6738 ‘An audit on compliance with BSPED and local guidelines for investigations in newly diagnosed children with T1DM at NNUH

Objectives The aim was to assess the compliance of the Paediatric team with the BSPED and local practice guidelines about the initiation of investigations for newly diagnosed children and young people with T1DM, regardless of their condition at diagnosis and location of care. Methods This was a retrospective study of all children and young people diagnosed with Type 1 diabetes who presented over a period of three years, from March 2020 to March 2023. The ICT team helped us to obtain a spreadsheet with all blood investigations performed during their admission at diagnosis. We manually reviewed the data to evaluate their location at presentation when initial investigations were initiated. Results During the study period, 97 children were diagnosed with T1DM. 64/97(66%) patients were presented to the Children Assessment Unit (CAU), 12/97(13%) to the Children's Emergency Department (ChED), and the majority of the remainder presented to the Children's Ward. 47 patients (49%) of all children and young people diagnosed with T1DM had all (100%) investigations sent prior to discharge, and 8 patients (7%) were discharged with less than half of the required blood tests being sent. The blood tests most frequently missed were: the bone profile, GAD antibodies, pancreatic islet cell antibodies, thyroid antibodies, and HbA1c. When broken down by location at presentation, children admitted to CAU were more likely to have a more complete set of blood tests performed than those admitted directly to the Children's Ward. Conclusion The awareness of the BSPED guidelines and local protocol amongst doctors and nursing staff should be maintained in order to continue providing high-quality care for our patients. It was agreed to arrange a diabetes session as part of the induction program for all staff working within the paediatric department and ChED to ensure all trainees are aware of required investigations for newly diagnosed children and young people with T1DM in order to improve further patient care. References National Children's and Young People's Diabetes Network, East of England British Society for Paediatric Diabetes and Endocrinology.