Three new interactive pathways support NHS teams at the ‘front door’ to care for patients with diabetes

Interactive resources to help ensure people with diabetes receive the best possible hospital care when in emergency and other acute care departments have been developed by the Getting It Right First Time (GIRFT) team.

Interactive versions of three GIRFT pathways for diabetes are now available to support NHS colleagues, demonstrating examples of the processes and key decisions they need to work through to offer best practice to patients in their care.

The pathways relate to:

  • The management of patients presenting to the emergency department (ED) with a foot problem
  • Initial management of hyperglycaemia in adults in the ED
  • The management of patients who are admitted in hypoglycaemia

Alongside the pathways is useful diagram outlining the five essential safety checks that should be carried out for all people with diabetes to help prevent diabetes-related harm in the ED and acute admissions units; provide a snack, think insulin, check ketones, look at the patient’s bare feet, and examine the feet for a loss of sensation.

The easy-to-navigate, web-based pathways are designed for use by clinicians and nurses in ED, same day emergency care (SDEC) and acute medical and surgical units, and can be used and bookmarked on all handheld and desktop devices for fast access.

"We know from our national review of services that some people with diabetes who go to hospital may not always get the best care because there is not enough awareness of diabetes and how to manage that patient group. These pathways have been designed to support all healthcare professionals who come into contact with patients with diabetes to make decisions based on best practice. The new interactive versions are an exciting development because they offer instant access. I’d urge all clinicians and nurses – especially those at the ‘front door’ – to save the link where they can access it quickly.”

GIRFT’s national report for diabetes (2020), authored by Professor Rayman and Professor Partha Kar, estimated that around 20% of hospital beds in England are occupied by someone with diabetes, but only 8% of those patients go to hospital because of their diabetes. Most are admitted for other reasons, such as pneumonia, fractures or elective surgery.

The report made a series of recommendations to help improve the care of people with diabetes in hospital, and flagged the importance of ensuring all healthcare professionals in all hospital departments are aware of a patient’s diabetes – from the emergency department to operating theatre and medical and surgical wards – to improve inpatient safety.

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