Shift in responsibilities in diabetes care: the Nurse-Driven Diabetes In-Hospital Treatment protocol (N-DIABIT).

Autor: Manders IG; Section of Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands., Stoecklein K; Department of Anesthesiology, VU University Medical Centre, Amsterdam, The Netherlands., Lubach CH; Diabetes Centre, VU University Medical Centre, Amsterdam, The Netherlands., Bijl-Oeldrich J; Diabetes Centre, VU University Medical Centre, Amsterdam, The Netherlands., Nanayakkara PW; Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands., Rauwerda JA; Department of Vascular Surgery, VU University Medical Centre, Amsterdam, The Netherlands., Kramer MH; Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands., Eekhoff EM; Section of Endocrinology, VU University Medical Centre, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Diabetic medicine : a journal of the British Diabetic Association [Diabet Med] 2016 Jun; Vol. 33 (6), pp. 761-7. Date of Electronic Publication: 2015 Oct 08.
DOI: 10.1111/dme.12899
Abstrakt: Aims: To investigate the feasibility, safety and efficacy of the Nurse-Driven Diabetes In-Hospital Treatment protocol (N-DIABIT), which consists of nurse-driven correctional therapy, in addition to physician-guided basal therapy, and is carried out by trained ward nurses.
Methods: Data on 210 patients with diabetes consecutively admitted in the 5-month period after the introduction of N-DIABIT (intervention group) were compared with the retrospectively collected data on 200 consecutive patients with diabetes admitted in the 5-month period before N-DIABIT was introduced (control group). Additional per-protocol analyses were performed in patients in whom mean patient-based protocol adherence was ≥ 70% (intervention subgroup, n = 173 vs. control subgroup, n = 196).
Results: There was no difference between the intervention and the control group in mean blood glucose levels (8.9 ± 0.1 and 9.1 ± 0.2 mmol/l, respectively; P = 0.38), consecutive hyperglycaemic (blood glucose ≥ 10.0 mmol/l) episodes; P = 0.15), admission duration (P = 0.79), mean number of blood glucose measurements (P = 0.21) and incidence of severe hypoglycaemia (P = 0.29). Per-protocol analyses showed significant reductions in mean blood glucose levels and consecutive hypoglycaemia and hyperglycaemia in the intervention compared with the control group.
Conclusions: Implementation of N-DIABIT by trained ward nurses in non-intensive care unit diabetes care is feasible, safe and non-inferior to physician-driven care alone. High protocol adherence was associated with improved glycaemic control.
(© 2015 Diabetes UK.)
Databáze: MEDLINE
Externí odkaz: