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- Title
Shift in responsibilities in diabetes care: the Nurse-Driven Diabetes In-Hospital Treatment protocol (N- DIABIT).
- Authors
Manders, I. G.; Stoecklein, K.; Lubach, C. H. C.; Bijl‐Oeldrich, J.; Nanayakkara, P. W. B.; Rauwerda, J. A.; Kramer, M. H. H.; Eekhoff, E. M. W.
- Abstract
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.
- Subjects
BLOOD sugar analysis; HYPOGLYCEMIA; INFECTION; EVALUATION of medical care; TYPE 2 diabetes diagnosis; CHI-squared test; STATISTICAL correlation; DIABETES; FISHER exact test; HOME care services; HOSPITAL admission &; discharge; INSULIN; INTENSIVE care units; TYPE 1 diabetes; MEDICAL care; MEDICAL protocols; NURSING assessment; PATIENTS; RESPONSIBILITY; T-test (Statistics); DATA analysis; CONTROL groups; RETROSPECTIVE studies; EARLY medical intervention; DESCRIPTIVE statistics; GLYCEMIC control; DIAGNOSIS
- Publication
Diabetic Medicine, 2016, Vol 33, Issue 6, p761
- ISSN
0742-3071
- Publication type
Article
- DOI
10.1111/dme.12899