RESUMEN
OBJECTIVE: The aim of this study was to examine the effectiveness of a subcutaneous insulin double-checking preparation intervention on insulin administration errors. BACKGROUND: Insulin accounts for 3.5% of medication-related errors. The Joint Commission and Institute for Safe Medication Practices recommend a 2-nurse double-checking procedure when preparing insulin. METHODS: This study used a randomized, controlled, nonblinded, intent-to-treat methodology. RESULTS: In total, 266 patients were enrolled, and over 4 weeks of data collection, there were 5238 opportunities for insulin administration. Overall, 3151 insulin administration opportunities had no errors; the double-checking group had more no-error periods than usual care. Of error types, wrong time was predominant, but less prevalent in the double-checking group. Omission errors were uncommon and occurred less in the double-checking group. CONCLUSIONS: The subcutaneous insulin double-checking preparation procedure led to less insulin administration errors; however, timing errors were most prevalent and are not resolved with double-checking interventions.
Asunto(s)
Diabetes Mellitus/tratamiento farmacológico , Hipoglucemiantes/administración & dosificación , Insulina/administración & dosificación , Errores de Medicación/prevención & control , Errores de Medicación/estadística & datos numéricos , Seguridad del Paciente/normas , Adulto , Diabetes Mellitus/enfermería , Femenino , Humanos , Inyecciones Subcutáneas , Análisis de Intención de Tratar , Masculino , Errores de Medicación/enfermería , Persona de Mediana Edad , Distribución Aleatoria , Administración de la Seguridad/normas , Estados UnidosRESUMEN
BACKGROUND: Nurses are responsible for critical aspects of diabetes care. PURPOSE: The purpose of this study was to examine nurses' knowledge of inpatient diabetes management principles before and after a structured diabetes education program. METHODS: In this descriptive, correlation study, 2250 registered nurses working in a quaternary health care center completed a 20 question assessment. The assessment was administered pre and post attendance at a 4hour diabetes management course. FINDINGS: Nurses' knowledge of inpatient diabetes management principles was low. There was no correlation between knowledge scores and age, education, employment status, years of experience or clinical specialty. CONCLUSIONS: In general, our findings suggest that nurses do not feel comfortable and are not adequately prepared to make patient care decisions or provide survival skill education for patients with diabetes in the hospital.
Asunto(s)
Diabetes Mellitus/enfermería , Conocimientos, Actitudes y Práctica en Salud , Educación Continua en Enfermería , Evaluación Educacional , Femenino , Humanos , Masculino , Personal de Enfermería en Hospital/educaciónRESUMEN
The intent of this project was to create a formalized educational program for bedside nurses responsible for inpatient diabetes management. Bedside nurses are recruited to serve as diabetes management mentors. The mentors receive advanced education concerning teaching and learning principles, the AADE7™ Self-Care Behaviors, and diabetes management strategies. They teach their peers, advocate for patients, and facilitate referrals for outpatient Diabetes Self-Management Education (DSME) programs. The focus of these ongoing educational activities is to foster the development of diabetes management mentors and to create teaching tools that mentors can use with peers to address practice gaps or skill deficiencies. The diabetes management mentor is integral in enhancing the care of patients with diabetes in the hospital. The empowerment of bedside nurses as mentors for their peers and their patients is an invaluable asset that helps nurses take ownership of their practice. This role could be applied to other complex disease entities, helping nurses to develop specific management skills to improve patient outcomes and enhance patient satisfaction.
Asunto(s)
Competencia Clínica/normas , Diabetes Mellitus/enfermería , Docentes de Enfermería/normas , Pacientes Internos , Mentores/educación , Desarrollo de Programa , Evaluación de Programas y Proyectos de Salud , Autocuidado , Docentes de Enfermería/organización & administración , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Indiana , Relaciones Interprofesionales , Liderazgo , Masculino , Rol de la Enfermera , Personal de Enfermería en Hospital/educación , Ohio , Grupo Paritario , Poder PsicológicoRESUMEN
PURPOSE: The purpose of this project was to enhance the knowledge of the bedside nurse in diabetes management. A forum for ongoing support and exploration of clinical problems, along with the distribution of educational tools were the components of this program. BACKGROUND: Diabetes accounts for 30% of patients admitted to the hospital. It has become more challenging to manage as the treatment choices have increased. There are a number of researchers who have identified nurse and physician knowledge of diabetes management principles as suboptimal. DESCRIPTION OF THE INNOVATION: Staff nurses are educated for a role as a Diabetes Management Mentor and are expected to educate/dialogue with peers monthly, model advocacy and diabetes patient education skills, facilitate referrals for diabetes education, and direct staff to resources for diabetes management. OUTCOMES: Diabetes Management Mentors feel more confident in their knowledge of diabetes and their ability to resolve clinical issues as they arise. CONCLUSION: The Diabetes Management Mentor role is another avenue for nurses to refine their clinical knowledge base and acquire skills to share with colleagues while remaining at the bedside. IMPLICATIONS: The clinical nurse specialist is expertly prepared to foster the professional development of bedside nurses while simultaneously making a positive impact on disease management. Opportunity for future investigation includes efficacy of teaching tools on diabetes mastery, the effect of clinical nurse specialist mentoring on a select group of bedside nurses, and the Diabetes Management Mentor's impact on prevention of near-miss events.