Journal of patient safety · 2026
Reducing Insulin Self-Administration Errors in Adults With Diabetes: A Quasi-Experimental Study of a Structured Intervention.
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de Oliveira Hudson C, Campos Juliana F, Silveira Cristiana D, Silva Fernanda F E, de Souza Patrícia S, Araujo Bruna G R, Vianna Carla de A, Jesus Sérgio A de, Barber Rebecca O L B
Аннотация
OBJECTIVE: To evaluate the effectiveness of a structured intervention based on Rapid-Cycle Deliberate Practice (RCDP) in reducing insulin self-administration errors in adults with diabetes.
METHODS: A quasi-experimental single-group pretest-post-test study was conducted in 2 public outpatient clinics in Rio de Janeiro, Brazil, between March 2020 and June 2023. Participants performed insulin self-administration using procedure-specific structured checklists. The intervention consisted of a structured, feedback-driven approach based on RCDP, involving real-time error correction and repeated practice cycles, using a low-fidelity simulation pad. Outcomes included the error rate, participant satisfaction, and self-confidence. Statistical analyses included the McNemar test, a generalized mixed-effects model, and effect size estimation.
RESULTS: A total of 103 participants were included. The error rate of insulin self-administration decreased from 47.2% at baseline to 5.7% after the intervention (P<0.001), representing a substantial reduction in unsafe practices. The intervention demonstrated a large effect size (Cohen d=1.55), indicating a marked improvement in procedural performance. Participants also reported high levels of satisfaction and self-confidence.
CONCLUSIONS: A structured RCDP-based intervention significantly reduced insulin self-administration errors, addressing a critical gap in medication safety in outpatient care. By enabling patients to perform a high-risk procedure more safely, this approach represents a practical and scalable strategy to reduce preventable harm and improve the safety of diabetes self-management.
METHODS: A quasi-experimental single-group pretest-post-test study was conducted in 2 public outpatient clinics in Rio de Janeiro, Brazil, between March 2020 and June 2023. Participants performed insulin self-administration using procedure-specific structured checklists. The intervention consisted of a structured, feedback-driven approach based on RCDP, involving real-time error correction and repeated practice cycles, using a low-fidelity simulation pad. Outcomes included the error rate, participant satisfaction, and self-confidence. Statistical analyses included the McNemar test, a generalized mixed-effects model, and effect size estimation.
RESULTS: A total of 103 participants were included. The error rate of insulin self-administration decreased from 47.2% at baseline to 5.7% after the intervention (P<0.001), representing a substantial reduction in unsafe practices. The intervention demonstrated a large effect size (Cohen d=1.55), indicating a marked improvement in procedural performance. Participants also reported high levels of satisfaction and self-confidence.
CONCLUSIONS: A structured RCDP-based intervention significantly reduced insulin self-administration errors, addressing a critical gap in medication safety in outpatient care. By enabling patients to perform a high-risk procedure more safely, this approach represents a practical and scalable strategy to reduce preventable harm and improve the safety of diabetes self-management.