Inpatient Diabetes Care

Published Date: 19th July 2016

Publication Authors: O'Brien S, , Cardwell J, Hardy KJ

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Aim:  Inpatient diabetes care is a burden on NHS resources. National inpatient audits identify areas of poor management but do not provide insight into underlying causes to fix the problems. Our aim was to explore the experiences of inpatients with diabetes, identify reasons for mismanagement and investigate these further.

Methods:  Ten people with diabetes discharged from hospital within six months undertook a taped semi-structured interview to explore their experience.Two independent researchers conducted framework analysis to identify themes and low staff knowledge was cited by all subjects; subsequently we used a 66-item validated knowledge questionnaire to test diabetes knowledge in 55 staff nurses.

Results:  Mean total score was 39/66. Scores were particularly low in key areas: 67% (37/55) scored incorrectly when to refer a high glucose to a doctor, 47% (26/55) did not know when to test glucose in relation to food, more than half answered incorrectly eight questions regarding medication and timing of insulin and 67% (37/55) were wrong about initial treatment of hypo; 98% (54/55) did not know how to interpret blood ketone readings and 40% (22/55) were wrong regarding GKI management.

Conclusion:  ‘Oh, they haven’t got a clue at all…I didn’t have any confidence in the way they managed my diabetes.’ The questionnaire results concur with patient experience that ward nurses do not understand diabetes. Previous studies have found inadequate knowledge indicating that we are not addressing the issue. Poor knowledge affects management and we need to address this if we are going to improve outcome and experience for inpatients with diabetes.

O'Brien, SV; Ford, N; Cardwell, J; Hardy, KJ. (2013).  Inpatient diabetes care: what can we learn from patient experience? . Diabetic Medicine. 30 (Supplement S1), 153.

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