Validated insulin preparation and administration protocol significantly boosts healthcare professionals' knowledge of safe practices.
Background
Medication errors, particularly with high-alert medications like insulin, pose significant risks to patient safety in healthcare settings. Despite its critical role in managing diabetes mellitus, insulin's complex preparation and administration procedures frequently lead to errors, including incorrect dosing, timing, or route. Current standard-of-care often lacks standardized, evidence-based protocols, contributing to variability in practice and increased potential for adverse events. This study addresses the gap by developing and validating a comprehensive protocol to enhance safety and reduce errors associated with insulin therapy.
Study Design
This methodological study, conducted from September 2022 to May 2024, involved two phases. Phase one focused on developing and validating the insulin preparation and administration protocol with 46 experts using the AGREE II instrument to assess content and methodological quality. Phase two involved training 40 healthcare professionals in Fortaleza, Brazil, on the new protocol. Knowledge acquisition was measured using pre- and post-training tests. Data analysis included descriptive statistics, reproducibility measures (Cronbach's alpha, McDonald's omega), Content Validity Index (CVI), and various statistical tests to compare knowledge scores.
Results
The developed protocol demonstrated high quality and strong internal consistency. Its Content Validity Index (CVI) ranged from 97.83% to 100% (p<0.001), indicating excellent expert agreement on its relevance and clarity. The protocol achieved an impressive overall quality score of 95.7% (6.70 ± 0.47) from the experts, with all six AGREE II domains scoring ≥ 90.0%. High reproducibility was further confirmed by a Cronbach's alpha of 0.94 and McDonald's omega of 0.95. Following the training intervention, healthcare professionals exhibited a significant increase in correct responses on knowledge assessments: > Their average correct response rate surged from 32% pre-training to 70% post-training, demonstrating a substantial enhancement in understanding safe insulin practices.
Key Findings
- The developed insulin protocol achieved a
Content Validity Indexof 97.83-100% (p<0.001). - Overall quality score for the protocol was 95.7% (6.70 ± 0.47) by expert evaluation.
- All six
AGREE IIdomains scored ≥ 90.0%, indicating high methodological rigor. - Reproducibility measures confirmed high internal consistency (
alpha=0.94,omega=0.95). - Healthcare professionals' correct responses increased from 32% to 70% after training.
Why It Matters
This validated protocol offers a robust, evidence-based framework that can significantly reduce medication errors and improve patient safety in insulin administration. For clinicians and healthcare institutions, adopting such a standardized protocol could lead to more consistent and safer practices, potentially decreasing adverse events related to insulin therapy. The study's success in boosting professional knowledge suggests that similar training programs could be implemented globally, providing a clear pathway for translating research into practical application. While this protocol is ready for implementation, further studies are needed to assess its long-term impact on actual patient outcomes and error rates in diverse clinical settings, beyond just knowledge acquisition.
insulin
protocol
patient-safety
healthcare-training
methodological-study
diabetes-management