Enhancing insulin administration safety in inpatient care: findings from a root cause analysis and continuous improvement intervention

Objectives This study aimed to quantify the incidence of insulin-related medication errors among hospitalized patients, identify underlying causal factors through root cause analysis (RCA), and evaluate the effectiveness of continuous improvement strategies in mitigating nursing adverse events associated with insulin administration. Methods A 25-week prospective quasi-experimental clinical study was conducted at a tertiary care hospital in Shanxi Province. Patients were assigned to either a control group receiving standard management or an intervention group managed under a continuous improvement protocol. Group assignment was determined by the chronological order of hospital admission, with the initiation of the intervention serving as the demarcation point. Primary outcomes included the frequency of insulin-related medication errors, adherence to established safety check protocols, and changes in nursing staff safety practices and psychological resilience. Results RCA identified key contributing factors to insulin-related medication errors, including the absence of a comprehensive management framework, inadequate staff training, limited pharmacological knowledge among nursing personnel, and insufficient diversity in patient education strategies. A total of 123 patients were enrolled, with 65 in the intervention group and 58 in the control group. The intervention group demonstrated a significantly lower incidence of insulin-related medication errors compared to the control group (p<0.001). Additionally, patients in the intervention group exhibited improved glycemic control, and nursing staff showed enhanced adherence to safety protocols and greater psychological resilience (p<0.001). Conclusions Conducting an RCA enabled the identification of critical factors contributing to insulin-related medication errors and informed the development of strategies to reduce these risks. The results underscore the importance of implementing continuous improvement approaches to enhance patient safety. These findings provide actionable recommendations for improving nursing practices and healthcare management to optimize safety outcomes.