Improving the peri-operative pathway of people with diabetes undergoing elective surgery: the IP3D project.
Adult
Aged
Aged, 80 and over
Diabetes Mellitus
/ metabolism
Elective Surgical Procedures
Female
Glycated Hemoglobin
/ metabolism
Glycemic Control
Humans
Hypoglycemia
/ chemically induced
Length of Stay
/ statistics & numerical data
Male
Middle Aged
Nurse Specialists
Patient Readmission
/ statistics & numerical data
Perioperative Care
/ methods
Perioperative Nursing
Postoperative Complications
/ epidemiology
Surgical Wound Infection
/ epidemiology
Journal
Diabetic medicine : a journal of the British Diabetic Association
ISSN: 1464-5491
Titre abrégé: Diabet Med
Pays: England
ID NLM: 8500858
Informations de publication
Date de publication:
12 2020
12 2020
Historique:
accepted:
09
04
2020
pubmed:
17
4
2020
medline:
30
10
2021
entrez:
17
4
2020
Statut:
ppublish
Résumé
To determine whether outcomes for people with diabetes undergoing elective surgery improve following the introduction of innovations in the peri-operative care pathway. Following a baseline audit of 185 people with diabetes listed for elective surgery (July to December 2017) with a length of stay > 24 hours, a number of changes in practice were implemented. These included dissemination of a 'diabetes peri-operative passport' to participants preoperatively, formation of a diabetes surgery working group, recruitment of surgical diabetes champions and the roll-out of surgical diabetes study days. Crucial was recruitment of a diabetes peri-operative nurse, whose role included engaging and educating others and supporting individuals throughout their peri-operative diabetes care. Records of 166 individuals listed for surgery during the implementation period (July to December 2018) were then audited using the same methodology. The availability of a recent HbA The new pathway improved important peri-operative outcomes for people with diabetes undergoing elective surgery with the potential for cost savings. These findings could have important implications for peri-operative care on a wider scale.
Substances chimiques
Glycated Hemoglobin A
0
hemoglobin A1c protein, human
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2019-2026Subventions
Organisme : Diabetes Charity Funds- Ipswich Hospital
Pays : International
Informations de copyright
© 2020 Diabetes UK.
Références
National Confidential Enquiry into Patient Outcome and Death Perioperative Diabetes Highs and Lows Report, 2018. Available at https://www.ncepod.org.uk/2018pd.htm. Last accessed 22 November 2019.
Levy N, Penfold N, Dhatariya K. Perioperative management of the patient with diabetes requiring emergency surgery. BJA Educ 2017; 17: 129-136.
Diabetes UK. Making Hospitals Safe for People with Diabetes, 2018. Available at https://www.diabetes.org.uk. Last accessed 22 November 2019.
Pournaras D, Photi E, Barnett N, Challand C, Chatzizacharias N, Dlamini N et al. Assessing the quality of primary care referrals to surgery of patients with diabetes in the East of England: A multi-centre cross sectional cohort study. Int J Clin Pract 2017; 71: e12971.
Garg R, Schuman B, Bader A, Hurwitz S, Turchin A, Underwood P et al. Effect of Preoperative Diabetes Management on Glycaemic Control and Clinical Outcomes After Elective Surgery. Ann Surg 2018; 267: 797-805.
Pomposelli JJ, Baxter JK, Babineau TJ, Pomfret EA, Driscoll DF, Forse RA et al. Early postoperative glucose control predicts nosocomial infection rate in diabetic patients. JPEN J Parenter Enteral Nutr 1998; 22: 77-81.
Joint British Diabetes Society for Inpatient Care, Management of adults with diabetes undergoing elective surgery and procedures, 2016. Available at https://www.diabetesorg.uk/resources. Last accessed 1 July 2019.
Underwood P, Askari R, Hurwitz S, Chamarthi B, Garg R. Perioperative A1C and clinical outcomes in patients with diabetes undergoing major non cardiac surgical procedures. Diabetes Care 2014; 37: 611-616.
Hommel I, van Gurp PJ, Tack CJ, Liefers J, Mulder J, Wollersheim H et al. Perioperative diabetes care: room for improving the person centeredness. Diabet Med 2015; 32: 561-568.
NHS Improvement. Getting It Right First Time (GIRFT) programme, 2018. Available at http://gettingitrightfirsttime.co.uk. Last accessed 1 July 2019.
Care Quality Commission, My Diabetes, My Care Sept, Sept 2016. Available at http://www.cqc.org.uk/publications/themed-work/my-diabetes-my-care-community-diabetes-care-review'>www.cqc.org.uk/publications/themed-work/my-diabetes-my-care-community-diabetes-care-review. Last accessed 22 November 2019.
National Audit of Diabetes Inpatient Care 2017, NHS Digital 2018. Available at https://digital.nhs.uk. Last accessed 13 February 2020.
Akiboye F, Adderley N, Martin J, Gokhale K, Rudge GM, Marshall TP et al. The impact of the Diabetes Inpatient Care and Education (DICE) project on length of stay and mortality. Diabet Med 2020; 37: 277-285.
Hommel I, van Gurp PJ, Tack CJ, Akkermans RP, Wollersheim H, Hulscher ME et al. Major gaps between recommended perioperative diabetes care and current practice. Eur J Intern Med 2016; 34: e11-e13.
Page E, Akiboye F, Jackson S, Kerry C, Round R, Rayman G. The Perioperative Passport: Empowering people with diabetes along their surgical journey. Diabet Med 2017; 34: 1737-1741.
Badyal DK, Singh T. Learning theories: The basics to learn in medical education. Int J Appl Basic Med Res 2017; 7: S1-S3.