130 Blood sugar monitoring in a hospice inpatient setting following transition to electronic prescribing

<h3>Background</h3> Diabetes in the hospice setting is common and may be precipitated by advanced disease and corticosteroids. Blood sugar management for hospice patients is important to optimise quality of life. Hyperglycaemia and hypoglycaemia can cause significant symptoms as well as being life threatening. <h3>Methods</h3> We audited monitoring of blood sugar at St Ann’s Hospice across both sites against St Ann’s Diabetes Management Policy and Guidelines following changing to electronic prescribing. We compared this to a previous audit on blood sugar monitoring for patients prescribed corticosteroids during paper-prescribing. Data collection was performed using patient electronic notes, EMIS, and the electronic-prescribing system, Ashtons. We took a snapshot of patients on the inpatient units for one day each week in July 2024, accounting for the changing needs of patients across their admission. <h3>Results</h3> 119 inpatient days were identified, patients supported by the individualised plan of care were excluded. Overall, 92% (n=110) had correct blood sugar monitoring, 83% (n=48) of those prescribed corticosteroids and 100% (n=17) who were diabetic. 51% (n=62) inpatient days required blood sugar monitoring, highlighting the importance in our patient population. The previous audit of blood sugar monitoring for patients prescribed corticosteroids was over 4 weeks (December23-January24) during paper-prescribing. 16 patients were identified, with 100% (n=3) blood sugar monitoring for patients who were diabetic, and 62% (n=13) for patients who were not diabetic. <h3>Conclusion</h3> This audit is reassuring that blood sugar monitoring is being performed as per standards, and comparable to during paper-prescribing. There is currently no specific system for blood sugar monitoring on our electronic prescribing system and it is therefore user dependent. Further studies would be useful to look at specific timings of monitoring of blood sugars, which is particularly prudent in patients prescribed steroids, as well as if out of range blood sugars are acted upon appropriately.