Strategies to reduce insulin prescribing errors in UK hospitals: results from a national survey

Aim To describe insulin prescribing practice in National Health Service hospitals in the UK and the current use of interventions and strategies to reduce insulin prescribing errors. Methods We sent a cross‐sectional questionnaire to chief pharmacists in all National Health Service hospital trusts in the UK in January 2019. Questions concerned the use and functionality of electronic and paper systems used to prescribe subcutaneous insulin, along with features and interventions designed to reduce insulin prescribing errors. Results Ninety‐five hospital trusts responded (54%). Electronic prescribing of insulin was reported in 40% of hospitals, most of which were teaching hospitals in England. We found a wide variation in the functionality of both electronic prescribing and paper‐based systems to enable the safe prescribing of insulin for inpatients. The availability of specialist diabetes pharmacists to support the safe prescribing of insulin was low (29%), but was positively associated with the use of a greater number of insulin prescribing error reduction strategies (P=0.002). The use of specific interventions to improve insulin prescribing quality (e.g. self‐administration policies) varied greatly between respondent hospitals. Conclusions There is potential to optimize the functionality of both electronic and paper‐based prescribing systems to improve the safe prescribing of insulin in hospitals in the UK. The wide variation in the use of insulin error reduction strategies may be improved by the availability of specialist diabetes pharmacists who can support the implementation of insulin‐prescribing interventions. What's new? Strategies to improve insulin prescribing quality are needed to reduce insulin errors in hospital. There is a wide variation in the use of recommended strategies to help improve insulin‐prescribing quality, including mandatory education of healthcare staff, self‐administration and self‐management policies, and prescriber support at the point of care transfer. The use of electronic prescribing systems is slowly increasing, but there are significant differences in the functionality of systems to optimize insulin prescribing safety. The presence of a specialist diabetes pharmacist is associated with the increased use of insulin prescribing safety strategies in hospital.