Background:
At any given time between 20-30% of hospital in-patients have diabetes[1]. Most are admitted for other medical conditions rather than for diabetes care, however their diabetes adds to the complexity of their management and length of stay. Despite this, knowledge of appropriate diabetes management is often suboptimal[2].
Aims:
1: To develop an electronic evidence-based resource regarding in-patient diabetes management for nursing staff
2: To evaluate the effectiveness of the electronic resources on patient nursing care.
Method:
Our team developed diabetes care sheets and an e-learning education package targeted at nursing staff to address common in-patient care issues supported by an intranet site to allow 24/7 access. Education sessions regarding use of ‘Sweet Support’ were held. We then administered pre & post knowledge questionnaires to nurses. A retrospective audit of 50 clinical notes was undertaken to assess the nursing compliance with diabetes related guidelines in use prior to the launch of intranet site. Data were collected at baseline, 3, 6, 9 & 12 months. For the purpose of statistical analysis data at 3 & 6 months and 9 & 12 months were combined.
Results:
Overall 475 questionnaires were completed. We noted an increased knowledge in all aspects of care except ‘How to refer to Diabetes Educator’. This increase in knowledge was statistically significant at 3/6months for ‘when to refer to Medical Officer [MO] in the presence of hyperglycaemia’ [p=0.02].
Clinical notation audit demonstrated statistical significance from baseline at 9/12months in treating an episode of hypoglycaemia appropriately and referring a patient with hyperglycaemia to MO [p= 0.02, p=0.01].There was a significant increase in the incidence of diabetes medication only being withheld with an instruction from MO reached at 3/6month and 9/12months [p=0.0008 & p=0.0001]
Conclusion:
These findings support the concept that accessible diabetes information may improve clinical care.