Dataset Information

Redesigning Hospital Diabetes Education: A Qualitative Evaluation With Nursing Teams.

ABSTRACT: BACKGROUND:Methods to deliver diabetes education are needed to support patient safety and glycemic control in the transition from hospital to home. PURPOSE:This study examined barriers and facilitators of integrating web-based, iPad-delivered diabetes survival skills education (DSSE) into the nursing inpatient unit workflow. METHODS:Nurses, nurse managers, and patient care technicians (PCTs) from 3 medical-surgical and 2 behavioral health units participated in semistructured interviews and focus groups. RESULTS:Four themes emerged: educational program and content; platform usability; tablet feasibility (eg, theft prevention, infection control, and charging); and workflow considerations. Behavioral health unit-specific concerns were also identified. Findings indicated that nurses and PCTs were eager to find approaches to deliver DSSE. CONCLUSIONS:Implementation of a web-based DSSE program for inpatients needs adaptation to overcome challenges at the patient, care team, and process levels.

SUBMITTER: Smith KM

PROVIDER: S-EPMC6338532 | biostudies-literature | 2019 Apr/Jun

REPOSITORIES: biostudies-literature

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Redesigning Hospital Diabetes Education: A Qualitative Evaluation With Nursing Teams.

Smith Kelly M KM Baker Kelley M KM Bardsley Joan K JK McCartney Patricia P Magee Michelle M

Journal of nursing care quality 20190401 2

<h4>Background</h4>Methods to deliver diabetes education are needed to support patient safety and glycemic control in the transition from hospital to home.<h4>Purpose</h4>This study examined barriers and facilitators of integrating web-based, iPad-delivered diabetes survival skills education (DSSE) into the nursing inpatient unit workflow.<h4>Methods</h4>Nurses, nurse managers, and patient care technicians (PCTs) from 3 medical-surgical and 2 behavioral health units participated in semistructure ...[more]

PMID: 30028413

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Project description:ObjectivesTo examine context-specific delivery factors, facilitators and barriers to implementation of the Diabetes Community Exercise and Education Programme (DCEP) for adults with type 2 diabetes (T2D) using the Reach, Effectiveness, Adoption, Implementation and Maintenance framework.DesignA qualitative evaluation embedded within the DCEP pragmatic randomised controlled trial. Data collected via focus groups and interviews and analysed thematically.SettingCommunity-based in two cities (Dunedin and Invercargill) in the lower south island of New Zealand.ParticipantsSeventeen adults diagnosed with T2D attending DCEP and 14 healthcare professionals involved in DCEP delivery.InterventionDCEP is a twice weekly session of exercise and education over 12 weeks, followed by a twice weekly ongoing exercise class.ResultsWhile our reach target was met (sample size, ethnic representation), the randomisation process potentially deterred Māori and Pasifika from participating. The reach of DCEP may be extended through the use of several strategies: promotion of self-referral, primary healthcare organisation ownership and community champions. DCEP was considered effective based on perceived benefit. The social and welcoming environment created relationships and connections. People felt comfortable attending DCEP and empowered to learn. Key to implementation and adoption was the building of trusting relationships with local health providers and communities. This takes time and care and cannot be rushed. Training of staff and optimising communication needed further attention. To maintain DCEP, delivery close to where people live and a generic approach catering for people with multiple chronic conditions may be required.ConclusionsFor success, lifestyle programmes such as DCEP, need time and diligence to build and maintain networks and trust. Beyond frontline delivery staff and target populations, relationships should extend to local healthcare organisations and communities. Access and ongoing attendance are enabled by healthcare professionals practicing in a nuanced person-centred manner; this, plus high staff turnover, necessitates ongoing training.Trial registration numberACTRN12617001624370.

Project description:ObjectiveCompassionate care continues to be a focus for national and international attention, but the existing evidence base lacks the experimental methodology necessary to guide the selection of effective interventions for practice. This study aimed to evaluate the Creating Learning Environments for Compassionate Care (CLECC) intervention in improving compassionate care.SettingWard nursing teams (clusters) in two English National Health Service hospitals randomised to intervention (n=4) or control (n=2). Intervention wards comprised two medicines for older people (MOPs) wards and two medical/surgical wards. Control wards were both MOPs.ParticipantsData collected from 627 patients and 178 staff.Exclusion criteriareverse barrier nursed, critically ill, palliative or non-English speaking. All other patients and all nursing staff and Health Care Assistant HCAs were invited to participant, agency and bank staff were excluded.InterventionCLECC, a workplace intervention focused on developing sustainable leadership and work-team practices to support the delivery of compassionate care.ControlNo educational activity.Primary and secondary outcome measuresPrimary-Quality of Interaction Schedule (QuIS) for observed staff-patient interactions. Secondary-patient-reported evaluations of emotional care in hospital (PEECH); nurse-reported empathy (Jefferson Scale of Empathy).ResultsTrial proceeded as per protocol, randomisation was acceptable. Some but not all blinding strategies were successful. QuIS observations achieved 93% recruitment rate with 25% of patient sample cognitively impaired. At follow-up there were more total positive (78% vs 74%) and less total negative (8% vs 11%) QuIS ratings for intervention wards versus control wards. Sixty-three per cent of intervention ward patients scored lowest (ie, more negative) scores on PEECH connection subscale, versus 79% of control. This was not a statistically significant difference. No statistically significant differences in nursing empathy were observed.ConclusionsUse of experimental methods is feasible. The use of structured observation of staff-patient interaction quality is a promising outcome measure inclusive of hard to reach groups.Trial registration numberISRCTN16789770.

Dataset Information

Redesigning Hospital Diabetes Education: A Qualitative Evaluation With Nursing Teams.

Publications

Redesigning Hospital Diabetes Education: A Qualitative Evaluation With Nursing Teams.

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