Insulin-related knowledge among health care professionals in internal medicine

Background. Inpatient diabetes treatment has become more complicated recently with the introduction of new insulin formulations and a new emphasis on tight blood glucose control. Insufficient knowledge of insulin contributes to errors in its use that may cause adverse patient outcomes. Methods. Seventy-three faculty members, 113 residents, and 191 nurses from four hospitals completed a 20-item multiple-choice questionnaire that assessed knowledge of insulin nomenclature and characteristics and inpatient insulin use. Results. The percentage of knowledge-based questions answered correctly was low: 51% for faculty, 59% for house staff, and 47% for nurses. Scores on questions testing knowledge of insulin nomenclature and characteristics were similar to scores on those addressing inpatient insulin use among faculty and house staff; however, nurses scored better on the former than the latter (60 vs. 34%, P < 0.0001). Knowledge of names and characteristics of newer insulins, such as glargine, aspart, and lispro, was poor compared to knowledge of older insulin formulations among all professional categories (46 vs. 78%, P < 0.0001). House staff performed better than faculty (62 vs. 49%, P = 0.09) and nurses (62 vs. 34%, P < 0.0001) on questions regarding inpatient diabetes management, but all groups frequently missed questions involving sliding-scale insulin use and dosing insulin in patients with type 1 diabetes. Conclusion. Educational programs teaching insulin characteristics and inpatient diabetes management are needed for all categories of health care providers. Increased knowledge may help to improve patient safety in the hospital.