Exploring the impact of a feedback intervention on insulin prescribing behaviour

Published Date: 26th June 2019

Publication Authors: Bennett N, Cardwell J, Furlong NJ, Hart A, Lloyd M, Michaels S

Aims

The aim of this research was to explore the impact of feedback on insulin prescribing behaviour.

Method(s)

Doctors that had received feedback on their insulin prescribing were invited to participate in the study. Semi-structured interviews were used to explore the potential impact of feedback on their insulin prescribing. Interviews were digitally recorded, transcribed verbatim, checked for accuracy and analysed themat-ically using a framework approach mapped to the COM-B model (Capability, Opportunity, Motivation, Behaviour). NHS research approval was obtained (IRAS248203).

Result(s)

Ten doctors were interviewed. Feedback was reported as essential to support development of prescribing competencies, with feedback welcomed, valued and considered feasible. The intervention was reported to provide an opportunity to ask questions and consolidate knowledge, raise awareness of insulin errors and their causation, and other professionals' roles within the team. Several doctors reported an increased confidence in their insulin prescribing and willingness to make insulin prescribing decisions. Avoiding negative feedback was described as a motivating factor on their prescribing behaviour, while doctors consistently described critically ReFLeCTing both on and in action to guide and support their insulin prescribing. Doctors agreed that feedback could reduce both technical and clinical prescribing errors with insulin. Doctors also described a more mindful approach to prescribing with greater information and feedback seeking behaviour reported, and enhanced team-working with pharmacists and specialist nurses to inform their prescribing.

Conclusion(s)

Feedback has potential to positively influence insulin prescribing behaviour. However, while feedback could be catalysing change, the influencing factors are complex, providing further avenues of enquiry to support prescribing education and safe prescribing outcomes.

Lloyd, M; Hart, A; Bennett, N; Michaels, S; Cardwell, J; Furlong, N. (2019). Exploring the impact of a feedback intervention on insulin prescribing behaviour: A qualitative study . Diabetic Medicine. 36 (S1), 112

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