Due-Christensen Mette, Kaldan Gudrun, Almdal Thomas P, Glindorf Mette, Nielsen Kirsten E, Zoffmann Vibeke
Steno Diabetes Center, Gentofte, Denmark; Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
Steno Diabetes Center, Gentofte, Denmark; Department of Pulmonary and Infectious Diseases, Nordsjællands Hospital, Hilleroed, Denmark.
Patient Educ Couns. 2015 Jul;98(7):890-4. doi: 10.1016/j.pec.2015.03.014. Epub 2015 Mar 23.
To map the usage of out-of-office hours acute telephone counselling (ATC) provided by diabetes specialist nurses (n=18) for diabetes patients to explore potentials for improvement.
A mixed methods study involved mapping of ATC-usage during 6 months and a retrospective audit of frequent users.
Altogether, 3197 calls were registered that were related to 592 individual patients, corresponding to 10% of the population. Proportionally more users suffered from type 1 diabetes (p<0.001). ATC-users' mean HbA1c was 8.8% (73 mmol/mol) compared to 8.1% (65 mmol/mol) for all patients attending the clinic (p<0.001). Hyperglycaemia was the most frequent reason for calling. The use of ATC likely prevented 15 admissions. More than half of the calls came from general nurses based in the community (n=619) and general nurses and nursing assistants based in care homes (n=1018). The majority (75%) of patients called less than five times. However, 8% called 16 times or more accounting for 52% of all calls. A retrospective audit identified them as physically and/or psychologically fragile patients.
Hyperglycaemia was the most frequent reason for calling, and insulin dose adjustment the most frequent advice given.
Frequent users identified need additional support.
梳理糖尿病专科护士（n = 18）为糖尿病患者提供的非工作时间急性电话咨询（ATC）的使用情况，以探索改进潜力。
一项混合方法研究包括梳理6个月期间的ATC使用情况以及对频繁使用者进行回顾性审核。
共记录了3197个电话，涉及592名个体患者，占总人群的10%。1型糖尿病患者的比例相对更高（p<0.001）。ATC使用者的平均糖化血红蛋白（HbA1c）为8.8%（73 mmol/mol），而到诊所就诊的所有患者的平均糖化血红蛋白为8.1%（65 mmol/mol）（p<0.001）。高血糖是最常见的致电原因。ATC的使用可能避免了15次住院。超过一半的电话来自社区的普通护士（n = 619）以及养老院的普通护士和护理助理（n = 1018）。大多数（75%）患者致电次数少于5次。然而，8%的患者致电16次或更多，占所有电话的52%。回顾性审核将他们确定为身体和/或心理脆弱的患者。
高血糖是最常见的致电原因，胰岛素剂量调整是最常给出的建议。
已确定频繁使用者需要额外的支持。
