Ann Pediatr Endocrinol Metab.  2017 Sep;22(3):170-175. 10.6065/apem.2017.22.3.170.

Impact of targeted education on managing warning and error signals by children and adolescents with type 1 diabetes using the Accu-Chek Combo Insulin Pump System

• Deeb A
• Qahtani NA
• Ali AA
• Akle M

• KMID: 2396136
• DOI: http://doi.org/10.6065/apem.2017.22.3.170

Abstract

PURPOSE
Insulin pumps are widely used in diabetes. They are equipped with safety alarms to alert users. Pump manuals contain alarm codes and how to troubleshoot them. However, these manuals are lengthy and difficult to use, particularly in emergencies. We aim to assess the impact of targeted education on warnings and errors in improving competency to troubleshoot the alarms.
METHODS
Twenty-one patients, with a median age of 13, were recruited over a 5-month period. Each patient had 2 study visits. The frequencies and types of alarms were recorded, and patients were given a summary sheet that outlined common alarms encountered and troubleshooting tips. In visit 2, the frequencies and types of alarms were compared to those of visit 1. The patients were asked to fill a questionnaire and to rate the education session given in visit 1, their level of competency in decrypting alarm codes, and their promptness in responding to alarms.
RESULTS
Low cartridge (W1), low battery (W2), and bolus cancelled (W8) were the commonest warnings. The most noted errors were occlusion (E4), power interruption (E8), empty battery (E2), set not primed (E11), and cartridge empty (E1). The numbers of warning and error signals markedly decreased after targeted education (P < 0.05). The ability in decrypting warning signals significantly improved (P=0.02), and the frequency of response to pump alarms significantly increased (P=0.001).
CONCLUSION
Certain warnings and errors are more common than others in insulin pumps. Targeted education is useful in improving competency and response of patients in managing pump alarms.

Keyword

Type 1 diabetes mellitus; Clinical alarms; Medical errors; Warnings; Insulin infusion systems

MeSH Terms

Adolescent*
Child*
Clinical Alarms
Diabetes Mellitus, Type 1
Education*
Emergencies
Humans
Insulin Infusion Systems
Insulin*
Medical Errors
Insulin

Figure

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  Fig. 1. (A) Total warnings encountered throughout the study per frequency of occurrence. W1, low cartridge; W8, bolus cancelled; W2, low battery. (B) Total errors encountered by patients in terms of frequency of occurrence. E4, occlusion; E8, power interruption; E2, empty battery; E11, set not primed; E1, empty cartridge.

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  Fig. 2. (A) Change of warnings frequency between visit 1 and visit 2 (P<0.001). (B) Changes of error frequency between visit 1 and visit 2 (P=0.04). W1, low cartridge; W8, bolus cancelled; W2, low battery; E4, occlusion; E8, power interruption; E2, empty battery; E11, set not primed; E1, empty cartridge.

• 

  Fig. 3. Patients’ subjective assessment of improvement in decrypting warning and error signals (Q1) and frequency of response to warnings and errors (Q2). a, visit 1; b, visit 2.

Reference

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