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National Diabetes Inpatient Audit (NaDIA) - 2019Audit, Open data
- Publication Date:
- 13 Nov 2020
- Geographic Coverage:
- England, Wales
- Geographical Granularity:
- Country, NHS Trusts, Hospital Trusts
- Date Range:
- 23 Sep 2019 to 27 Sep 2019
The National Diabetes Inpatient Audit (NaDIA) measures the quality of diabetes care provided to people with diabetes while they are admitted to hospital whatever the cause, and aims to support quality improvement.
Data is collected and submitted by hospital staff in England.
Wales did not participate in NaDIA 2019. Following a change in legal basis in England to a Direction from NHS England for NHS Digital to process data, the Welsh Assembly government have been pursuing a request as a legal basis, but this was not completed in time for Welsh hospitals to participate.
The NaDIA audit is part of the National Diabetes Audit (NDA) portfolio within the National Clinical Audit and Patient Outcomes Programme (NCAPOP), commissioned by the Healthcare Quality Improvement Partnership (HQIP).
The audit sets out to measure the quality of diabetes care provided to people with diabetes while they are admitted to hospital, by answering the following questions:
- Did diabetes management minimise the risk of avoidable complications?
- Did harm result from the inpatient stay?
- Was patient experience of the inpatient stay favourable?
- Has the quality of care and patient feedback changed since NaDIA 2010, 2011, 2012, 2013, 2015, 2016 and 2017?
Version 1.1 release notes:
The NaDIA 2019 Full Report (PowerPoint and pdf versions) has been updated to remove references to the NaDIA 2019 deep-dive reports. A decision was taken not to produce deep-dive reports for NaDIA 2019 due to delays in finalising the content of the main report and the additional resources these delays incurred. A minor update to the Local reports table on Slide 9 has also been made, reflecting that two reports have been consolidated into one.
Due to compatibility issues with the slicer selection method in older versions of Excel, an alternative version of the main Hospital Level Analysis report has been uploaded: NaDIA 2019 - Hospital Level Analysis 2010-19 (Radio buttons) v1.0.xlsm. This version uses radio buttons to select the NaDIA site, and should be compatible with Excel 2010 and earlier. The original version of the Hospital Level Analysis using the slicer method has also been retained: NaDIA 2019 - Hospital Level Analysis 2010-19 v1.0.xlsm.
Addendum: An error in a mapping table caused a service to view incorrect data. This was rectified and the new file - 'Hospital Level Analysis 2010-19 (Radio buttons) v1.1.xlsm', was published. Only one service was affected by this issue.
NaDIA 2019 found that inpatient diabetes teams have:
- Delivered more personal care to inpatients with diabetes – 75 per cent of those surveyed in 2019 were seen by the diabetes team where appropriate compared to only 54 per cent in 2010.
- Reduced the proportion of inpatient drug charts found to contain medication errors by 15 percentage points since 2010 (from 45 to 30 per cent).
- Reduced severe hypoglycaemic episodes from 12 per cent of inpatients during the last 7 days of their hospital stay in 2010 to 7 per cent in 2019.
- Reduced the need for injectable rescue treatment for severe hypoglycaemia – from 2.4 per cent of inpatients during the last 7 days of their hospital stay in 2010 to 1.4 per cent in 2019.
- Reduced patients developing foot ulcers at any point during their hospital stay – from 2.2 per cent of inpatients audited in 2010 to 1.1 per cent in 2019.
However, on the day of the audit in 2019, NaDIA found high levels of:
- Medication errors – almost 1 in 3 of the inpatient drug charts surveyed had at least one medication error.
- Insulin errors – two fifths of inpatient drug charts for insulin-treated inpatients had one or more insulin error.
- Hospital-acquired diabetic ketoacidosis (DKA): on the day of the audit, 3.6 per cent of inpatients with type 1 diabetes had developed in-hospital DKA at any point during their hospital stay.
- Capillary blood glucose (CBG) levels not being recorded at all recommended stages of the perioperative pathway.