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Shift in responsibilities in diabetes care: the Nurse‐Driven Diabetes In‐Hospital Treatment protocol (N‐ DIABIT )
Author(s) -
Manders I. G.,
Stoecklein K.,
Lubach C. H. C.,
BijlOeldrich J.,
Nanayakkara P. W. B.,
Rauwerda J. A.,
Kramer M. H. H.,
Eekhoff E. M. W.
Publication year - 2016
Publication title -
diabetic medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 145
eISSN - 1464-5491
pISSN - 0742-3071
DOI - 10.1111/dme.12899
Subject(s) - medicine , diabetes mellitus , incidence (geometry) , basal (medicine) , type 2 diabetes , endocrinology , physics , optics
Aims To investigate the feasibility, safety and efficacy of the Nurse‐Driven Diabetes In‐Hospital Treatment protocol (N‐ DIABIT ), which consists of nurse‐driven correctional therapy, in addition to physician‐guided basal therapy, and is carried out by trained ward nurses. Methods Data on 210 patients with diabetes consecutively admitted in the 5‐month period after the introduction of N‐ DIABIT (intervention group) were compared with the retrospectively collected data on 200 consecutive patients with diabetes admitted in the 5‐month period before N‐ DIABIT was introduced (control group). Additional per‐protocol analyses were performed in patients in whom mean patient‐based protocol adherence was ≥ 70% (intervention subgroup, n = 173 vs. control subgroup, n = 196). Results There was no difference between the intervention and the control group in mean blood glucose levels (8.9 ± 0.1 and 9.1 ± 0.2 mmol/l, respectively; P = 0.38), consecutive hyperglycaemic (blood glucose ≥ 10.0 mmol/l) episodes; P = 0.15), admission duration ( P = 0.79), mean number of blood glucose measurements ( P = 0.21) and incidence of severe hypoglycaemia ( P = 0.29). Per‐protocol analyses showed significant reductions in mean blood glucose levels and consecutive hypoglycaemia and hyperglycaemia in the intervention compared with the control group. Conclusions Implementation of N‐ DIABIT by trained ward nurses in non‐intensive care unit diabetes care is feasible, safe and non‐inferior to physician‐driven care alone. High protocol adherence was associated with improved glycaemic control.