Drincic Andjela, Pfeffer Elisabeth, Luo Jiangtao, Goldner Whitney S
University of Nebraska Medical Center, Department of Internal Medicine, Division of Diabetes, Endocrinology and Metabolism, United States.
Director, Diabetes & Bariatric Services, The Nebraska Medical Center, 984100 Nebraska Medical Center, Omaha, NE 68198-4100, United States.
J Clin Transl Endocrinol. 2017 Apr 8;8:29-34. doi: 10.1016/j.jcte.2017.03.003. eCollection 2017 Jun.
Patients with diabetes have higher readmission rates than those without diabetes, yet limited data on efforts to reduce their readmissions are available. We describe a novel model of inpatient diabetes care, expanding the role of diabetes educators to include case management, and establishment of a Diabetes Resource Nurse program, aimed at increasing the knowledge of staff nurses, and evaluate the impact of this program on readmission rates.
We performed retrospective analysis of 30-day readmission rates of patients with diabetes before (July 2010-December 2011), and after (January 2012-June 2013) starting the implementation of this tiered inpatient diabetes care delivery model.
We analyzed 34,472 discharged patient records from the 18-month pre-intervention period, and 32,046 records from the 18-month post-intervention period. The overall 30-day readmission rate for patients with diabetes decreased significantly from 20.1% (pre) to 17.6% (post) intervention ( < 0.0001). Patients seen by diabetes educators had the lowest 30-day readmission rates (∼15% during the whole study), a rate approaching the overall hospital readmission rates in those without diabetes in our institution.
The Diabetes Resource Nurse program is effective in decreasing readmission rates. Patients seen by the diabetes educators have the lowest rates of readmission.
糖尿病患者的再入院率高于非糖尿病患者，但关于降低其再入院率的努力的数据有限。我们描述了一种新型的住院糖尿病护理模式，扩大糖尿病教育者的角色以纳入病例管理，并建立了糖尿病资源护士项目，旨在提高注册护士的知识水平，并评估该项目对再入院率的影响。
我们对实施这种分层住院糖尿病护理模式之前（2010年7月至2011年12月）和之后（2012年1月至2013年6月）糖尿病患者的30天再入院率进行了回顾性分析。
我们分析了干预前18个月的34472份出院患者记录，以及干预后18个月的32046份记录。糖尿病患者的总体30天再入院率从干预前的20.1%显著降至干预后的17.6%（P<0.0001）。由糖尿病教育者诊治的患者30天再入院率最低（在整个研究期间约为15%），这一比率接近我们机构中非糖尿病患者的总体医院再入院率。
糖尿病资源护士项目在降低再入院率方面是有效的。由糖尿病教育者诊治的患者再入院率最低。
