Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Integrated diabetes management program provides rapid improvements in patient care

26.10.2012
In Canada alone, almost 2 million people are known to be living with diabetes.

And around a million more have the disease but are not aware of that fact, and have not been given the tools they need to control their blood sugar and safeguard their health. The Heart Institute will be presenting the results of an innovative pilot program on October 29, at the Canadian Cardiovascular Congress in Toronto, Canada.

Diabetic patients have a much greater risk of dangerous cardiovascular events, including recurrent heart attacks and development of heart failure. "Patients with diabetes account for a disproportionately high number of hospital inpatients globally. At the University of Ottawa Heart Institute, over 40 percent of all our inpatients are diagnosed with diabetes," reported Bonnie Quinlan, an Advanced Practice Nurse at the Heart Institute.

Heart Institute staff recognized that hospitalization for heart disease provides a valuable opportunity to identify patients with uncontrolled or undiagnosed diabetes and connect them with the care they need—similar to how the Ottawa Model for Smoking Cessation uses hospitalization as a unique opportunity to help smokers quit.

In May of 2011, the Institute rolled out a pilot program to identify and manage every patient with diabetes admitted as an inpatient. The program trained 15 nurses to serve as "diabetes champions" on the wards, led by a newly hired Diabetes Nurse Specialist, Kim Twyman.

These champions in turn provided peer-to-peer training to other nurses, doctors, dietitians, and medical and surgical residents, centered around a new guideline and educational 'tool box' designed to walk staff through the steps to identifying and managing diabetes with every patient. In February 2012, this optional guideline became a mandatory medical directive. By March, the number of patients referred to the diabetes nurse specialist had doubled.

The effort paid off: for example, after implementation of the program 85 percent of patients had their doctors notified of their diabetic status compared with only 26 percent before the program. Thirty-four percent received a referral to a community diabetes management program compared to none before the program started.

And most importantly, average blood sugar levels in diabetic inpatients dropped by almost 2 points, to the target level considered reflective of adequately managed diabetes, "which is amazing," recounted Amy Charlebois, one of the program's nurse champions.

The remarkable HbA1c drop of 2% demonstrates the success and effectiveness of a diabetes management program within our tertiary in-patient environment. The development of a systematic plan to educate staff on the management of diabetes, identifying on admission those affected by diabetes , diagnosing diabetes and standardizing the treatment of diabetes within our institution and ensuring timely, seamless transition to the community for self management care of diabetes with our community partners resulted in a dramatic improvement of HbA1c.

The United Kingdom Prospective Diabetes Study, a large randomized study trial of intensively, managed people living with Type 2 diabetes compared to usual care showed significant benefits of A1c reduction. 43% lower risk of amputation or death from peripheral vascular disease, 37% lower risk of blindness and kidney failure, 21% lower risk of diabetes complications, 21% lower risk of death related to diabetes, 14% lower risk of heart attack and 12% lower risk of stroke with each 1% drop in A1c.

Challenges still being addressed include how to fit all the pieces of the program into patient care for brief stays, such as overnight or elective day surgery, and how to influence patients who refuse to accept an unexpected diagnosis.

"There was also the challenge of 'this is just one more piece of paper' in an already busy day, or one more thing to do,'" said Quinlan. "This barrier seemed to become less of an issue as the program gained momentum: staff felt empowered by being able to manage their patients' diabetes and felt tremendous positive feedback from patients and families who in many cases for the first time were receiving support to assist them in managing this chronic disease."

INFORMATION

Vincent Lamontagne
Senior Manager, Public Affairs
University of Ottawa Heart Institute
613-899-6760
vlamontagne@ottawaheart.ca

Vincent Lamontagne | EurekAlert!
Further information:
http://www.ottawaheart.ca

Further reports about: Diabetes HbA1c Nurse blood sugar diabetes management

More articles from Health and Medicine:

nachricht Nanoparticles as a Solution against Antibiotic Resistance?
15.12.2017 | Friedrich-Schiller-Universität Jena

nachricht Plasmonic biosensors enable development of new easy-to-use health tests
14.12.2017 | Aalto University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: First-of-its-kind chemical oscillator offers new level of molecular control

DNA molecules that follow specific instructions could offer more precise molecular control of synthetic chemical systems, a discovery that opens the door for engineers to create molecular machines with new and complex behaviors.

Researchers have created chemical amplifiers and a chemical oscillator using a systematic method that has the potential to embed sophisticated circuit...

Im Focus: Long-lived storage of a photonic qubit for worldwide teleportation

MPQ scientists achieve long storage times for photonic quantum bits which break the lower bound for direct teleportation in a global quantum network.

Concerning the development of quantum memories for the realization of global quantum networks, scientists of the Quantum Dynamics Division led by Professor...

Im Focus: Electromagnetic water cloak eliminates drag and wake

Detailed calculations show water cloaks are feasible with today's technology

Researchers have developed a water cloaking concept based on electromagnetic forces that could eliminate an object's wake, greatly reducing its drag while...

Im Focus: Scientists channel graphene to understand filtration and ion transport into cells

Tiny pores at a cell's entryway act as miniature bouncers, letting in some electrically charged atoms--ions--but blocking others. Operating as exquisitely sensitive filters, these "ion channels" play a critical role in biological functions such as muscle contraction and the firing of brain cells.

To rapidly transport the right ions through the cell membrane, the tiny channels rely on a complex interplay between the ions and surrounding molecules,...

Im Focus: Towards data storage at the single molecule level

The miniaturization of the current technology of storage media is hindered by fundamental limits of quantum mechanics. A new approach consists in using so-called spin-crossover molecules as the smallest possible storage unit. Similar to normal hard drives, these special molecules can save information via their magnetic state. A research team from Kiel University has now managed to successfully place a new class of spin-crossover molecules onto a surface and to improve the molecule’s storage capacity. The storage density of conventional hard drives could therefore theoretically be increased by more than one hundred fold. The study has been published in the scientific journal Nano Letters.

Over the past few years, the building blocks of storage media have gotten ever smaller. But further miniaturization of the current technology is hindered by...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

See, understand and experience the work of the future

11.12.2017 | Event News

Innovative strategies to tackle parasitic worms

08.12.2017 | Event News

AKL’18: The opportunities and challenges of digitalization in the laser industry

07.12.2017 | Event News

 
Latest News

Engineers program tiny robots to move, think like insects

15.12.2017 | Power and Electrical Engineering

One in 5 materials chemistry papers may be wrong, study suggests

15.12.2017 | Materials Sciences

New antbird species discovered in Peru by LSU ornithologists

15.12.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>