Authors (including presenting author) :
Chan HY(1), Chee PY(2), Lam L(2), Lo CW(2), Wong WM(1), Law LC(1), Chan WS(1)
Affiliation :
(1)Nursing Services Division, (2) Department of Accident and Emergency, St. John Hospital
Introduction :
Diabetes mellitus (DM) is an international medical problem which greatly burdens to health care systems worldwide. The prevalence of diabetes in adults aged 20 to 79 in 2015 in Hong Kong was 10.2% and the 2016 population by census showed that the Cheung Chau Island resident population in mid-2016 was twenty-one thousand. As a result, more than two thousand residents were potentially suffering by diabetes mellitus. However, there was no on-site support of endocrinologist for DM patients. As a result, a nurse-led diabetes enhancement service was set up in 2015 to provide early assessment, investigation and management planning for those DM patients in Cheung Chau.
Objectives :
To evaluate the outcomes of nurse-led diabetes enhancement service in management of patients with diabetes mellitus
Methodology :
All patients who met the inclusion criteria such as HbA1c >7% or low-density lipoprotein (LDL) >2.6mmol/L or newly diagnosed DM that referred to the nurse-led enhancement service from Jan 2017 to Dec 2019 were recruited. Patient demographics and any change of key performance indicator like HbA1c, fasting glucose and LDL were analysed retrospectively. Day hospital nurses provided services to new referred DM patients like group education class, individual consultation, diet modification, insulin injection training and technique of self-monitoring of blood glucose with close collaboration with multidisciplinary term members including emergency medical specialists, physiotherapists, dietitians and pharmacists.
Result & Outcome :
A total of 578 patients were recruited. 309 were female (53%) and 269 were male (47%). Age ranged from 30 to 93 (Mean age: 65.7). Compared with the baseline on 1st visit, the mean HbA1c percentage on 3 months follow up was significantly improved from 7.3% to 6.7% (p< 0.05). The mean fasting glucose and LDL were also improved from 7.7 mmol/L to 6.7 mmol/L and 2.7mmol/L to 2.3 mmol/L respectively (p< 0.05). Furthermore, in one year follow up, the HbA1c, fasting glucose and LDL still maintain improvement of 6.6%, 6.6 mmol/L and 2.2 mmol/L respectively. In addition, there were only 38 patients (6.5%) need to be referred out to Specialist Out-patient Clinics (SOPC) for further management because of complex insulin regimen or severe chronic kidney disease.
