护理人员教育对糖尿病住院患者血糖管理的影响：一项试点集群随机对照试验。

The impact of nursing staff education on diabetes inpatient glucose management: a pilot cluster randomised controlled trial.

机构信息

School of Medicine, Western Sydney University, Campbelltown, NSW, Australia.

Macarthur Diabetes Endocrinology and Metabolism Service, Camden and Campbelltown Hospitals, Campbelltown, NSW, Australia.

出版信息

BMC Endocr Disord. 2022 Mar 10;22(1):61. doi: 10.1186/s12902-022-00975-y.

DOI:10.1186/s12902-022-00975-y

PMID:35272649

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8911103/

Abstract

BACKGROUND

An increasing number of patients in hospital have diabetes, with most of them cared for by non-specialist staff. The effect of diabetes education for staff on patient outcomes, as well as the most effective method of staff education is unclear. Therefore, the aim of this study was to compare diabetes outcomes in medical wards where nursing staff were offered one face-to-face (F2F) session followed by access to online education (online), F2F education only, or standard care (control).

METHODS

We conducted a pilot cluster randomised controlled trial involving 16-weeks baseline/rollout followed by a 28-week post-intervention period across three medical wards (clusters) in a Sydney Teaching Hospital. The online ward provided an online competency-based diabetes education program and 1-h F2F teaching from a diabetes nurse educator (DNE), the F2F ward provided four separate 1-h teaching sessions by a DNE, with no additional sessions in the control ward. The primary outcome was length of stay (LOS); secondary outcomes included good diabetes days (GDD), hypoglycaemia and medication errors. Poisson and binary logistic regression were used to compare clusters.

RESULTS

Staff attendance/completion of ≥ 2 topics was greater with online than F2F education [39/48 (81%) vs 10/33 (30%); p < 0.001]. Among the 827/881 patients, there was no difference in LOS change between online [Median(IQR) 5(2-8) to 4(2-7) days], F2F [7(4-14) to 5(3-13) days] or control wards [5(3-9) to 5(3-7) days]. GDD improved only in the online ward 4.7(2.7-7.0) to 6.0(2.3-7.0) days; p = 0.038. Total patients with hypoglycaemia and appropriately treated hypoglycaemia increased in the online ward.

CONCLUSIONS

The inclusion of online education increased diabetes training uptake among nursing staff. GDD and appropriate hypoglycaemia management increased in the online education wards.

TRIAL REGISTRATION

Prospectively registered on the Australia New Zealand Clinical Trials Registry (ANZCTR) on 24/05/2017: ACTRN12617000762358 .

摘要

背景

越来越多的住院患者患有糖尿病，其中大多数由非专科医务人员照顾。糖尿病教育对患者结局的影响，以及对医务人员最有效的教育方式尚不清楚。因此，本研究旨在比较接受 1 次面对面（F2F）课程和在线教育（在线）、仅 F2F 教育或标准护理（对照）的医疗病房中糖尿病患者的结局。

方法

我们开展了一项试点性集群随机对照试验，涉及悉尼教学医院的 3 个医疗病房（集群），在 16 周的基线/铺开阶段后进行了 28 周的干预后阶段。在线病房提供基于能力的在线糖尿病教育课程和由糖尿病护士教育者（DNE）进行的 1 小时 F2F 教学，F2F 病房由 DNE 提供 4 次单独的 1 小时教学，对照病房没有额外的教学。主要结局是住院时间（LOS）；次要结局包括良好的糖尿病天数（GDD）、低血糖和药物错误。使用泊松和二项逻辑回归比较集群。

结果

在线教育的员工出勤率/完成率（≥2 个主题）高于 F2F 教育[39/48（81%）比 10/33（30%）；p<0.001]。在 827/881 名患者中，在线组的 LOS 变化无差异[中位数（IQR）5（2-8）至 4（2-7）天]，F2F 组[7（4-14）至 5（3-13）天]或对照组[5（3-9）至 5（3-7）天]。仅在线病房的 GDD 改善[4.7（2.7-7.0）至 6.0（2.3-7.0）天]；p=0.038。在线病房的低血糖患者和接受适当治疗的低血糖患者增加。