Atsalos Christine, Payk Marlene, O'Neill Ann, Inglis Sally, Cheung N Wah, Jackson Debra
Faculty of Health, University of Technology Sydney, Ultimo, Australia.
Diabetes and Endocrinology Ambulatory Care Centre, Westmead Hospital, Wentworthville, Australia.
Contemp Nurse. 2019 Dec;55(6):469-485. doi: 10.1080/10376178.2019.1657359. Epub 2019 Sep 4.
The ongoing escalation in the incidence of diabetes is contributing to a growing burden on health services because patients with diabetes as a co-morbidity are now spread throughout the hospital (rather than being located in specific areas). Thus, there is a need for expertise in diabetes care throughout services to ensure optimal care and reduce threats to patient safety. To identify new strategies to maintain optimal care for patients with diabetes while in hospital. Mixed methods underpinned by Appreciative Inquiry. The Diabetes Knowledge Questionnaire Survey (DKQS) ( = 173); focus group interviews with nurses and midwives ( = 40), and individual interviews with recently discharged hospital patients ( = 6). Quantitative data were analysed using descriptive statistics and qualitative data by thematic analysis. Highlight a need to enhance knowledge and confidence of diabetes management among nursing, midwifery, medical and ancillary staff through the introduction of focused education strategies. This, together with improved communication and team work, is required to relieve the burdens on frontline nursing staff and patients caused by delays in prescribing and reviewing insulin requirements and in accessing needed food for people with diabetes. In seeking solutions to the challenges in caring for hospitalised patients with diabetes there is a need to work across the entire hospital workforce and to develop effective and efficient methods for ensuring appropriate skills and knowledge of diabetes management for staff across complex and rapidly changing hospital systems. The introduction and implementation of innovative educational and organisational strategies are needed to assist in meeting the challenges posed by an escalating diabetes healthcare burden. The safety of patients with diabetes can be optimised with the timely availability of appropriate meals and snacks, and enhanced coordination and communication between and within multidisciplinary teams.
糖尿病发病率的持续上升给医疗服务带来了越来越大的负担,因为患有糖尿病合并症的患者现在遍布整个医院(而非集中在特定区域)。因此,整个医疗服务体系都需要糖尿病护理方面的专业知识,以确保提供最佳护理并降低对患者安全的威胁。旨在确定在患者住院期间维持糖尿病患者最佳护理的新策略。采用以欣赏式探询为基础的混合方法。开展了糖尿病知识问卷调查(DKQS)(n = 173);对护士和助产士进行焦点小组访谈(n = 40),并对近期出院的住院患者进行个人访谈(n = 6)。定量数据采用描述性统计分析,定性数据采用主题分析。强调需要通过引入有针对性的教育策略,提高护理、助产、医疗和辅助人员在糖尿病管理方面的知识和信心。这一点,再加上改善沟通与团队协作,对于减轻一线护理人员和患者因胰岛素处方和复查延迟以及糖尿病患者获取所需食物延迟而造成的负担是必要的。在寻求解决照顾住院糖尿病患者所面临挑战的方法时,需要整个医院的工作人员共同努力,并制定有效且高效的方法,以确保在复杂且快速变化的医院系统中,工作人员具备适当的糖尿病管理技能和知识。需要引入和实施创新的教育及组织策略,以帮助应对糖尿病医疗负担不断升级所带来的挑战。通过及时提供合适的膳食和小吃,以及加强多学科团队之间及团队内部的协调与沟通,可以优化糖尿病患者的安全。