DIABEZE：比利时一家养老院中老年人的糖尿病自我管理：一个最佳实践实施项目。
DIABEZE: Diabetes self-management among the elderly in a Belgian home for the aged: a best practice implementation project.
作者信息
Corremans Marleen, Ohenewaa Comfort, Van Steenberghe Isaura, Bekkering Trudy, Jespers Hilke
机构信息
JBI Belgium: A JBI Centre of Excellence, Leuven, Belgium.
Cebam, Leuven, Belgium.
出版信息
JBI Evid Implement. 2025 Jan 1;23(1):72-80. doi: 10.1097/XEB.0000000000000461.
OBJECTIVES
The aim of this project was to improve the self-management of diabetes among elderly residents in a Belgian home for the aged.
INTRODUCTION
Diabetes is a common chronic condition with significant comorbidity. Incidence is increasing, but a third of patients with diabetes are unaware that they have the disease. The treatment of diabetes requires a multifactorial approach. Treatment guidelines on diabetes recommend involving patients in monitoring their condition because supported self-management improves daily glycemic control.
METHODS
This evidence implementation project used the JBI Evidence Implementation Framework, which follows three phases. In the first phase, the area of change, stakeholders' role, and practice context and readiness for change are investigated. In the second phase, a baseline audit is conducted to compare current practice with best practice. Strategies are then implemented to address any areas of non-compliance with best practice. In the third phase, a follow-up audit is conducted to evaluate changes in practice.
RESULTS
At baseline, six criteria had 0% compliance, two criteria had compliance lower than 50%, and only 49% of health care workers were familiar with the procedure for hypoglycemia treatment. Improvement strategies included creating awareness among health workers. In the follow-up audit, one criterion improved from 0% to 100%, three criteria improved from 0% to 85%, two criteria reached the threshold of 50% compliance, and one criterion reached 19%. Further audits are needed to ensure sustainability.
CONCLUSIONS
This project improved diabetes self-management in elderly people living in a Belgian home for the aged. An in-depth planning phase with internal facilitation and interdisciplinary collaboration between all co-workers addressed barriers related to quality systems, structure, communication, and education.
SPANISH ABSTRACT
目标
本项目旨在改善比利时一家养老院中老年居民的糖尿病自我管理情况。
引言
糖尿病是一种常见的慢性病，常伴有严重的合并症。其发病率正在上升，但三分之一的糖尿病患者并未意识到自己患有该病。糖尿病的治疗需要多方面的方法。糖尿病治疗指南建议让患者参与病情监测，因为有支持的自我管理可改善日常血糖控制。
方法
本证据实施项目采用了JBI证据实施框架，该框架分为三个阶段。在第一阶段，调查变革领域、利益相关者的角色、实践背景以及变革的准备情况。在第二阶段，进行基线审核，将当前实践与最佳实践进行比较。然后实施策略以解决任何不符合最佳实践的领域。在第三阶段，进行跟进审核以评估实践中的变化。
结果
在基线时，六项标准的合规率为0%，两项标准的合规率低于50%，只有49%的医护人员熟悉低血糖治疗程序。改进策略包括提高医护人员的意识。在跟进审核中，一项标准从0%提高到了100%，三项标准从0%提高到了85%，两项标准达到了50%的合规阈值，一项标准达到了19%。需要进一步审核以确保可持续性。
结论
本项目改善了居住在比利时养老院中的老年人的糖尿病自我管理情况。一个深入的规划阶段，通过内部推动以及所有同事之间的跨学科合作，解决了与质量体系、结构、沟通和教育相关的障碍。
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