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Adult Subcutaneous Insulin Prescribing Chart

What is it?

adult subcutaneous insulin prescribing chart
Download the chart

The chart combines subcutaneous insulin prescription and administration with blood glucose, ketone monitoring and glycaemic management guidelines.

It is designed to minimise delays in management decisions and provide clinicians with clear guidelines for:

  • Insulin prescription 
  • Insulin administration
  • Hypoglycaemic and hyperglycaemic management
  • Safe supplemental insulin use

How do I get it?

To order the please contact FujiXerox and quote NH606615. The cost is $7.98 per pack of 50 (without carbon copy).

When should you use it?

The chart is intended for use in acute adult inpatient areas.

How do you use it?

Download these resources to help you:

NSW Health staff can watch this video via HealthShare.

Why do we need it?

  • Insulin errors are one of the most frequent forms of prescription errors in hospitals. The aim of standardising a subcutaneous insulin chart is to minimise these errors.
  • A standardised chart supports less experienced front line clinicians through the provision of guidelines and advice as close to the point of care as possible.
  • The inclusion of daily blood glucose and ketone monitoring results in parallel to the prescribing chart, allows staff to refer to recent readings more easily when prescribing and administering insulin doses. Doses supplied by telephone order, supplemental doses and one-off orders are all recordable in this single document.

How will it be implemented?

A comprehensive training and education package is available to allow hospital staff to tailor an implementation plan specific for their LHD. This includes:

Who developed it?

The chart was developed by the ACI Endocrine Network following an extensive review of charts across the state and nationally. It involved widespread input from rural and metropolitan clinicians.

The chart has been successfully piloted and refined following feedback from key staff across the state.

What about local policies?

The guidelines do not take the place of local policies, or override the treatment plans of individual patients. They may be of use in areas where local policies do not exist or are difficult to access by front line or after hours staff.

How will it be evaluated?

Evaluation and audit will take place across NSW hospitals using the chart.

Evaluation will include the review of IIMs data, looking for incidence and trends relating to subcutaneous insulin prescription and administration, and seeking feedback from users over time.

Subcutaneous Insulin Prescribing Chart Audit Form for a Single Day

Subcutaneous Subcutaneous Insulin Prescribing Chart Audit Form for an Episode

Subcutaneous Insulin Prescribing Chart Episode Audit Summary

Subcutaneous Insulin Prescribing Chart for a Single Day Audit Summary

Who do I contact for more information?

Rebecca DonovanNetwork Manager- Endocrine
Agency for Clinical Innovation
Phone: +61 2 9464 4626

Melissa TinsleyImplementation Project Officer
Agency for Clinical Innovation
Phone: +61 2 9464 4653

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