{
  "abstract": "Background and Importance Insulin is among the drugs most frequently implicated in medication errors across Europe. As a high-alert drug, it may cause serious adverse events, especially in hospitalised patients, since poor glycaemic control is associated with a worse prognosis, particularly in perioperative and acute care settings. This highlights the need for safer insulin management. In our institution, recurrent insulin-related incidents were found during pharmaceutical review. The multidisciplinary diabetology team reported similar findings across prescribing, administration, and dosage errors, highlighting the need for a structured evaluation.Aim and objectives Our objectives were to identify and classify the most frequent and clinically relevant insulin prescribing errors to develop safer prescribing protocols, and to implement a training programme to strengthen pharmacists’ knowledge of insulin.Material and methods Over four weeks (February–March 2025), insulin prescriptions from adult medical wards (excluding intensive care and paediatrics) were reviewed in the electronic prescribing software (DxCare). Each day, 10–15 random prescriptions were analysed by a clinical pharmacist. Errors were classified into three categories: confusions between rapid-acting insulins, therapeutic redundancies, and dose/timing errors.Results A total of 275 prescriptions were analysed, of which 51 contained at least one error (18.5%). Confusions between rapid-acting insulins accounted for 24 cases (47%), mainly between insulin aspart and fast-acting insulin aspart. In some cases, prescription misunderstanding led to inappropriate suspension of rapid insulin, with risk of poor glycaemic control. Therapeutic redundancies with basal insulins (6 cases, 12%) included concomitant glargine use or combinations with other long-acting insulins. A frequent example was co-prescription of infusion via syringe pump with basal insulin, increasing hypoglycaemia risk. Other errors in dose/timing (21 cases, 41%) included omissions and wrong schedules. The most frequent error was inappropriate use of corrective insulin alone, prescribed routinely or for longer than recommended. Two standardised protocols were developed: ‘meal insulin’ and ‘correction insulin’ with a strict 48-hour limit. A pharmacist training programme was introduced, including reminders on insulin types, dose adjustment and interactive case-based learning.Conclusion and Relevance One in five insulin prescriptions contained errors, mainly rapid-acting insulin confusions. Error classification supported standardised protocols and targeted pharmacist training, offering a transferable strategy to reduce risks, improve prescribing practices, and optimise patient safety in hospitals.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "Nancy University Hospital, Pharmacy, Nancy, France"
      ],
      "name": "A Bouvet"
    },
    {
      "affiliations": [
        "Nancy University Hospital, Pharmacy, Nancy, France"
      ],
      "name": "E Boschetti"
    },
    {
      "affiliations": [
        "Nancy University Hospital, Endocrinology, Nancy, France"
      ],
      "name": "E Berchoux"
    },
    {
      "affiliations": [
        "Nancy University Hospital, Endocrinology, Nancy, France"
      ],
      "name": "C Creton"
    },
    {
      "affiliations": [
        "Nancy University Hospital, Endocrinology, Nancy, France"
      ],
      "name": "B Guerci"
    },
    {
      "affiliations": [
        "Nancy University Hospital, Pharmacy, Nancy, France"
      ],
      "name": "B Demoré"
    }
  ],
  "title": "5PSQ-080 Improving insulin safety in a university hospital: prescribing error analysis and standardisation of use",
  "uid": "5c27c9c9-4e08-5db3-b364-c9a72c30e7d3"
}