Reducing Insulin Self-Administration Errors in Adults With Diabetes: A Quasi-Experimental Study of a Structured Intervention
Hudson C. de Oliveira, Juliana F. Campos, Cristiana D. Silveira, Fernanda F. e Silva, Patrícia S. de Souza, Bruna G. R. Araujo, Carla de A. Vianna, Sérgio A. de Jesus, Rebecca O. L. B. BarberObjective:
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 (
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.