Authors (including presenting author) :
LEUNG SM (1), LEUNG HSS (2), MAK KP (2), WONG KK (2), YUEN YL (1), POON MY (1)
Affiliation :
(1) Centre for Diabetes Education and Management, Our Lady of Maryknoll Hospital
(2) Department of Medicine & Geriatrics, Our Lady of Maryknoll Hospital
Keyword 1: :
Medication Safety
Keyword 3: :
Proactive Knowledge Sharing
Keyword 4: :
Patient Safety
Keyword 6: :
Staff Engagement
Introduction :
Toujeo is a newly launched concentrated (U300) basal insulin product in Hospital Authority (HA) drug formula. It is quite different from other insulin products (U100) that each ml of Toujeo with 300units Glargine. If Toujeo from penfill cartridge was withdrawn with insulin syringe (U100) for administration, it will lead to serious adverse medication consequence.
Objectives :
A proactive preventive strategy should be adopted in HKBH, OLMH, WTSH (BMW) to prevent those concentrated insulin related medication incidents.
Methodology :
An Insulin Safety Promotion Campaign (ISPC) was designed to enhance the nursing colleagues’ competencies for inpatient care. The first phrase of ISPC -Insulin Safety Round (ISR) was delivered by NC (Diabetes) and Diabetes Nurse from mid-June to early-July 2025. All the pharmacokinetic & pharmacodynamic properties, safety nursing intervention for this concentrated insulin (Toujeo) were delivered through a 15-min knowledge sharing and live demonstration session. The pathway of retrieving Toujeo-related training materials (eg. Updated guideline, e-learning program, Poster and Maxim: 胰島素筆唔抽得 ’ 選對針頭先至得) from HA Nursing Apps were also demonstrated at the end of ISR. Souvenirs with iconic maxim were prepared to highlight those insulin safety related take home messages to colleagues. A pre-test of five Toujeo-related MCQs was delivered to participants before starting the ISR to evaluate their baseline understanding on Toujeo. The allocation of pre-tests could activate the orienting and motivational attributes, and amplify the attentiveness, curiosity, eagerness to listen among the participants. Diabetes nurses could instantly identify their weaknesses for formulating the focused knowledge reinforcement in second phrase of ISPC (4 half-day Insulin Safety Promotion Day in early September 2025). All the training materials would be shared thereafter. Upon completion of ISR, an insulin safety mandatory training curriculum was endorsed and promulgated by BMW and Kowloon Central Cluster Nursing Service Department in early-July. It consisted of a 10-min training video on “Medication Safety (Insulin administration) for Nurses in Hospital Authority” edited and filmed by OLMH diabetes nurses, and E-learning Program “Safe Practice on Subcutaneous Insulin Therapy”.
Result & Outcome :
Total 205 nurses from 19 wards (Medicine & Geriatrics, Surgery, Respiratory, Rehabilitation, Palliative Care, Orthopaedics) in BMW were enrolled in the ISR. The responsive rate of the pre-test MCQs was 100%. The findings of this pre-test guided the formulation of a training contents focused on the correct explanation and description of Toujeo (67.8% correct), dosing schedule (84.8% correct) as well as the injection procedures (87.3% correct). Post-test MCQ results reflected there were sustainable Toujeo-related knowledge improvement after 3-month (overall mean score: 94.7%). The overall comments from the ISR revealed that majority of the participants (98.5%) felt that this method of knowledge sharing as such was a triggering and encouraging stimulus for them to study by instantly knowing their levels of knowledge. It also contributed significantly to the direction and implementation of advanced nursing education within the same context. Apart from these quantifiable findings, the overwhelming positive feedback from participants together with the full support from top medical (HCE/Deputised HCE) and nursing support (GMNs) from BMW. Nursing colleagues were well equipped for the upcoming service challenge ahead. The result of ISPC outlined the delineation of a new knowledge delivery modality for further promulgation, and also cultivate the collaborative relationships among different care settings to strive for the higher quality and safety diabetes care for patients in BMW. Reference: Shivaraju et al. (2017). Evaluating the effectiveness of pre- and post-test model of learning in a medical school. National Journal of Physiology, Pharmacy and Pharmacology. 7 (9).
