2.8.6. If hypoglycaemia occurs treat the hypo (as per management of RCHT hypoglycaemia guideline), reduce the dose of insulin and ensure snacks are being taken.
2.8.7. If breastfeeding is suddenly stopped, the dose of insulin will need to be increased.
At first contact with the Diabetes Specialist Midwife the RCHT Joint Diabetes Antenatal Clinic Record of Pregnancy care booklet will be commenced.
| Information Category | Detail of process and methodology for monitoring compliance |
|---|---|
| Element to be monitored | The audit will take into account record keeping by obstetric, anaesthetic and paediatric doctors, midwives, nurse, students and maternity support workers. The results will be inputted onto an excel spread sheet. The audit will be registered with the Trust’s audit department. |
| Lead | Diabetes Specialist Midwife. |
| Tool | Did the woman have initial contact with the diabetes specialist midwife? Was the woman seen in the Joint Obstetric/Endocrinologist Diabetic ANC? If required was a referral made to a Dietician and/or a Diabetes Specialist Nurse? |
| Frequency | 10 sets of all health records of women who have delivered with a diagnosis of pre-existing diabetes will be audited over the lifetime of the guideline. |
| Reporting arrangements | A formal report of the results will be received annually at the maternity Patient Safety Meeting and clinical audit forum, as per the audit plan. During the process of the audit if compliance is below 75% or other deficiencies identified, this will be highlighted at the next maternity Patient Safety Meeting and clinical audit forum and an action plan agreed. |
| Acting on recommendations and Lead(s) | Any deficiencies identified on the annual report will be discussed at the maternity Patient Safety Meeting and clinical audit forum and an action plan developed. Action leads will be identified and a time frame for the action to be completed by. The action plan will be monitored by the maternity Patient Safety Meeting and clinical audit forum until all actions complete. |