Implementing self-administration of insulin in hospital: a journey of discovery and innovation. Part 1: Culture and storage

Patients with diabetes routinely manage their insulin at home, but when they are admitted to hospital it is common practice to take their insulin away and store it in the ward fridge. Medicines rounds and mealtimes are poorly aligned and, as a result, patients can have delayed doses and increased hypo- and hyperglycaemic episodes. Best practice states that patients should be offered self-administration of insulin, but it is not routine in most trusts. This paper reports on a project to increase the number of patients assessed and supported to administer their insulin in hospital, the reasons why the project was initially unsuccessful and the challenges of changing culture and beliefs around insulin administration. A second paper discusses steps taken to support changes in hospital trusts.