Developing a model of resilience in the use of IV insulin infusion
Research type
Research Study
Full title
Understanding safety differently: developing a model of resilience in the use of intravenous insulin infusions in hospital in-patients.
IRAS ID
244771
Contact name
Mais Iflaifel
Contact email
Sponsor organisation
University of Reading
Clinicaltrials.gov Identifier
N/A, N/A
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Controlling blood glucose in hospitalised patients is very important for optimal patient outcomes. An intravenous (IV) insulin infusion (the giving of insulin via the blood veins) is considered the treatment of choice for critically ill patients and non-critically ill patients who are unable to eat by mouth, to achieve optimal blood glucose levels. The scientific literature reports benefits of using IV insulin infusions to control elevated blood glucose levels, such as reduced risk of death, time spent in hospital, and improved wound healing. However, there have also been other reported problems with the use of IV insulin infusions such as patient-related factors (e.g. patients admitted with additional health conditions and variability in insulin doses), medication-related factors (e.g. complex preparation of insulin solution in clinical areas, loss of drug efficacy during the time of storage, and frequent monitoring and adjustment of IV insulin infusion rates) and organisational related factors (e.g. low numbers of nursing staff, and the absence of clinical pharmacists). As a result of the wide range and complex interplay of factors associated with the use of IV insulin infusions, errors have been made and in some cases, have led to patient harm.
Traditional approaches for improving patient safety have focused on identifying unwanted events such as errors, understanding the causes of these errors and designing solutions to prevent errors. Arguably, such approaches do not take into account the constantly changeable and complex nature of healthcare systems, which cannot be controlled solely by following standards or procedures. An emerging approach called Resilient Healthcare proposes that it is necessary to focus on how work can be performed successfully (what goes right) as well as how work has failed (what can go wrong) in order to improve safety.
To the best of our knowledge, no previous studies have explored resilient practices in the use of IV insulin infusion in hospitals. Thus, the overall aim of the research project is to develop in-depth understanding of how IV insulin infusions are used in practice by exploring the everyday clinical work (what goes right and what can go wrong) of healthcare professionals in their management of adult patients admitted to hospital.REC name
South Central - Oxford C Research Ethics Committee
REC reference
18/SC/0456
Date of REC Opinion
8 Aug 2018
REC opinion
Favourable Opinion