CLINICAL GUIDELINE FOR THE USE OF INTRAVENOUS SLIDING SCALE REGIMEN FOR ADULTS 1. Aim/Purpose of this Guideline This guideline is for the management of for the management of Adult patients with Mellitus requiring Intravenous Sliding Scale Insulin Infusion. It has been benchmarked against national guidance, to provide detailed guidance on the clinical management of in line with best practice guidelines. 2. The Guidance See Appendi 1 for a sample of the form and guidelines. 3. Monitoring compliance and effectiveness Element to be monitored Lead Tool Frequency Reporting arrangements Acting on recommendations and Lead(s) Change in practice and lessons to be shared Compliance with the relevant process above for patients seen at a Team Review. Specialist Adult In-Patient Team Patient Documentation Adult in-patients with diabetes who have had an Intravenous Sliding Scale Regimen and who are reviewed by the specialist diabetes team Non compliance will be reported to the responsible surgical team, ward /area manager. Non compliance resulting in an adverse patient event will be reported via Dati Ward / area managers will undertake subsequent recommendations and action planning for any or all deficiencies and recommendations within reasonable timeframes for their areas The Specialist Adult In-Patient Team will undertake any trust wide recommendations and action planning for any or all deficiencies and recommendations within reasonable timeframes Lesson learned or changes to practice will be shared with all the relevant stakeholders 4. Equality and Diversity 4.1. This document complies with the Royal Cornwall Hospitals NHS Trust service Equality and Diversity statement which can be found in the 'Equality, Diversity & Human Rights Policy' or the Equality and Diversity website. 4.2. Equality Impact Assessment The Initial Equality Impact Assessment Screening Form is at Appendi 2. Page 1 of 8
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Appendi 2. Governance Information Document Title Clinical Guideline for the Use of Intravenous Sliding Scale Regimen For Adults Date Issued/Approved: 4 August 2017 Date Valid From: 4 August 2017 Date for Review: 4 August 2020 Directorate / Department responsible (author/owner): Contact details: 01872 253104 Medical Directorate Amanda Veall Clinical Nurse Specialist Brief summary of contents This guideline is for the management of for the management of Adult patients with Mellitus requiring Intravenous Sliding Scale Insulin Infusion. Suggested Keywords: Target Audience Eecutive Director responsible for Policy: and Sliding Scale RCHT PCH CFT KCCG Medical Director Date revised: 05/12/16 This document replaces (eact title of previous version): Approval route (names of committees)/consultation: Divisional Manager confirming approval processes Name and Post Title of additional signatories Signature of Eecutive Director giving approval Publication Location (refer to Policy on Policies Approvals and Ratification): Document Library Folder/Sub Folder Clinical Guideline for the Use of Intravenous Sliding Scale Regimen For Adults In-Patient Specialist Nurses, Consultant Endocrinologists, Pharmacist, Senior Staff Nurse Endocrine Ward Not required {Original Copy Signed} Internet & Intranet Intranet Only Links to key eternal standards DoH:NSF 2001 standard 8 Page 5 of 8
Related Documents: Training Need Identified? JBDS the use of variable rate insulin infusion in medical patients 2014 No Version Control Table Date September 2008 April 2009 December 2010 Versi on V1.0 Initial Issue V2.0 Updated V2.1 Updated Summary of Changes Changes Made by (Name and Job Title) Amanda Veall CNS Amanda Veall CNS Amanda Veall CNS October 2013 V 3 Update and amended to incorporate continuing long acting insulin, and rate for insulin infusion if glucose < 4mmol/l Amanda Veall Lead CNS March 2017 V 3.1 Date for review. EPMA added into guidance notes Amanda Veall Lead CNS All or part of this document can be released under the Freedom of Information Act 2000 This document is to be retained for 10 years from the date of epiry. This document is only valid on the day of printing Controlled Document This document has been created following the Royal Cornwall Hospitals NHS Trust Policy on Document Production. It should not be altered in any way without the epress permission of the author or their Line Manager. Page 6 of 8
Appendi 2.Initial Equality Impact Assessment Screening Form Name of service, strategy, policy or project (hereafter referred to as policy) to be assessed: Clinical Guideline for the Use of Intravenous Sliding Scale Regimen For Adults Directorate and service area: Medical, Eisting Procedure Name of individual completing Telephone: 01872 253104 assessment: Amanda Veall 1. Policy Aim* To provide detailed guidance on the use of Intravenous Sliding Scale Insulin Infusions in Adults with 2. Policy Objectives* To provide a consistent approach to the management of during the use of Intravenous Sliding Scale Insulin within RCH sites. To maintain patient safety and improve outcomes for adult patients with 3. Policy intended Outcomes* 4. How will you measure the outcome? 5. Who is intended to benefit from the Policy? 6a. Is consultation required with the workforce, equality groups, local interest groups etc. around this policy? Consistent management of at RCHT sites. Prompt and safe management of Intravenous Sliding Scale Insulin Audit Dati Reporting Review of surgical / nursing documentation as required All adult patients with diabetes who require Intravenous Sliding Scale Insulin Infusion hospital within all RCH sites. Yes b. If yes, have these groups been consulted? c. Please list any groups who have been consulted about this procedure. Yes Inpatient Specialist Nurses Consultant Endocrinologists Specialist Pharmacist Senior Staff Nurse Endocrine Ward 7. The Impact Please complete the following table. Are there concerns that the policy could have differential impact on: Equality Strands: Yes No Rationale for Assessment / Eisting Evidence Age Se (male, female, transgender / gender reassignment) Race / Ethnic communities /groups Page 7 of 8
Disability - Learning disability, physical disability, sensory impairment and mental health problems Religion / other beliefs Marriage and civil partnership Pregnancy and maternity For capacity to consent refer to consent form 4 Seual Orientation, Biseual, Gay, heteroseual, Lesbian You will need to continue to a full Equality Impact Assessment if the following have been highlighted: You have ticked Yes in any column above and No consultation or evidence of there being consultation- this ecludes any policies which have been identified as not requiring consultation. or Major service redesign or development 8. Please indicate if a full equality analysis is recommended. No 9. If you are not recommending a Full Impact assessment please eplain why. It is not required for this as it is clinical guidance for all the care of all Adults with requiring Siding Scale insulin. Signature of policy developer / lead manager / director Amanda Veall Date of completion and submission Names and signatures of members carrying out the Screening Assessment 1. Amanda Veall 2. Keep one copy and send a copy to the Human Rights, Equality and Inclusion Lead, c/o Royal Cornwall Hospitals NHS Trust, Human Resources Department, Knowledge Spa, Truro, Cornwall, TR1 3HD A summary of the results will be published on the Trust s web site. Signed Date 06/03/17 Page 8 of 8