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Publication, Part of

National Diabetes Inpatient Audit - Harms 2020 England



NaDIA-Harms is a mandatory year-round collection of four harms that can occur to diabetic inpatients in Acute hospitals in England.

The Audit seeks to monitor these four complications:

Did the patient require injectable rescue treatment for Hypoglycaemia (Hypo) more than 6 hours after admission?

Was the patient diagnosed with new onset Diabetic KetoAcidosis (DKA) more than 24 hours after admission?

Was the patient diagnosed with new onset Hyperglycaemic Hyperosmolar State (HHS) more than 24 hours after admission?

Was the patient diagnosed with a new onset foot ulcer more than 72 hours after admissions?

Recommendation 1: NHS trusts should participate in the NaDIA harms audit to review the safety and quality of inpatient diabetes services. This is consistent with the Getting It Right First Time (GIRFT) recommendation that NHS trusts should participate in local and national audits of patient harms.

Recommendation 2: NHS trusts should implement robust systems to identify all people with diabetes on admission to hospital, in line with GIRFT recommendations. Systems should involve triage to identify those at risk and rapidly refer them to the diabetes team, including for all emergency admissions and elective surgical admissions.

Recommendation 3: Healthcare professionals should reassess plans for diabetes management in patients with stroke on or during admission including nutrition, hydration and medication, to avoid episodes of HHS.

Recommendation 4: NHS trusts should incorporate reduction of DKA arising in people admitted under surgical specialties within Quality Improvement programmes, focusing on the establishment of processes to ensure that insulin is not stopped in people with type 1 diabetes.

102, out of a possible 126, NHS trusts submit data to the audit.

High risk characteristics have been determined by linking to characteristics held in the core National Diabetes Audit (NDA) 

Last edited: 9 September 2021 11:32 am