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Are they high on steroids? Tailored interventions help improve screening for steroid-induced hyperglycaemia in hospitalised patients
  1. Punith Kempegowda1,10,
  2. Alana C Livesey2,
  3. Laura McFarlane-Majeed3,
  4. Joht Singh Chandan2,
  5. Theresa Smyth2,
  6. Martha Stewart2,
  7. Karen Blackwood2,
  8. Michelle McMahon2,
  9. Anitha Vijayan Melapatte4,
  10. Sofia Salahuddin2,
  11. Jonathan Webber2,
  12. Sandip Ghosh2
  1. 1Department of Diabetes, Endocrinology and General Internal Medicine, Heart of England NHS Foundation Trust, Birmingham, UK
  2. 2Department of Diabetes, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
  3. 3Medical School, University of Birmingham, Birmingham, UK
  4. 4Department of Health Informatics, Queen Elizabeth Hospital Birmingham, Birmingham, UK
  5. 10Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
  1. Correspondence to Dr Punith Kempegowda; p.kempegowda{at}nhs.net

Abstract

Steroid-induced hyperglycaemia (SIH) is a common adverse effect in patients both with and without diabetes. This project aimed to improve the screening and diagnosis of SIH by improving the knowledge of healthcare professionals who contribute to the management of SIH in hospitalised patients. Monitoring and diagnosis of SIH were measured in areas of high steroid use in our hospital from May 2016 to January 2017. Several interventions were implemented to improve knowledge and screening for SIH including a staff education programme for nurses, healthcare assistants and doctors. The Trust guidelines for SIH management were updated based on feedback from staff. The changes to the guideline included shortening the document from 14 to 4 pages, incorporating a flowchart summarising the management of SIH and publishing the guideline on the Trust intranet. A questionnaire based on the recommendations of the Joint British Diabetes Societies for SIH was used to assess the change in knowledge pre-intervention and post-intervention. Results showed an increase in junior doctors’ knowledge of this topic. Although there was an initial improvement in screening for SIH, this returned to near baseline by the end of the study. This study highlights that screening for SIH can be improved by increasing the knowledge of healthcare staff. However, there is a need for ongoing interventions to sustain this change.

  • healthcare quality improvement
  • health professions education
  • patient-centred care
  • quality improvement
  • team training

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjoq-2017-000238

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    Footnotes

    • Contributors PK and ACL conceptualised the study and are joint first authors for the study. LM-M helped with study designing and data collection. JSC helped in analysing the data and revising the manuscript. AVM assisted in data collection and data mining. TS, MS, KB and MM delivered training as part of interventions to improve service. SS, JW and SG supervised the study.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement There are no additional unpublished data from the study.