Empowering prescribers to empower patients and fellow professionals: a novel approach to safe, person-centred practice

South Eastern Health and Social Care Trust

This project is under way, and will run until July 2020.

  • Led by South Eastern Health and Social Care Trust, in partnership with Queen’s University Belfast, Western Health and Social Care Trust, Centre for Pharmacy Learning and Development, and Northern Ireland Medical and Dental Training Agency.
  • Aiming to improve the experiences of inpatients on insulin and the education of foundation trainees (FTs).
  • Will empower FTs to acknowledge uncertainty when prescribing insulin and collaborate with patients and fellow professionals.

Junior trainee doctors write most insulin prescriptions for hospitalised patients with diabetes. This difficult task is prone to errors, which decrease patients’ satisfaction, lengthen their hospital stay, and can cause harm.

Under-dosing is as common as over-dosing, with around one in 25 diabetic patients developing dangerously high blood sugar levels after being admitted to hospital. 

Research carried out by South Eastern Health and Social Care Trust found that errors in prescribing insulin are due to faulty systems more than individual mistakes. Errors result from a culture of ‘getting by’ rather than learning good practice, and a reluctance to admit uncertainty and request help.

This project aims to improve prescribing by educating doctors, nurses and pharmacists, and encouraging patients to be more involved. 

The Making Insulin Treatment Safer (MITS) intervention empowers trainee clinicians to: handle the complexity and uncertainty of prescribing insulin; work with members of different disciplines and different levels of seniority; involve patients in their own care; and access and make good use of other people and information sources. ‘Debriefers’ do this by holding one-to-one conversations, which help trainees learn from earlier prescribing experiences.

Participants will acquire these debriefing skills in three-hour workshops, where up to 20 doctors, nurses, pharmacists and service users learn to educate trainee clinicians, following empowerment principles. 

This project will extend the MITS intervention to Western Health and Social Care Trust, and from medicine to nursing and pharmacy. It will involve education providers and senior professional decision-makers, to ensure the sustainability of the intervention. 

Contact information

For more information about this project, please contact Professor Timothy Dornan, Professor of Medical Education, South Eastern Health and Social Care Trust.

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