Failures in the practices of preparation and administration of insulins: situational diagnosis for patient safety

Abstract

Objective: to map failures related to insulin preparation and administration practices in healthcare settings, from the comparative perspective of frontline professionals and experts. Method: a cross-sectional observational study conducted with 86 healthcare professionals, including frontline workers from a hospital in Fortaleza-Ceará and experts in the field, carried out between August 2023 and April 2024. A tool with 20 multiple-check items, divided into six domains, was used to identify the main errors and adverse events related to patient safety resulting from insulin preparation and administration practices in clinical care. Results: the most frequently reported inconsistencies by healthcare professionals were: failure to rotate insulin injection sites; use of inappropriate abbreviations and symbols in insulin prescriptions; in-use vials without a label indicating the opening date; improper storage of insulins; incorrect timing between insulin administration and meals; and disposal of sharps related to treatment in inappropriate locations. The identification of the following aspects was significantly higher among expert professionals: "In-use insulin vials without a label indicating the opening date," "Storage of insulins and heparins near refrigerators, and "Administration of insulin using large needles with improper angulation or without creating a skinfold." Conclusion: these findings are significant as they serve as indicators of patient safety, contributing to the re-planning of actions aimed at improving the quality of care provided to people with diabetes.