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Publications

BBI Healthcare HypoBoxTM initiative

Download: Success Story Summary, Jan 2012 (PDF 215.7KB) / Award Entry Form (PDF 189.6KB)

The challenge

Approximately one in four people with diabetes suffers a hypoglycaemic event during a hospital stay. This may not only increase length of stay and associated costs, but is also associated with increased mortality. Hypoglycaemia can be treated inconsistently across the country, within trusts and even between the wards of an individual hospital. Symptoms of hypoglycaemia may not be recognised until they became severe. BBI Healthcare wanted to work with NHS trusts to improve and reduce the number of hypoglycaemic episodes experienced by inpatients with diabetes. In January 2008 they launched an initiative to deliver a “one-stop” hypoglycaemia management first aid box to customers.

The aim

The main objective of the initiative was to improve inpatient management of hypoglycaemia by educating staff and placing HypoBoxesTM on hospital wards. Crucially, they wanted to encourage an audit of initial implementation, enabling the project to be measured, monitored and reviewed in light of audit results.

What did they do?

The HypoBoxTM was developed by BBI Healthcare and contains measured doses of fast-acting carbohydrate for mild to moderate hypoglycaemia, along with a “space” for the Glucagon Hypokit to be stored. The HypoBoxTM also contains a laminated treatment pathway to remind ward staff of the signs and symptoms of hypoglycaemia along with the appropriate treatment to be delivered. As part of the initiative BBI Healthcare developed training materials which can be adapted to meet local requirements across multidisciplinary settings. This developed into the Hypoglycaemia Management Package. Patient support and education materials include a hypoglycaemia DVD, hypoglycaemia education sheets and “I have Diabetes Cards”.

Account managers from BBI Healthcare work with diabetes specialist nurses (DSNs) and hospital pharmacists in hospitals or trusts to implement the Hypoglycaemia Management Package. They establish the level of knowledge among staff and factor in local guidelines and requirements for education, training and implementation so they can adapt the tools to local needs. All training is reinforced by the inclusion of treatment pathways contained in the HypoBoxesTM, which can also be supported by treatment pathway posters placed on wards.

What happened?

Staff uptake, use and understanding of the HypoBoxTM is measured through audit, supported by patient record books from the HypoBoxTM. This allows evaluation of the initiative and shows if update training is needed. Overall, the HypoBoxTM Hypoglycaemia Management package has been implemented across over 50 hospital trusts in the UK. There has also been significant success within primary care and care homes. NHS Bury was the first PCT/Community Diabetes Service to implement the HypoBoxTM initiative with around 140 boxes being rolled out to district nursing teams. 

Key outcomes

  • The HypoBoxTM has been implemented in 50 trusts across the UK
  • HypoBoxesTM being rolled out in community settings
  • Hospitals implementing the initiative have won high profile awards
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