Authors (including presenting author) :
Lam CY(1)
Affiliation :
(1) Department of Rehabilitation & Extended Care, TWGHs Wong Tai Sin Hospital
Introduction :
Diabetes is a devastating disease affecting many people worldwide, and a vast majority of the in-patients in WTSH 2F ward have diabetes mellitus (DM). From July to September 2023, we noted 20 episodes of hypoglycemia among our patients. However, the compliance rate among WTSH 2F nursing staff to the "Hospital Management of Hypoglycemia in Patients with DM" algorithm, issued in August 2021 at TWGHs Wong Tai Sin Hospital, was only 25%. We realized that nurses were hesitant to follow the algorithm due to knowledge deficits and unfamiliarity with the properties of DM medications, which resulted in hesitation to comply with the algorithm.
Objectives :
The main objective of this project is to strengthen and update our staff's knowledge on DM, including medications and related management, to reassure them and improve their compliance with the hypoglycemia management algorithm, and hence enhance patient care and safety.
Methodology :
We conducted pre and post surveys to identify misconceptions, investigate the reasons for the low compliance rate, and compare pre- and post-intervention attitudes among our staff. Additionally, educational talks were organized in the form of presentations and group discussions to provide up-to-date DM management knowledge and in-depth explanation of the algorithm. Posters and reminders were placed at easy-to-notice spots, and QR codes were generated for easy access to the algorithm. Furthermore, pre and post tests were administered to assess the knowledge level on DM before and after the educational interventions.
Result & Outcome :
Following the interventions from October 2023 to January 2024, we recorded another 20 episodes of hypoglycemia within our ward. This time, the compliance rate of our staff to the algorithm increased to 95%. The patients treated under the algorithm showed a steadier H'stix trend (within ~3 to 11 mmol/L), while those not following the algorithm had a fluctuated trend (~2 to 16 mmol/L). The scores in the DM knowledge-related tests improved from 78% to 100%. Additionally, pre- and post-survey indicated a higher level of satisfaction towards implementing the algorithm. The project successfully highlighted the importance of educational interventions in improving compliance with clinical algorithms. By addressing knowledge deficits and providing comprehensive training, we were able to significantly enhance the adherence to the hypoglycemia management algorithm. This resulted in better patient outcomes and increased confidence among the nursing staff in managing hypoglycemia in patients with diabetes.
