Department of Endocrinology, Piedmont HealthCare, Statesville, NC, USA (Dr Meade, Ms Rushton)
School of Pharmacy, Wingate University, Wingate, NC, USA (Dr Meade)
Diabetes Educ. 2013 Nov-Dec;39(6):841-7. doi: 10.1177/0145721713504628. Epub 2013 Sep 17.
The purpose of the study was to assess insulin pump use and provide ongoing education.
A quality improvement project using a pump assessment questionnaire was implemented at an endocrinology office in the southeastern United States. The questionnaire was designed to evaluate all aspects of insulin pump therapy, including pump operations, infusion set failure, management of acute complications, and usage of advanced device features. Eighty-nine patients (80% with type 1 diabetes and 20% with type 2 diabetes) completed the questionnaire at the endocrinology practice. A certified diabetes educator reviewed the questions with each patient, identifying deficiencies and training opportunities.
The most common areas of deficiency identified after implementation of the assessment form included the following: expired or no basal insulin prescription in the event of pump failure or removal, no mupirocin (Bactroban®, GlaxoSmithKline, Research Triangle Park, North Carolina) prescription for suspected site infections, lack of insulin syringe if pump stopped working, failure to check urine ketones, no antiemetic prescription for sick day intervention, using manual bolus instead of bolus calculator, and lack of in-date glucagon kit.
Use of a pump assessment questionnaire allows for focused discussion concerning patient behaviors related to pump operations, troubleshooting, and self-management. Incorporating use of a pump assessment questionnaire into routine practice may result in improved patient education and avoidance of adverse events specific to insulin pump therapy.
本研究旨在评估胰岛素泵的使用情况并提供持续教育。
在美国东南部的内分泌科诊所实施了一项使用胰岛素泵评估问卷的质量改进项目。该问卷旨在评估胰岛素泵治疗的各个方面，包括泵操作、输注套件故障、急性并发症管理以及先进设备功能的使用。89 名患者（80%为 1 型糖尿病患者，20%为 2 型糖尿病患者）在内分泌科完成了问卷。一位认证的糖尿病教育者与每位患者一起审查了这些问题，确定了不足之处和培训机会。
实施评估表后，确定的最常见的不足之处包括以下几点：在泵故障或移除时，无过期或无基础胰岛素处方；对于疑似部位感染，无莫匹罗星（Bactroban®，葛兰素史克，美国北卡罗来纳州三角研究园）处方；如果泵停止工作，无胰岛素注射器；未检查尿酮体；无恶心呕吐治疗药物处方；使用手动推注而不是推注计算器；以及无在效期的胰高血糖素试剂盒。
使用胰岛素泵评估问卷可以针对与泵操作、故障排除和自我管理相关的患者行为进行重点讨论。将胰岛素泵评估问卷纳入常规实践可能会改善患者教育并避免与胰岛素泵治疗相关的不良事件。
