Division of Endocrinology & Metabolism, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Division of Endocrinology & Metabolism, Department of Medicine, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada.
Can J Diabetes. 2021 Aug;45(6):566-570. doi: 10.1016/j.jcjd.2020.10.016. Epub 2020 Nov 1.
In this study, we evaluated the feasibility of a nurse practitioner-led outpatient clinic (NPC) to facilitate the safe transition of patients with diabetes receiving insulin therapy between hospital and the community.
An NPC was set up to manage patients who had diabetes education in hospital and who were discharged on insulin. In addition to patient demographics and admission diagnosis, days seen postdischarge, duration of follow up, diabetes interventions and discharge care plan were recorded. For quality improvement, patients were asked to complete a questionnaire at the time of discharge from the NPC.
Within a 12-month period, 71 patients with diabetes attended the NPC 3 to 21 days after discharge and they were followed for 1 to 98 days. Thirteen patients required management of hypoglycemia and 56 patients had adjustment of medications to basal/prandial insulin or switched to oral antihyperglycemic agents. Fifty-four patients were returned to the care of their family physicians and 18 patients required a referral to a diabetes specialist. A postclinic questionnaire indicated that the clinic enabled patients to improve management of their diabetes. However, communication of the diabetes management plan to the family physician was an identified concern.
An NPC clinic can provide timely management and is a viable option to ensure safe transition of patients with diabetes from hospital back to their family physicians.
本研究旨在评估由执业护师主导的门诊诊所（NPC）在促进接受胰岛素治疗的糖尿病患者在医院和社区之间安全过渡方面的可行性。
设立 NPC 以管理在医院接受糖尿病教育并出院时接受胰岛素治疗的患者。除了患者的人口统计学和入院诊断外，还记录了出院后的就诊天数、随访时间、糖尿病干预措施和出院护理计划。为了进行质量改进，患者在离开 NPC 时被要求填写一份问卷。
在 12 个月的时间内，71 名糖尿病患者在出院后 3 至 21 天内就诊，随访时间为 1 至 98 天。13 名患者需要管理低血糖，56 名患者需要调整药物为基础/餐时胰岛素或改用口服降糖药。54 名患者转回家庭医生管理，18 名患者需要转介给糖尿病专家。诊所后问卷表明，该诊所能够帮助患者改善糖尿病管理。然而，向家庭医生传达糖尿病管理计划是一个被识别到的关注点。
NPC 诊所可以提供及时的管理，是确保糖尿病患者从医院安全过渡到家庭医生的可行选择。
