Kempegowda Punith, Livesey Alana C, McFarlane-Majeed Laura, Chandan Joht Singh, Smyth Theresa, Stewart Martha, Blackwood Karen, McMahon Michelle, Melapatte Anitha Vijayan, Salahuddin Sofia, Webber Jonathan, Ghosh Sandip
Department of Diabetes, Endocrinology and General Internal Medicine, Heart of England NHS Foundation Trust, Birmingham, UK.
Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom.
BMJ Open Qual. 2018 Mar 14;7(1):e000238. doi: 10.1136/bmjoq-2017-000238. eCollection 2018.
Steroid-induced hyperglycaemia (SIH) is a common adverse effect in patients both with and without diabetes. This project aimed to improve the screening and diagnosis of SIH by improving the knowledge of healthcare professionals who contribute to the management of SIH in hospitalised patients. Monitoring and diagnosis of SIH were measured in areas of high steroid use in our hospital from May 2016 to January 2017. Several interventions were implemented to improve knowledge and screening for SIH including a staff education programme for nurses, healthcare assistants and doctors. The Trust guidelines for SIH management were updated based on feedback from staff. The changes to the guideline included shortening the document from 14 to 4 pages, incorporating a flowchart summarising the management of SIH and publishing the guideline on the Trust intranet. A questionnaire based on the recommendations of the Joint British Diabetes Societies for SIH was used to assess the change in knowledge pre-intervention and post-intervention. Results showed an increase in junior doctors' knowledge of this topic. Although there was an initial improvement in screening for SIH, this returned to near baseline by the end of the study. This study highlights that screening for SIH can be improved by increasing the knowledge of healthcare staff. However, there is a need for ongoing interventions to sustain this change.
类固醇诱导的高血糖症（SIH）是糖尿病患者和非糖尿病患者中常见的不良反应。该项目旨在通过提高参与住院患者SIH管理的医护人员的知识水平，改善SIH的筛查和诊断。2016年5月至2017年1月，在我院类固醇使用量大的区域对SIH进行监测和诊断。实施了多项干预措施以提高对SIH的认识和筛查，包括为护士、医疗助理和医生开展员工教育项目。根据员工反馈更新了信托基金关于SIH管理的指南。指南的变化包括将文件从14页缩短至4页，纳入总结SIH管理的流程图，并在信托基金内联网上发布该指南。基于英国糖尿病协会联合委员会关于SIH的建议设计了一份问卷，用于评估干预前和干预后知识的变化。结果显示实习医生对该主题的知识有所增加。虽然SIH筛查最初有所改善，但到研究结束时又回到了接近基线的水平。这项研究强调，通过增加医护人员的知识可以改善SIH的筛查。然而，需要持续进行干预以维持这种变化。
