Navigation Links
Integrated diabetes management program provides rapid improvements in patient care
Date:10/25/2012

Ottawa, October 26, 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 needsimilar 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."


'/>"/>

Contact: Vincent Lamontagne
vlamontagne@ottawaheart.ca
613-899-6760
University of Ottawa Heart Institute
Source:Eurekalert

Related medicine news :

1. Serious games could be integrated into surgical training subject to validation
2. Physician-Patient Alliance for Health & Safety: The Path to a Safer PCA Pump - Improving Patient Safety with Integrated Capnography
3. Integrated Services Becomes Preferred Rental Provider for Rural/Metro Corporation
4. Offenders need integrated, on-going, mental health care
5. Qualicode and CellTrak Deliver Integrated Mobile Scheduling and Health Record Solution
6. Foot Ulcers Tied to Increased Death Risk for People With Diabetes
7. Stop diabetes with insulin tablets
8. Belly Fat Adds to Diabetes Risk in Obese Adults, Study Finds
9. Aerobic Exercise Cuts Kids Diabetes Risk: Study
10. Bariatric surgery substantially reduces the risk of diabetes
11. Leading stem cell scientists to focus on diabetes, eye diseases at Cedars-Sinai symposium
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/27/2016)... ... May 27, 2016 , ... With a ... medical and food industries. Aside from its GMP accreditation, Validation Center is also ... successfully certified products, services and staff. , Validation Center is ISO17025 accredited and ...
(Date:5/26/2016)... ... May 26, 2016 , ... There are many ways ... and Sausage Council (NHDSC) suggests that Americans prefer their dogs straight off the grill. ... say grilling is their favorite way to cook a hot dog, far outpacing other ...
(Date:5/26/2016)... ... May 26, 2016 , ... Cabot Corporation, Pfizer, and ... according to court documents and SEC filings. A jury has returned a ... American Optical Corporation, Case No. BC588866, Los Angeles County, California. The jury awarded ...
(Date:5/26/2016)... Georgia (PRWEB) , ... May 26, 2016 , ... ... certificate in intellectual property (IP) to its specialty academic programs. , Answering to ... the college’s existing certificate programs in health law, and environmental and land use ...
(Date:5/26/2016)... ... May 26, 2016 , ... On Memorial Day, Hope For Heroes ... lives in military battle for the country. The nonprofit Hope For Heroes partnered ... programs that empower independence for disabled military veterans, as well as police, firemen, and ...
Breaking Medicine News(10 mins):
(Date:5/26/2016)... York , May 26, 2016 ... Research "Medical Waste Management Market - U.S. Industry Analysis, Size, ... waste management market in the U.S. was valued at US$ ... a CAGR of 3.4% from 2015 to 2023 to reach ... exhaustive analysis of current and emerging needle free drug delivery ...
(Date:5/25/2016)... , May 25,2016 ... the near-infrared Cellvizio platform for urological and surgical ... OTCQX: MKEAY) inventor of Cellvizio®, the multidisciplinary confocal ... regulatory milestone in the US with the 12 ... and Drug Administration (FDA). This new FDA clearance ...
(Date:5/25/2016)... YORK , May 25, 2016  According to ... reached $381 billion in 2015.  Though these are ... plenty of opportunity for success for companies that ... in search of new growth prospects medical device ... on research and development (R&D) than do companies ...
Breaking Medicine Technology: