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Q Bulletin, Volume 1, No. 32 (Supplement 1), Jan - Dec 202412th National QA Convention, 8 %u2013 10 October 2024QLL-121Improving the Management of Poorly Controlled Diabetic Patients on Insulin in PKDKuala PilahSiti Mariam S1, Nur Nadiah Z1, Nur Fariha AR1, Norainaa AR1, Mas Anida M1, Imanul Hassan AS1,Marhani A2, Nur Diyana AS2, Siti Noor Faezah MS2, Sharon C3, Yuet Yin S3, Imbraida MI3,Norkhairunnisak I3, Noraida AR41Farmasi Pesakit Luar, Klinik Kesihatan Senaling, Negeri Sembilan2Farmasi Pesakit Luar, Klinik Kesihatan Terachi, Negeri Sembilan3Farmasi Pesakit Luar, Klinik Kesihatan Johol, Negeri Sembilan4 Jabatan Pesakit Luar, Klinik Kesihatan Juasseh, Negeri SembilanSELECTION OF OPPORTUNITIES FOR IMPROVEMENT:There are only 30% of diabetes patients on insulin therapy with HbA1c <10% at PKD Kuala Pilah in2019. Therefore, specific strategies are crucial to improve diabetes management in patients with ongoinginsulin therapy.KEY MEASURES FOR IMPROVEMENT:The standard used in this study was 100% of diabetes patients on insulin therapy achieved HbA1c <10%.The indicator was agreed upon by consensus with the Family Medicine Specialist (FMS) of PKD KualaPilah.PROCESS OF GATHERING INFORMATION:The cross-sectional study was conducted using universal sampling in eight primary clinics in PKD KualaPilah. Validated questionnaires were given out to patients while data collection form was used to collectdata from medical reports.ANALYSIS AND INTERPRETATION:Pre-remedial phase showed that only 30% of diabetic patients on insulin therapy achieved HbA1c <10%.The contributing factors that lead to poorly controlled of diabetic patients on insulin are, lowempowerment of patient to self-monitor their blood glucose at home (74%), poor utilisation of glucometerfor insulin self-dose adjustment (73%), lack of disease awareness (65%) and poor insulin injectiontechnique (47%).STRATEGIES FOR CHANGE:With the involvement of doctors and diabetic educators, specific referral criteria were developed in theclinic for diabetic patients with HbA1c>10%. A structured diabetic health education was also created toeducate targeted diabetic patients. We organised %u201cDiabetic camp%u201d to focus on self-monitoring of bloodglucose, insulin self-dose adjustment and insulin technique assessment.EFFECT OF CHANGE:The percentage of diabetic patients on insulin with HbA1c <10% was increased from 30% to 85% inCycle 1 and from 85% to 89% in Cycle 2. Achievable Benefit Not Achieved (ABNA) was reduced from70% to 15% in Cycle 1 and from 15% to 11% in Cycle 2.THE NEXT STEP:We aim to expand this project to other clinics under PKD Kuala Pilah. We also plan to develop aninnovation called DM-ME to enhance continuity of diabetic health education for patients.213 | Page