Evidence map›Paper›PMID 30057957›Full record

ArticleBMJ open quality2018

Making surgical wards safer for patients with diabetes: reducing hypoglycaemia and insulin errors.

Aminder Singh, Angela Adams, Bethany Dudley, Eliza Davison, Lauren Jones, Lucy Wales

Open access · goldAbstract read
In one paragraph

Article in BMJ open quality, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.5field-weighted citation impact, top 32% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 7 citations in OpenAlex.

  1. Use of equipment whiteboard checklists in improving communication while reducing case cost during ureteroscopy.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2026
    Article
  2. Developing an Intervention for Safe Hospital Insulin Use for Older Adults With Diabetes Undergoing Surgical Admission (SHINE Study): A Co-Design Study.Health expectations : an international journal of public participation in health care and health policy · 2026
    Article
  3. 'Why, Can I Not Have Control of My Own Insulin?': Qualitative Exploration Amongst Older Adults With Diabetes With Lived Experience of Surgical Hospital Admission.Health expectations : an international journal of public participation in health care and health policy · 2025
    Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

Aminder SinghNorthern Vascular Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.ORCID 0000-0002-9099-4162
Angela AdamsNorthern Vascular Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Bethany DudleyNorthern Vascular Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Eliza DavisonNorthern Vascular Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Lauren JonesNorthern Vascular Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Lucy WalesNorthern Vascular Centre, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK.
Newcastle upon Tyne Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

High-quality perioperative diabetes care is essential to improve surgical outcomes for patients with diabetes. Inadequate perioperative diabetes care is associated with increased wound complications, higher mortality rates and increased length of hospital stay. Despite national guidelines, surgical wards remain a high-risk area for poor diabetes care. An initial baseline audit in 2014 of vascular patients with diabetes undergoing major lower limb amputation identified poor glycaemic control in 90% of patients, with high rates of hypoglycaemia and insulin management errors in 75%. Less than 15% of patients received specialist diabetes input and 20% required third-party assistance for hypoglycaemia. This quality improvement project aimed to reduce hypoglycaemia, insulin management errors and patient harm events by 50% in vascular surgery patients over a 3-year period. Key interventions over three successive Plan, Do, Study, Act cycles included educational and guideline initiatives (2015), establishing a diabetes in-reach service (2016) and implementing a whiteboard sugar cube alert system for poor glycaemic control (2017). The final introduction of the whiteboard sugar cube alert system delivered the greatest impact in reducing hypoglycaemia rates by more than 50%, insulin management errors by 70% and patient harm events by 75%.

Indexed as

audit and feedbackdiabetes mellitusPDSAquality improvementsurgery

Identifiers

PMID30057957
PMCPMC6059342
OpenAlexW2883434173

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.