2026/06/03 by Nicholas A. Levy, Kariem El‐Boghdadly, Ketan Dhatariya · 1 voice
Health Professions · Medicine · #Patient Safety and Medication Errors #Hyperglycemia and glycemic control in critically ill and hospitalized patients #Safe Handling of Antineoplastic Drugs
paper · doi:10.1111/anae.70260
openalex publication_date 2026/06/03 · openalex created_date 2026/06/04 · openalex updated_date 2026/07/22
We agree with Whitaker [1] on the importance of drug safety. We are aware that insulin remains one of the highest risk medicines used in hospitals, for which drug errors have been reported frequently. Mitigation strategies include: writing ‘units’ in full; using the full, correct name of the insulin (ideally the brand name); and always using dedicated insulin syringes [2]. We agree with the suggestion by Whitaker that ready-to-administer prefilled syringes should be used where possible and this likely applies to most medicine preparations [3]. Catastrophic drug errors have been reported for several medicines that are prepared at the bedside [4]. Indeed, one of our key recommendations is that multidisciplinary leadership, including pharmacy and diabetes specialists, should be involved in the governance of people with diabetes having surgery. One of the areas in which they may wish to collaborate is with medicine safety leads locally to ensure the implementation of prefilled syringes for all medicines. We did acknowledge that some institutions already use prefilled soluble human insulin syringes and that these should be used according to local policies [5]. However, prefilled syringes of soluble insulin in saline for intravenous use are unlicensed medicines. They are manufactured under a special manufacturing authorisation licence and are not, therefore, readily available [5]. The Delphi process used in the writing of our consensus document started with several statements being considered and, through discussions and debate, this recommendation, while of utmost importance, did not reach a high enough priority to be included in the final list. We do, however, support the perspective from Whitaker and fully endorse the initiatives from the National Patient Safety Agency and Association of Anaesthetists to improve the safer handling of medicines and encourage diabetes leads to support this potential systemic safety initiative.