Rajendran R, Kerry C, Round R-M, Barker S, Scott A, Rayman G
Diabetes Centre, The Ipswich Hospital NHS Trust, Ipswich, UK.
Diabet Med. 2015 Jul;32(7):920-4. doi: 10.1111/dme.12765. Epub 2015 Apr 10.
To evaluate the impact of the Diabetes Inpatient Care and Education project and a comprehensive diabetes care pathway, the Diabetes Inpatient Care and Education Care Pathway, on patient outcomes and on the knowledge and confidence of trainee doctors.
The effect on patient outcomes was evaluated by comparing the National Diabetes Inpatient Audit data before (2012) and after (2013) implementing the Diabetes Inpatient Care and Education project. The impact on trainee doctors was evaluated using the Modified Kirkpatrick model. Just before the project began and again 3 months later, trainee doctors were surveyed to assess their knowledge and confidence in inpatient diabetes care.
Patient harm was found to have been reduced significantly when National Diabetes Inpatient Audit data for 2012 and 2013 were compared. Severe hypoglycaemia decreased from 15.4 to 9.7%, medication errors from 56.9 to 21.1% and insulin errors from 31 to 7%. Across the 96 trainee doctors surveyed, the mean (sd) knowledge and confidence scores increased significantly (P < 0.001 for both) from 57.1 (16.8) and 61.8 (14.9) to 68.4 (13.3) and 74.3 (11.7), respectively.
The Diabetes Inpatient Care and Education project and the Diabetes Inpatient Care and Education Care Pathway improved patient outcomes and the knowledge and confidence of trainee doctors in this hospital. The impact of a similar project in other hospitals needs to be evaluated.
评估糖尿病住院护理与教育项目以及综合糖尿病护理路径(糖尿病住院护理与教育护理路径)对患者预后以及实习医生知识水平和信心的影响。
通过比较实施糖尿病住院护理与教育项目之前(2012年)和之后(2013年)的国家糖尿病住院患者审计数据,评估对患者预后的影响。使用改良的柯克帕特里克模型评估对实习医生的影响。在项目开始前以及3个月后,对实习医生进行调查,以评估他们在住院糖尿病护理方面的知识和信心。
比较2012年和2013年的国家糖尿病住院患者审计数据时发现,患者伤害显著减少。严重低血糖从15.4%降至9.7%,用药错误从56.9%降至21.1%,胰岛素错误从31%降至7%。在接受调查的96名实习医生中,平均(标准差)知识和信心得分分别从57.1(16.8)和61.8(14.9)显著提高(两者P均<0.001)至68.4(13.3)和74.3(11.7)。
糖尿病住院护理与教育项目以及糖尿病住院护理与教育护理路径改善了该医院患者的预后以及实习医生的知识水平和信心。其他医院类似项目的影响有待评估。