Cook Curtiss B, Wilson Rebecca D, Hovan Michael J, Hull Bryan P, Gray Richard J, Apsey Heidi A
Division of Endocrinology and the Division of Preventive, Occupational, and Aerospace Medicine, Mayo Clinic, Scottsdale, Arizona 85259, USA.
J Diabetes Sci Technol. 2009 Nov 1;3(6):1377-87. doi: 10.1177/193229680900300618.
Treating hyperglycemia promotes better outcomes among inpatients. Knowledge deficits about management of inpatient diabetes are prevalent among resident physicians, which may affect the care of a substantial number of these patients.
A computer-based training (CBT) curriculum on inpatient diabetes and hyperglycemia was developed and implemented for use by resident physicians and focuses on several aspects of the management of inpatient diabetes and hyperglycemia: (1) review of importance of inpatient glucose control, (2) overview of institution-specific data, (3) triaging and initial admission actions for diabetes or hyperglycemia, (4) overview of pharmacologic management, (5) insulin-dosing calculations and ordering simulations, (6) review of existing policies and procedures, and (7) discharge planning. The curriculum was first provided as a series of lectures, then formatted and placed on the institutional intranet as a CBT program.
Residents began using the inpatient CBT in September 2008. By August 2009, a total of 29 residents had participated in CBT: 8 in family medicine, 12 in internal medicine, and 9 in general surgery. Most of the 29 residents confirmed that module content met stated objectives, considered the information valuable to their inpatient practices, and believed that the quality of the online modules met expectations. The majority reported that the modules took just the right amount of time to complete (typically 30 min each).
Improvement in inpatient diabetes care requires continuous educational efforts. The CBT format and curriculum content were well accepted by the resident physicians. Ongoing assessment must determine whether resident practice patterns are influenced by such training.
治疗高血糖可使住院患者获得更好的治疗效果。住院医师中普遍存在对住院糖尿病管理的知识欠缺,这可能会影响大量此类患者的护理。
开发并实施了一个关于住院糖尿病和高血糖的计算机辅助培训(CBT)课程,供住院医师使用,该课程侧重于住院糖尿病和高血糖管理的几个方面:(1)回顾住院血糖控制的重要性,(2)概述机构特定数据,(3)糖尿病或高血糖的分诊及入院初期措施,(4)药物治疗概述,(5)胰岛素剂量计算及医嘱模拟,(6)审查现有政策和程序,以及(7)出院计划。该课程最初以系列讲座的形式提供,然后整理并作为CBT项目放在机构内部网上。
住院医师于2008年9月开始使用住院CBT。到2009年8月,共有29名住院医师参加了CBT:8名家庭医学专业、12名内科专业和9名普通外科专业。这29名住院医师中的大多数确认模块内容符合既定目标,认为这些信息对他们的住院实践有价值,并认为在线模块的质量符合预期。大多数人报告说完成这些模块所需时间恰到好处(通常每个模块30分钟)。
改善住院糖尿病护理需要持续的教育努力。CBT形式和课程内容受到住院医师的广泛接受。必须进行持续评估以确定住院医师的实践模式是否受到此类培训的影响。