaneous insulin with administration and recorded blood glucose levels (BGLs)
- Provide forcing functions to reduce the use of non-standard abbreviations and non-standard dosing regimens
- Provide guidelines for action to be taken in the event of BGLs reaching levels which indicate a medical officer should be alerted and action taken
- Prompt daily review and adjustment of insulin doses in response to BGLs.
Safety features and enabling functions of national subcutaneous insulin charts
- Notification prompts for BGLs outside of target range
- UNITS pre-printed
- Discouragement of stand-alone subcutaneous ‘sliding scale’ insulin
- Ability to prescribe supplemental (or correctional) insulin
- Multidisciplinary communication documentation
- Recommended initial insulin infusion rates
- Guidelines for the management of hypo and hyperglycaemia (available in two chart variations to suit acute hospital settings)
- Insulin administration associated with meals by pre-printing meal times.
Safety performance of national subcutaneous insulin charts
The national subcutaneous insulin chart has been piloted in public and private hospitals in two waves. The safety performance of the subcutaneous insulin chart points to 35 areas of positive performance (of statistical significance) which led to improved management of BGLs in hospitalised patients.
The chart is based on the best evidence available at the time of development, and included human factor analysis and piloting results. Healthcare professionals are advised to use clinical discretion and consideration of the circumstances of the individual patient when using the chart to manage BGLs.
National subcutaneous insulin charts and resources
National subcutaneous insulin chart for acute hospitals
- National subcutaneous insulin chart for acute hospitals (PDF 208KB)
- National subcutaneous insulin chart evaluation report – acute hospitals (PDF 156KB)
National subcutaneous insulin chart for sub-acute hospitals and mental health facilities
- National sub-acute subcutaneous insulin chart (PDF 221KB)
- Development and evaluation of a subcutaneous insulin chart in sub-acute hospitals and mental health facilities (PDF 116KB) (Word 118KB)
The following support materials have been developed by the Commission and the University of Queensland to help hospitals and health services implement the national subcutaneous insulin charts:
- Insulin chart quick start guide - Poster (PDF 6MB)
- Insulin chart quick start guide - Handout (PDF 6MB)
- User guide to the national subcutaneous insulin chart: Acute facilities (PDF 4MB) (Word 6MB)
- User guide to the national subcutaneous insulin chart: Sub-acute hospitals and mental health facilities (PDF 4MB) (Word 6MB)
A series of instructional videos are also available on the Commission's YouTube channel.