ArticleLiterature Review

# Diabetes Knowledge of Nurses in Different Countries: An Integrative Review

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## Abstract

Objective: The aim of this study was to identify, critically appraise and synthesise evidence of nurses' knowledge of diabetes and identify factors that function as barriers to nurses' acquisition of diabetes knowledge. Design: An integrative review Methods: A systematic search was conducted for English-language, peer reviewed publications of any research design via CINAHL, Medline, EMBASE, and Education Research Complete databases from 2004 to 2014. Of 374 articles retrieved, after removal of duplicates and quality appraisal, 25 studies were included in the review and synthesised based on study characteristics, design and findings. Findings: Studies originated from developed and developing countries and applied a variety of research designs and tools to assess nurses' knowledge of diabetes. Assessed aspects of diabetes care included knowledge of diabetes medications (12 studies), nutrition (7), blood glucose monitoring (7), diabetes complications (6), and pathology, symptoms and diabetes management (9). Factors/barriers affecting nurses' acquisition of diabetes knowledge were identified (11). Overall, findings indicated wide-spread serious and sustained deficiencies in nurses' knowledge of diabetes and diabetes care. Conclusion: With nurses demonstrating significant and long-standing knowledge deficits in many aspects of diabetes care, strategies are urgently required to overcome the identified barriers to knowledge acquisition.

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... Yet, results of previous studies suggest significant knowledge gap among nurses with regards to nutritional management of patients with diabetes [7,8]. Poor knowledge of health care providers of dietary requirements of patients with diabetes can lead to a poor glycemic control and increase the risk of diabetes-associated complications [9]. ...
... Knowledge deficits of diabetes care, including nutritional management of diabetes, imposes a significant risk to delivery of safe practice [7]. The results of a review study revealed a significant knowledge deficit in the core aspects of diabetes care among nurses globally [7]. ...
... Knowledge deficits of diabetes care, including nutritional management of diabetes, imposes a significant risk to delivery of safe practice [7]. The results of a review study revealed a significant knowledge deficit in the core aspects of diabetes care among nurses globally [7]. Comparing our findings with the past research, the mean knowledge score in our study was higher than the overall 44% correct responses reported by Mogre et al. [5]. ...
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Background The prevalence of diabetes is increasing rapidly worldwide. Nurses work collaboratively with multidisciplinary teams to improve diabetes management. Yet, little is known about nurses’ role in nutritional management of diabetes. This study aimed to evaluate nurses’ knowledge, attitudes, and practice (KAP) toward nutritional management of diabetes. Methods This cross-sectional study was conducted with 160 nurses, who were recruited between July 4 and July 18, 2021 from two referral tertiary teaching hospitals in Iran. A validated paper-based self-reported questionnaire was used to assess nurses’ KAP. Data were analyzed using descriptive statistics and multiple linear regression analysis. Results The mean knowledge score of nurses about nutritional management of diabetes was 12.16 ± 2.83, and 61.2% showing a moderate knowledge level on nutritional management of diabetes. The mean attitudes score was 60.68 ± 6.11, with 86.92% of participants demonstrating positive attitudes. The mean practice score of study participants was 44.74 ± 7.81, with 51.9% having a moderate level of practice. Higher knowledge scores were observed among male nurses (B = -7.55, p = 0.009) and those with blended learning as a preferred learning method (B = 7.28, p = 0.029). Having an opportunity to provide education to patients with diabetes during shifts affected nurses’ attitudes positively (B = -7.59, p = 0.017). Practice scores were higher among nurses who perceived themselves competent in the nutritional management of diabetes (B = -18.05, p = 0.008). Conclusion Nurses’ knowledge and practice in the nutritional management of diabetes should be increased to help improve the quality of the dietary care and patient education they provide these patients. Further studies are needed to confirm the results of this study both in Iran and internationally.
... 22 In busy environments with high workloads such as PHC settings, nurses may not prioritise diabetes SMS. 17 In South Africa, possible factors may include unavailability of guidelines and the lack of structures within the institution that encourage SMS. The guideline mostly used is the South African primary care setting is the adult primary care (APC or primary adult care [PAC]) guide. ...
... 26 Therefore, a comprehensive integrated chronic care system with a high level of engagement from nurses is needed. 17 Patients living with diabetes in PHC settings are primarily seen and managed by nurses. Community-based, nurse-led SMS interventions can improve the health-related outcomes of persons with diabetes if nurses are specifically trained. ...
... 28 However, findings from an integrative review on nurses' diabetes knowledge found that university education does not guarantee a high level of knowledge and that continuous professional education is needed. 17 Other factors influencing knowledge include exposure to patients with diabetes and access to knowledgeable practitioners, 17 although we did not find associations between diabetes knowledge and experience. ...
Article
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Background: Patients living with diabetes are primarily managed and supported by nurses in primary health care (PHC). Therefore, PHC nurses require knowledge of diabetes and confidence (self-efficacy) to perform diabetes self-management support (SMS). Aim: This study evaluated the diabetes knowledge, self-efficacy and performance of diabetes SMS by PHC nurses. Setting: Primary health care facilities in King Sabata Dalindyebo subdistrict, O.R. Tambo district, Eastern Cape. Methods: A quantitative cross-sectional and simple correlational design was used. Registered nurses (n = 100) completed a validated self-reporting questionnaire to measure diabetes knowledge, self-efficacy and performance of SMS. Results: Participants’ diabetes knowledge mean scores were high (mean of 11.9, standard deviation [s.d.] 1.8, out of 14). Self-efficacy scores (mean 18.91, s.d. 3.2 out of 24) were higher than performance of SMS scores (mean 17.81, s.d. 3.3 out of 24). Knowledge was not associated with self-efficacy or performance, but self-efficacy was positively correlated with performance of SMS (r = 0.78, p < 0.01). Nurses with a postgraduate qualification in primary care nursing had significantly higher diabetes knowledge scores (mean = 92.9 vs. 83.8; p = 0.03), and years of experience as a nurse were positively correlated with the performance of SMS (r = 0.21, p = 0.05). Conclusion: Diabetes knowledge of PHC nurses in this study does not translate into self-efficacy and the performance of SMS in practice, indicating the need for specific SMS training, support by experienced mentors, appropriate guidelines and comprehensive integrated chronic care systems. Contribution: This is the first study to report on the SMS self-efficacy and performance of PHC nurses in South Africa.
... A study from the Republic of Rwanda reported a low knowledge level among nurses in terms of diabetes education, specifically on diet, complications, insulin use and impact of stress [9]. A previous review indicated the substantial knowledge inadequacies of nurses from developed and developing nations in the core areas of diabetes care, including 'insulin therapy, oral diabetes medications, nutrition, BGM, diabetes complications and foot care, diabetes pathology, symptoms and management' [10]. ...
... The significance of education and training in improving nurses' knowledge regarding diabetes and its care has been emphasized in previous scholarly works [8,10]. The foundation of nurses' knowledge must start in the undergraduate nursing program. ...
... The overall mean (SD) score of the students was 22.54 (8.57), with scores ranging from 1 to 34. The mean (SD) scores for the dimensions were as follows: diabetes pathology, symptoms and management ( The regression model was statistically significant (F [10,319] = 142.29, p < 0.001), explaining an 81.1% variance in actual diabetes knowledge (R 2 = 0.817, adjusted R 2 = 0.811). ...
... A study from the Republic of Rwanda reported a low knowledge level among nurses in terms of diabetes education, specifically on diet, complications, insulin use and impact of stress [9]. A previous review indicated the substantial knowledge inadequacies of nurses from developed and developing nations in the core areas of diabetes care, including 'insulin therapy, oral diabetes medications, nutrition, BGM, diabetes complications and foot care, diabetes pathology, symptoms and management' [10]. ...
... The significance of education and training in improving nurses' knowledge regarding diabetes and its care has been emphasized in previous scholarly works [8,10]. The foundation of nurses' knowledge must start in the undergraduate nursing program. ...
... The overall mean (SD) score of the students was 22.54 (8.57), with scores ranging from 1 to 34. The mean (SD) scores for the dimensions were as follows: diabetes pathology, symptoms and management ( The regression model was statistically significant (F [10,319] = 142.29, p < 0.001), explaining an 81.1% variance in actual diabetes knowledge (R 2 = 0.817, adjusted R 2 = 0.811). ...
Article
Full-text available
... Despite this importance, nurses often demonstrate a poor knowledge about nutritional requirements of patients with diabetes and use nutritional assessment tools poorly in clinical settings [7][8][9][10][11][12]. Poor knowledge of health care workers can lead to poor management of hyperglycemia and increased diabetes-associated complications [13]. ...
... p = 0.008). [9]. In the Alhaiti et al. ...
... systematic review study, ndings revealed signi cant knowledge de ciency in the core aspects of diabetes care among nurses globally [9]. ...
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Background: The prevalence of diabetes is increasing rapidly worldwide. Nurses work collaboratively with health care team to improve diabetes management. Yet, little is known about nurses’ role in the nutritional management of diabetes. This study aimed to evaluate nurses’ knowledge, attitude, and practice (KAP) about nutritional management of diabetes. Methods: This cross-sectional study was conducted on 160 nurses recruited between July 4 and July 18, 2021 from two referral tertiary teaching hospitals in Iran. A validated paper-based self-reported questionnaire was used to assess Nurses’ KAP. Nurses’ KAP regarding nutritional management of diabetes were assessed and the associated factors identified using multiple linear regression analysis. Results: The mean knowledge score was 12.16 ± 2.83, with 61.2% of participants showing a moderate knowledge level on nutritional management of diabetes. The mean attitude score was 60.68 ± 6.11, with 86.92% of participants demonstrating positive attitudes. The mean practice score of study participants was 44.74 ± 7.81, with 51.9% having a moderate level of practice. Higher knowledge scores were observed among male nurses (B = -7.55, p = 0.009) and those with blended learning as a preferred learning method (B = 7.28, p = 0.029). Having an opportunity to provide education to patients with diabetes during shifts affected nurses’ attitudes positively (B = -7.59, p = 0.017). Practice scores were higher among nurses who perceived themselves competent in the nutritional management of diabetes (B = -18.05, p = 0.008). Conclusion: Nurses’ knowledge and practice in the nutritional management of diabetes should be increased to help improve the quality of the dietary care and patient education they provide these patients. Further studies are needed to confirm the results of this study both in Iran and internationally.
... Many studies assessing diabetes knowledge have found different deficits among nurses, medical students, and other medical staff (Drass et al., 1989;Mogre et al., 2015;Kamińska et al., 2013;Alotaibi et al., 2017;Dafogianni et al., 2016;Thomas, 2004;Tawalbeh and Gharaibeh, 2014;Abduelkarem and El-Shareif, 2013;Odili and Eke, 2010). To our knowledge, however, no study has assessed the knowledge of type 1 diabetes among school nurses, although such an assessment is recommended, for example, by the American Diabetes Association (Alotaibi et al., 2016;American Diabetes Association, 2018). Thus, we assessed both actual and perceived knowledge of diabetes among school nurses in Poland. ...
... In our study, better diabetes knowledge was associated with better education, participation in diabetes training, and having relatives or friends with diabetes. These factors were also associated with better diabetes knowledge in previous studies (Mogre et al., 2015;Alotaibi et al., 2017;Abduelkarem and El-Shareif, 2013;Alotaibi et al., 2016). Poor access to postgraduate training on diabetes is an important problem among nurses, with only 20% of nurses having had such training (Dafogianni et al., 2016;Alotaibi et al., 2016). ...
... These factors were also associated with better diabetes knowledge in previous studies (Mogre et al., 2015;Alotaibi et al., 2017;Abduelkarem and El-Shareif, 2013;Alotaibi et al., 2016). Poor access to postgraduate training on diabetes is an important problem among nurses, with only 20% of nurses having had such training (Dafogianni et al., 2016;Alotaibi et al., 2016). The need to provide opportunities to school nurses, so they could improve their knowledge on diabetes is also indicated in the research by Rhodes et al. ...
Article
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Background: In general, school nurses are aware that it is important to have knowledge of type 1 diabetes to give adequate care to children with the disease. Many studies assessing diabetes knowledge have found different deficits among nurses. To our knowledge, however, no study has assessed the knowledge of type 1 diabetes among school nurses. Objective: To assess actual and perceived diabetes knowledge among school nurses. Design: Cross-sectional studies. Settings: Seventeen primary care facilities in Warsaw that employed school nurses. Participants: Two hundred and thirty school nurses. Methods: With the Diabetes Knowledge Questionnaire (DKQ), we assessed actual diabetes knowledge. With the Self-Assessed Diabetes Knowledge (SADK), we assessed perceived diabetes knowledge. Both the DKQ and SADK assessed seven domains of diabetes knowledge: general diabetes knowledge; insulin and glucagon; insulin pumps; diabetes complications; nutrition; physical activity, stress, and comorbidities; and glycemia measurements. We related DKQ and SADK scores to each other and to sociodemographic and work-related factors. Results: The rate of correct responses in the DKQ was 46.7%, with the lowest rate regarding knowledge of insulin pumps (36.5%), nutrition (37.4%), and insulin and glucagon (37.9%). Actual and perceived diabetes knowledge were moderately positively correlated (rho = 0.18, p =.009). In six of the seven knowledge domains examined, school nurses perceived their diabetes knowledge better compared with their actual knowledge. DKQ scores were higher in nurses with higher education (p = .024), those who had relatives or friends with diabetes (p = .032), and those who had prior diabetes training (p = .050). Interestingly, DKQ scores were higher among nurses with fewer years of experience (rho = - 0.18, p = .011). Conclusions: There is a need for additional diabetes training among nursing students and practicing nurses to provide safe and effective care for children with type 1 diabetes.
... However, subsequent to the removal of DNE related QOF indicator DM013, there is less incentive to meet these (33) . Subsequently, the provision and uptake of DNE training to PNs remains opportunistic and ad hoc (14,16) and knowledge and skills levels is variable (34) . ...
... The lack of inter-professional working between nurses and dietitians identified in the present study and found elsewhere appears to worsen the situation for a number of reasons (26) , including undefined professional roles and no clear pathway for when to refer on. Despite nurses recognising that they should only provide 'basic' care, this situation appears to lead to nurses providing DNE beyond their skill level (34,49) . ...
... It was more likely for PNs to feel their level of knowledge and skills was insufficient for this role compared to ANPs. This diabetes knowledge gap is reported elsewhere (26,49,50) as a consistent feature of nursing in a range of settings (34) . The lack of courses was cited as the main obstacle to training; however, other studies highlight more barriers (16,49,51) . ...
Article
Background: High-quality nutrition education is recommended as an essential component of diabetes care. In the UK, there has been a gradual shift of inter-professional boundaries with respect to providing nutritional care for people with type 2 diabetes. Only a minority now regularly receive advice from a dietitian. Instead, increased demands for nutrition education are being absorbed by practice nurses. The present study seeks to explore this situation through the views of practice nurses on the services that they provide and the issues they face. Methods: A qualitative approach using semi-structured interviews was employed. Practice nurses were recruited using purposive sampling, and nine were interviewed. Data were analysed using the Framework Method. The Theoretical Domains Framework from the COM-B ('capability', 'opportunity', 'motivation' and 'behaviour') model of behaviour change, as increasingly employed to explore the behaviour of healthcare professionals, was used to further frame the findings. Results: Practice nurses reported that ongoing diabetes nutrition education only took place at annual review appointments and was limited to 5-10 min. They described how they are expected to take on a more advanced role in diabetes nutrition education than they can provide and are becoming increasingly isolated in this role as a result of a lack of time, practical and informational support, and training standards and provision. Conclusions: A range of service improvements led by dietitians, which focus on strengthening the working environment and enhancing professional support available for practice nurses who provide diabetes nutrition education, could improve quality of care and health outcomes in people with diabetes within current time restraints.
... [10,11,12] Two other studies, in Rwanda, [13] and Zimbabwe, [14] reported nurses lacked knowledge of pain management. Other studies reported that nurses lack updated resources and insufficient knowledge, and many patients do not receive any formal diabetes education [14,15,16] Conversely, a study in Nigeria reported nurses had good knowledge of HIV, [17] a topic with specific WHO protocols, regular nationwide training and international support. ...
... [25] -An OPENED insulin vial means the insulin cap has been removed and the rubber stopper has been punctured with a needle. OPEN vials can be kept at room temperature [15][16][17][18][19][20][21][22][23][24][25] or in the refrigerator for 28 days. [25] More Most participants were knowledgeable of the importance of foot care for diabetic patients and its prevention, as half (50.98%) were knowledgeable of poor sensation and circulation related to diabetic foot. ...
... [25] The findings of an integrative review of the international nursing workforce reported knowledge deficits of diabetes care. [16] The results of the review and our study findings, considering the likely increased prevalence of T2DM worldwide, indicates a need for more importance placed on diabetes education in nursing school and regular, affordable CPD and training at work. The limited number to diabetic experts, a shortage of nurses in certain health facilities, and heavy patient workloads, with subsequent low staff morale, creates many barriers to improve the situation of diabetic care. ...
... There are very few reports of diabetes knowledge held by nurses providing community-based diabetes care. A recent review identified three cross-sectional studies published in the last 10 years that documented actual knowledge and perceived knowledge held by nurses providing community-based diabetes care (Alotaibi, Al-Ganmi, Gholizadeh, & Perry, 2016). One of the three studies reviewed was the previous cross-sectional survey carried out in Auckland with 287 PHC nurses , and two were carried out in Australia that included 29 (Hollis, Glaister, & Lapsley, 2014) and 21 PNs (Livingston & Dunning, 2010), respectively. ...
... Nurses continue to pursue educational opportunities with significantly more nurses in 2016 than in 2006-2008 wanting further diabetes education which is associated with seeking further education (Alotaibi et al., 2016). Key findings from this study highlight the strong association between diabetes education and diabetes knowledge. ...
... Key findings from this study highlight the strong association between diabetes education and diabetes knowledge. Education programmes have been shown to increase knowledge of diabetes and improve the quality of care provided by nurses (Gerard, Griffin, & Fitzpatrick, 2010 Gaps in knowledge of major risk factors for type 2 diabetes, related complications and medication management were similar to those reported in a recent review of several hospital and primary care nurses surveyed across several countries (Alotaibi et al., 2016). ...
Article
Aim and objectives To examine trends since a previous 2006–2008 survey in diabetes knowledge held by primary health care nurses and their use of national diabetes guidelines, perceived ability to advise diabetes patients and preferences for further diabetes education. Background The obesity epidemic has led to a rapid increase in the prevalence of prediabetes and type 2 diabetes and to greater expectations for an expanded role for primary health care nurses in the prevention and community management of diabetes. Design Cross‐sectional survey using a self‐administered questionnaire and telephone interview and adheres to the STROBE guidelines. Methods All nurses who provide community‐based care in a major urban area were identified, and stratified by group, prior to random selection to participate in the study. A total of 1,416 practice, district (home care) and specialist nurses were identified who provide community‐based care. Of the 459 who were randomly selected, 336 (73%) participated in 2016 and were compared with a representative sample of 287 nurses surveyed in 2006–2008. Results Compared with nurses in 2006–2008, significantly more nurses in 2016 used diabetes guidelines, knew that stroke was a diabetes‐related complication, had a greater understanding of the pathology of diabetes and reported having sufficient knowledge to advise patients on laboratory results and improving outcomes through lifestyle changes. Despite these improvements, in 2016, only 24% of nurses could state that stroke was a complication of type 2 diabetes, only 37% felt sufficiently knowledgeable to advise patients on medications, and <20% could state that hypertension, smoking and the dyslipidaemia profile were important modifiable risk factors. Conclusion There have been improvements in nurse's knowledge but gaps remain for cardiovascular outcomes and associated modifiable risk factors and medication management. Relevance to clinical practice Education programmes should focus on improving cardiovascular risk management in patients with type 2 diabetes.
... Some differences were noted in the barriers encountered by nurses in different countries: while poor attendance at continuing education programs was identified as the main reason for poor diabetes knowledge by British nurses (Nash 2009), nurses working in developing countries were less likely to have access to educational materials and resources and appropriate diabetes training programs (Oyetunde & Famakinwa 2014). The wider employment milieu was also an influence, with nursing shortages, high workloads and consequent low job morale identified as barriers to nurses' acquisition of adequate diabetes knowledge (Alotaibi et al. 2016, Mutea & Baker 2008. ...
... Studies have also identified factors that facilitate nurses' diabetes knowledge acquisition and practice. Examples include participation in formal educational programs (Modic et al. 2014), provision of regular diabetes sessions (Gerard et al. 2010), diabetes resources groups, continuing in-service diabetes education, discussion of updates on diabetes care, and provision of resources for bedside nurses (Alotaibi et al. 2016, Gerard et al. 2010. There is, however, limited evidence of which factors facilitate or hinder diabetes knowledge acquisition of nurses in Saudi Arabia. ...
... There are clearly very real workload barriers, but few nurses anywhere, worldwide, would not report this as an issue (Mwebaza et al. 2014). Inadequate diabetes education programs, lack of institutional support and materials, heavy workloads and shortages of nursing staff have also been identified in studies from UK, the United States, Australia, Jordan and Nigeria (Alotaibi et al. 2016). ...
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... As for knowledge on the AKIN classification, in question 10, the nurses who work in private hospitals had more knowledge in relation to the nurses from public hospitals (14.0% vs. 5.6%) (p=0.08). Some studies measured the knowledge of nurses on topics such as the systematization of nursing care (10) , drug administration via nasogastric and nasoenteral feeding tubes (11) , hand hygiene (12) , diabetes (13) , and anticoagulation and atrial fibrillation (14) . However, no study related to AKI identification was found. ...
... Data drawn from other studies suggest knowledge deficits in other areas, including a systematic review regarding knowledge on diabetes (10)(11)(12)(13) . A study that included nurses from different countries showed significant deficiencies in several aspects of care to diabetic patients (13) . ...
... Data drawn from other studies suggest knowledge deficits in other areas, including a systematic review regarding knowledge on diabetes (10)(11)(12)(13) . A study that included nurses from different countries showed significant deficiencies in several aspects of care to diabetic patients (13) . When nurses start working in hospital units, they are faced with the need for taking over several administrative and care tasks and functions with an extensive weekly workload and, often, with several employment bonds, which can keep them away from continuous learning that is so crucial for caring for high-risk patients (15) . ...
Article
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OBJECTIVE To evaluate the knowledgeof nurses on early identification of acute kidney injury (AKI) in intensive care, emergency and hospitalization units. METHOD A prospective multi-center study was conducted with 216 nurses, using a questionnaire with 10 questions related to AKI prevention, diagnosis, and treatment. RESULTS 57.2% of nurses were unable to identify AKI clinical manifestations, 54.6% did not have knowledge of AKI incidence in patients admitted to the ICU, 87.0% of the nurses did not know how to answer as regards the AKI mortality rate in patients admitted to the ICU, 67.1% answered incorrectly that slight increases in serum creatinine do not have an impact on mortality, 66.8% answered incorrectly to the question on AKI prevention measures, 60.4% answered correctly that loop diuretics for preventing AKI is not recommended, 77.6% answered correctly that AKI does not characterize the need for hemodialysis, and 92.5% said they had no knowledge of the Acute Kidney Injury Networkclassification. CONCLUSION Nurses do not have enough knowledge to identify early AKI, demonstrating the importance of qualification programs in this field of knowledge.
... In vitro, 7 TTR binds Aβ and keeps it in a soluble form, preventing Aβ aggregation and fibrillation. In an in vivo AD transgenic mouse model, 8 ...
... Nurses play an essential role in the selfmanagement training of individuals with diabetes in health care settings (2). However, studies show that nurses and nursing students have inadequate knowledge about diabetes and its management (3)(4)(5)(6)(7)(8). Whereas, healthcare professionals should be owned with the basic knowledge and skills about diabetes care and management (9). ...
Article
Objective: This study aimed to examine the effectiveness of hybrid learning pedagogy in a redesigned diabetes nursing course for senior nursing students in enhancing knowledge and skills related to diabetes education. Methods: A single-group pre-test and post-test quasi-experimental design were used. The study was conducted between January-June 2018 in a state university's nursing department in Istanbul, Turkey. Sixteen senior nursing students were included in the sample group of the study. Results: It was detected that the Insülin Injection Skill Checklist (II-SC) post-test score, Blood Glucose Measurement Skill Checklist (BGM-SC) post-test score, and Educational Skills Checklist (ESC) post-test score were significantly higher than the pre-test scores. There was a significant difference between the Mini Exams (ME) pre-test and post-test scores of participants for each online lesson. Conclusions: The study results showed that a hybrid learning-based diabetes nursing course effectively increases the knowledge and skills of students regarding diabetes education.
... There were four distractors for each question, including the "I don't know" response category, coded as an incorrect answer during analyses. Three levels of knowledge were defined for the purpose of analyses: poor (a score of 0-6), fair (7)(8)(9)(10)(11)(12)(13)(14), and good (15)(16)(17)(18)(19)(20). STATISTICA 10.0 was used for statistical analysis. ...
... In the present study, significantly higher levels of knowledge of diabetic care recommendations were reported for specialised nurses and those participating in diabetes training courses. Other authors also showed that these factors were associated with better knowledge of diabetes [12,13,14,15]. ...
Article
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Aim. The aim of this study was to assess the need for updating nurses’ knowledge and skills in the field of diabetes care recommendations. Material and methods. The study included 580 nurses who were master’s degree students. A knowledge test including 20 questions on 10 procedures mentioned in the recommendations was used to collect research data. A total of 93.3% of students in the study group were professionally active. Results. A total of 11.9% of respondents had access to diabetes care recommendations. The largest knowledge deficits were found for: leaving an ‘old’ cannula for continuous insulin infusion using an insulin pump for 2-3 hours in place to allow for absorption of the accumulated insulin after inserting a new one; the time it takes to calibrate a continuous glucose monitoring (CGM) system by measuring capillary blood glucose after insertion of a CGM electrode; and indications for alternate site testing. Poor, fair, and good level of knowledge on recommendations was found in 12.8%, 84.3%, and 2.9% of respondents, respectively. Conclusions. 1) The level of knowledge of studying nurses on diabetic care recommendations is unsatisfactory. 2) Specialised nurses, as well as those participating in in-house training courses on diabetes and those declaring the accessibility of recommendations at workplace show a higher level of knowledge. 3) In the light of the development of new medical technologies, periodic workshops focusing on practical skills should be organised for nurses in their workplace, enabling the use of equipment for insulin administration and glucose monitoring.
... The World Health Organization (WHO) and the International Working Group on the Diabetic Foot (IWGDF) define diabetic foot disease as a state where the foot of a patient with diabetes presents with ulceration, infection, and/or destruction of the deep tissues, associated with various degrees of peripheral vascular disease and neurological abnormalities in the lower limb. [5][6][7][8] Diabetic foot disease is a serious and potentially devastating complication of diabetes. In extreme cases, it can result in non-trauma-related lower extremity amputation. ...
... Diabetic foot disease is a devastating complication of diabetes mellitus. [5][6][7][8] Determining medical students' level of knowledge regarding diabetic foot complications and the factors that lead to a higher level, will contribute to an improvement in the curriculum material, as well as help in focusing on the factors that result in a higher knowledge level. This study assessed the level of knowledge regarding diabetic foot management and the factors contributing to improved knowledge of this disease among medical students in their clinical years at KAUH. ...
Article
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Objectives: To evaluate medical students' knowledge of diabetic foot care management and its related factors. Methods: This was a cross-sectional, descriptive study of 303 students studying at King Abdulaziz University Hospital, Jeddah, Saudi Arabia conducted from June to July 2019. Data were collected using a two-part questionnaire. The first one captured student information; the second assessed student knowledge. It consists of 68 true and false questions divided into 4 subscales (risk factors, foot examination, foot complications and footwear selection). The higher the total score is, the higher the students' knowledge. Results: The total average knowledge score was 55.5±5.5 out of 68. While the mean score was 14.11/16 for risk factors, 9.24/10 for foot examination, 24.21/32 for foot complications, and 7.88/10 for footwear selection subscales. Only 56.4% of students educated diabetic patients about diabetic foot risks;concurrently, only 63% performed foot examinations in diabetes patients. Students who educated diabetic patients, preformed foot exam, or attended extra elective clinical rotation in a diabetic foot team, had a significantly higher knowledge level. Conclusion: Students were found to have high level of knowledge regarding diabetic foot management. Students who educated patients about diabetic foot risk, performed foot examination on patients and students who took elective rotations in a diabetic foot care team had a higher knowledge level.
... Association (ADA) and the American Association of Diabetes Educators (AADE) have defined the role and responsibilities of nurses through standardizing the patient education for diabetes educators [7]. According to the data of National Certification Board for Diabetes Educators (NCBDE) [8], approximately 1723 health professionals received a diabetes educator certificate in 2014. It is stated that the percentage of nurses having the certificate is 0.02%-19.6% in Turkey [9]. ...
... This finding supported the fact that determining the knowledge levels of clinic nurses about diabetes education is necessary. Similarly, in other studies it is shown that the nurses have lack of knowledge in diabetes education [8,18]. It is suggested that the health education for patients should be provided by the nurses who have become experts in their fields [5,14]. ...
... As an essential member of the care team in LTCFs, RNs' knowledge of diabetes care is very important (Aaron, 2014). A recent integrative review showed, however, that there were significant deficits in diabetes care knowledge among nurses across developed and developing countries (Alotaibi, Al-Ganmi, Gholizadeh, & Perry, 2016). Previous research has addressed issues of RNs' knowledge of diabetes care for older adults, mainly in acute care settings, not in LTCFs (Alotaibi et al., 2016). ...
... A recent integrative review showed, however, that there were significant deficits in diabetes care knowledge among nurses across developed and developing countries (Alotaibi, Al-Ganmi, Gholizadeh, & Perry, 2016). Previous research has addressed issues of RNs' knowledge of diabetes care for older adults, mainly in acute care settings, not in LTCFs (Alotaibi et al., 2016). To improve diabetes care in LTCFs, an understanding of current practices and RNs' knowledge of diabetes care for older adults is essential. ...
Article
... Nurses, as primary health care professionals, are in an ideal position to provide DM self-management education, both in hospital and community settings (Hollis et al., 2014). However, a plethora of research identifies that a significant number of nursing students and Registered Nurses either have questionable or a significant knowledge deficit in the area of diabetes mellitus and its management (Alotaibi et al., 2016;Chan and Zang, 2007;El-Deirawi and Zuraikat, 2001;Findlow and McDowell, 2002;Gerard et al., 2010;Modic et al., 2014;Tawalbeh and Gharaibeh, 2014;Thomas, 2004;Yacoub et al., 2014). This is disconcerting because good diabetes management requires competent healthcare professionals. ...
... Most studies to date have used various versions of the diabetes general knowledge test and have focused on the general diabetes knowledge of qualified nurses working in predominantly clinical settings (Baxley et al., 1997;Chan and Zang, 2007;Drass et al., 1989;El-Deirawi and Zuraikat, 2001;Findlow and McDowell, 2002;Gerard et al., 2010;Thomas, 2004;Van Zyl and Rheeder, 2008;Yacoub et al., 2014). An integrative review by Alotaibi et al. (2016), of diabetes knowledge of nurses internationally identified "wide-spread serious and sustained deficiencies in nurses' knowledge of diabetes and diabetes care" (p. 32). ...
Article
Objectives: To investigate the associations between knowledge and perceptions of diabetes mellitus (DM) among nursing students from Japan and Australia; and to compare curriculum differences. Research design and methods: Cross-sectional study. Convenience sample of students from Japan (N=78) and Australia (N=85) in their final year were surveyed. Students reported demographic details, and perceptions towards caring for patients with DM. The 23-item Michigan Diabetes Knowledge Test (MDKT) was used to assess general knowledge, and seven additional questions were used to assess DM-related clinical knowledge (CDKT). Multivariate logistic regression models were used to determine the associations between knowledge and perceptions. The curricula of the two universities were compared through a review of teaching hours on DM, teaching methods, class sizes and self-reported number of DM patients cared for during clinical placement. Results: Australian students were more likely to be aware of DM and identified caring for more patients on clinical placement during the course. They also performed better on the CDKT in comparison to the Japanese students (71.43% versus 65.02%). When teaching models were compared, the Japanese curriculum dedicated more hours to didactic classroom teaching on DM and had a smaller teacher to student ratio. While both groups felt they received enough classroom education on DM, the Japanese students self-reported lower perceived competency, self-confidence, and felt less prepared to care for DM patients. However Japanese students performed slightly better on the MDKT than Australian students (74.25% versus 70.03%). Being from Japan was a predictor for high MDKT score (>73.91%), while perceived preparedness was a predictor for high CDKT score (>71.43%). Conclusions: Statistically significant differences in DM knowledge (CDKT score) between students were found. There remains room for improvement, particularly a need for increased teaching hours at University and greater clinical practice time caring for patients with DM, to further improve knowledge and skills.
... Internationally, a number of barriers have been reported to contribute to nurses' failure to acquire or retain adequate diabetes knowledge. These include, lack of adequate training, lack of access to relevant resources, limited experiences in caring for patients with diabetes and poor attendance at diabetes continuing education (Alotaibi et al., 2016). These factors also featured for these nurses in Saudi Arabia and may at least have contributed to the differences in knowledge among and between groups of nurses. ...
... High workloads and low job morale have also been identified as barriers to nurses' knowledge of diabetes, its care and management (Alotaibi et al., 2016). It is important that hospitals focus on addressing these barriers, to enhance nurses' knowledge of diabetes. ...
Article
Background: With the worldwide increase in the incidence and prevalence of diabetes, there has been an increase in the scope and scale of nursing care and education required for patients with diabetes. The high prevalence of diabetes in Saudi Arabia makes this a particular priority for this country. Aim: The aim of this study was to examine nurses' perceived and actual knowledge of diabetes and its care and management in Saudi Arabia. Methods: A convenience sample of 423 nurses working in Prince Sultan Medical Military City in Saudi Arabia was surveyed in this descriptive, cross-sectional study. Perceived knowledge was assessed using the Diabetes Self-Report Tool, while the Diabetes Basic Knowledge Tool was used to assess the actual knowledge of participants. Results: The nurses generally had a positive view of their diabetes knowledge, with a mean score (SD) of 46.9 (6.1) (of maximum 60) for the Diabetes Self-Report Tool. Their actual knowledge scores ranged from 2 to 35 with a mean (SD) score of 25.4 (6.2) (of maximum of 49). Nurses' perceived and actual knowledge of diabetes varied according to their demographic and practice details. Perceived competency, current provision of diabetes care, education level and attendance at any diabetes education programs predicted perceived knowledge; these factors, with gender predicted, with actual diabetes knowledge scores. Conclusion: In this multi-ethnic workforce, findings indicated a significant gap between participants' perceived and actual knowledge. Factors predictive of high levels of knowledge provide pointers to ways to improve diabetes knowledge amongst nurses.
... Taken together, these results indicate that nurses perceive nutritional management as a part of their role, despite the fact that they have not received the proper training to do so, which makes them feel unconfident when conducting such a role (Carney et al. 2013). Although our study did not investigate the nurses' level of knowledge regarding diabetes nutrition, there are other studies in the literature that have shown that nurses lack knowledge regarding diabetes nutrition (Mogre et al. 2015;Alotaibi et al. 2016). Therefore, it is concerning that nurses perceive that giving dietary advice is one of their roles, while nurses' inadequate knowledge could mean that people with diabetes might receive inappropriate assistance in the management of their disease. ...
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Aim: The aim of the study was to understand how non-specialized nurses and people with diabetes understand nurses’ roles in diabetes inpatient care. Background: Diabetes mellitus is a major public health issue that places a significant burden on patients and healthcare systems and world leaders have targeted it for priority action. Design: An interpretative phenomenology approach (IPA). Methods: A total of 24 non-specialized nurses working in medical, surgical and nephrology wards and 24 people with type 1 diabetes who use the services of the state hospitals in Cyprus. The data were collected in two phases: firstly, focus groups with nurses (n = 1) and people with diabetes (n = 2) were conducted and analysed and then individual semi-structured interviews with nurses (n = 18) and with people with diabetes (n = 12) were conducted. Findings: It is evident from the study findings that nurses experience several roles in diabetes inpatient care. Most of these roles have been identified by people with diabetes as well. These roles are summarized as follows: medication administration, patient education, screening of complications, diet and psychological support. However, most of the participants raised concerns about nurses’ ability to conduct such roles. Conclusion: Participants suggest that nurses experience several roles in caring for diabetes inpatients and this view was also shared by people with diabetes. However, it was obvious that these roles differ between specialities. The findings showed that even though participants recognized a number of roles in diabetes inpatient care, their description of how they perform these roles was vague, and they raised concerns about their readiness to take on some of these roles.
... In addition, the recurrence rate for diabetic ulcers is as high as 30%-40% following the successful treatment of a first ulcer, with inadequate control of blood glucose levels being one of the main causes (Chu et al., 2016;Loveman et al., 2008). Diabetic patients often describe a lack of professional guidance in managing their own disease, which may be attributable, in part, to the lack of diabetes-related knowledge among orthopaedic nurses (Alotaibi et al., 2016). Studies have confirmed that when medical staffs are provided with high-quality health education, patients' blood glucose management and clinical outcomes are significantly improved (Jiang et al., 2015). ...
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Aim: To evaluate the level of diabetes knowledge and related influencing factors among Chinese orthopaedic nurses. Design: A cross-sectional observational study. The STROBE checklist was followed. Methods: A convenience sampling method was adopted by using the Questionnaire Star application to publish online questionnaire. The nurses' diabetes knowledge levels were assessed, including a total of 34 items from the "Orthopaedic Nurses Diabetes Knowledge Mastery Questionnaire" and the "Orthopaedic Nurses General Information Questionnaire" between July 2020 and September 2020. Results: Altogether, 363 nurses participated in the survey. Their levels of diabetes-related knowledge were moderate or lower (16.51 ± 2.96 out of 25 points). The knowledge level was closely related to five factors: professional title, education level, whether the hospital employed diabetes specialist nurses or treated outpatients, type of diabetes-related training received and whether the individual was familiar with and adhered to current treatment guidelines. The knowledge level can be improved by providing additional training that accounts for these factors.
... Study done among nurses in a tertiary hospital of Saudi Arabia found that there was significant gap between their perceived and actual knowledge [7]. An integrative review of 25 studies from developed and developing countries was done to synthesise nurses knowledge of diabetes and to identify factors that function as barriers and it demonstrated that there was a long standing knowledge deficit in many aspects of diabetes care [8]. ...
Article
General awareness about diabetes among patients is important for its management and prevention of its complications. Imparting such information to the people is the responsibility of health care workers among which nursing staff has a pivotal role. Hence it becomes important that the knowledge, attitude and practice among nursing staff regarding diabetes is assessed so that they can provide optimum care to the community. Diabetes was India's seventh biggest cause of early death in 2016. Diabetes increases the susceptibility for many life threatening infections as well, that is why tuberculosis is becoming highly prevalent in this group of patients. As the incidence and prevalence of diabetes is increasing, more people will require care from health professionals. Thus health care professionals like nurses in this case have responsibility to generate basic awareness about diabetes. It is important that the nurses should have right knowledge, attitude and practice of diabetes. Diabetes involves maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco.Diabetes may be treated with medications such as insulin sensitizers with or without insulin. The blood pressure and maintaining proper foot and eye care are important for people with the disease.
... The result showed that diabetes educators had higher overall score than other types of nurses, indicating that training on insulin injection knowledge should focus more on non-diabetes clinic nurses. It has been shown that nurses showed deficiencies in diabetes and diabetes care knowledge [18]. Our study further revealed that approximately one-third of the nurses surveyed had a poor insulin injection knowledge score and the deficits were particularly acute in injection site management and insulin needle disposal and hypoglycemia management. ...
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Introduction: To evaluate insulin injection knowledge, attitudes, and practices of nurses across China in order to provide reference for the formulation of a national unified standard of insulin injection practice and the targeted implementation of standardized training on insulin injection for nurses. Methods: We enrolled nurses who worked and injected insulin at grassroot hospitals including community health service centers and township clinics, secondary and tertiary care hospitals across China between July 28, 2019 and August 30, 2019. A nurse insulin injection knowledge, attitude, and practice questionnaire was used to evaluate the knowledge, attitude, and practice level of nurses. Results: A total of 223,368 nurses were included in the study. The mean knowledge score was 13.70 ± 3.30 and 35.19% had a poor knowledge score. The mean attitude score was 17.18 ± 2.69 for the study nurses; merely 3.15% had a poor attitude score. The mean practice score of the study population was 83.03 ± 8.16 and only 0.88% had a poor practice score. Pearson correlation analysis showed significant correlation between the knowledge score and the attitude score (r = 0.29; P < 0.001), the knowledge score and the practice score (r = 0.27; P < 0.001), and between the attitude score and the practice score (r = 0.56; P < 0.001). A multivariate analysis revealed that nurses with higher knowledge scores were also more likely to have higher attitude scores and practice scores, and nurses with higher attitude scores were also more likely to have higher practice scores. Conclusion: Chinese nurses have a good attitude and behavior towards insulin injection, while their knowledge of insulin injection is insufficient. It is also revealed that knowledge of insulin injection can directly or indirectly affect insulin injection behavior through attitude, indicating that hospitals should formulate unified insulin injection norms and regularly organize relevant training and assessment so as to improve nurses' knowledge, attitude, and behavior of insulin injection.
... The findings of the present study revealed that cadre of HCWs, location, years in practice with professional certificate, NCD training course attendance and the reported number of diabetic patients seen in the last 3 months were the major determinants of adequate knowledge of prevention and control of NCDs amongst HCWs in the PHC facilities. Alotaibi et al. 40 in their integrative review of studies on diabetes knowledge amongst nurses reported similar findings of nurses' inadequate training and education about diabetes, lack of access to relevant knowledge-based resources and work experience being major factors that influenced diabetes knowledge of nurses in developed and developing countries. Also, in the Democratic Republic of Congo, the level of knowledge of therapeutic objectives of treatment and control of diabetes was related to the level of healthcare providers' training and level of responsibilities at their health facilities. ...
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Background: There is a rising burden of non-communicable diseases (NCDs) in the sub-Saharan Africa, and calls for integration of management of selected NCDs with primary healthcare (PHC) have been unrelenting. Cost-effective interventions for the prevention and control of NCDs can be delivered at PHC facilities in low-resource settings by clinical healthcare workers (HCWs). Aim: This study compared the knowledge of HCWs in PHC facilities regarding the prevention and control of NCDs in rural and urban local government areas (LGAs) of Osun State. Setting: A comparative cross-sectional study was conducted amongst 400 eligible HCWs recruited using a multistage sampling technique in PHC facilities of six rural and six urban LGAs. Methods: A pretested self-administered case-scenarios questionnaire was used to assess the knowledge of HCWs regarding the prevention and control of three selected NCDs (diabetes, hypertension and chronic respiratory diseases). Both descriptive and inferential statistics were conducted. Results: The mean knowledge scores of HCWs regarding the prevention and control of the three NCDs were 17.76 ± 4.41 in rural and 17.62 ± 4.02 in urban LGAs out of 30 maximum scores. The proportion of HCWs with adequate knowledge in the rural LGAs (31.0%) was slightly higher than the urban LGAs (23.0%); however, it was not statistically significant (χ2 = 3.247; p = 0.072). The major determinants of adequate knowledge include cadre of HCWs, location, years in practice with professional certificate, NCD training course attendance and reported experience managing diabetic patients. Conclusion: The HCWs in PHC facilities in rural and urban LGAs of Osun State, Nigeria, had a poor knowledge regarding the prevention and control of NCDs. Training and re-training of less-skilled HCWs in the PHC facilities using relevant WHO NCD protocols and guidelines are imperatives to improve their knowledge about the prevention and control of NCDs.
... Previous studies affirmed that nurses' knowledge of diabetes management improved after receiving an educational intervention package on diabetes management intervention [22,23,24]. On the contrary, a study carried out in Jordan and Libya among registered nurses, and a systematic review carried out among nurses in different countries, the overall results indicated general deficiencies in nurses' knowledge of diabetes and diabetes care [22,24,25]. The knowledge level of nurses on diabetic management and creating a balance on the glycaemic index among diabetes patients cannot be over-emphasized. ...
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Introduction Diabetes mellitus is a chronic metabolic disorder that can lead to an increased length of hospital stay, delayed healing, and exacerbation of co-morbidities with complications arising if not properly managed. Better understanding and maintenance of normal blood glucose by nurses can positively influence care outcomes. The study aimed to assess nurses’ knowledge on the management of diabetes and skills in blood glucose monitoring. Material and methods A structured pre- and post-questionnaire was used to assess nurses’ knowledge on the management of diabetes, and a structured checklist was used to assess their skills in blood glucose monitoring. Three hundred and thirty-eight (338) participants directly involved in the provision of care to diabetic patients were randomly selected for the study. Data were analyzed using descriptive and inferential statistics. Results The study revealed that 58.9% of the respondents scored above the mean score of 33.1±3.5 during pre-assessment, which shows they had a good baseline knowledge of blood glucose. A post-intervention finding showed 64.8% scored above the mean score of 36.3±3.1. Assessment of nurses’ knowledge of blood glucose monitoring proficiency showed that 70.1% scored above the mean score of 11.4. Conclusions The educational intervention programme with a practical training session was an effective method of approach for improving blood glucose management among the participants. However, it is recommended that protocols and practice guidelines should be placed at strategic locations, and methods of empowering nurses, such as providing them with equipment needed to sustain this practice, should be heightened.
... [4,5] Due to high and increasing prevalence, diabetes is one of the most significant challenges of public health in Iran as a developing country. [6][7][8] In Iran, special care programs for people with diabetes began in the 1990s, but the first consolidated national program of diabetes control and prevention was implemented in 2004. The goals of diabetes control in Iran include reducing blood sugar to the recommended level through lifestyle modification and using drug, evaluation, and reduction of cardiac risk factors and regular screening of micro-and macro-vascular complications and rapid treatment of existing cases. ...
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Introduction: Diabetes is one of the most common metabolic disorders in the world and because of high prevalence and incidence rate, it is a serious challenge posed to the health system in Iran. Despite extensive knowledge of the desirable care for these patients, evidence suggests that the quality of care provided to these patients is not desirable. Objective: The aim is to develop a training program to enhance the preparation of health professionals for evidence utilization in providing comprehensive health cares to patients with diabetes. Materials and methods: This is an exploratory mixed-method study using consecutive qualitative-quantitative methods that will be conducted in three phases using the approach proposed by Werner and DeSimone to design the program. In the first phase, a qualitative study will be conducted for context assessment and identification of the requirements to enhance evidence utilization taking into account the overall knowledge translation process using semi-structured interviews with policymakers and health professionals. In the second phase, a training program will be designed based on the data extracted from the first phase, experts' opinions, and review of the literature. In the third phase, the training program will be implemented, and its effectiveness on the readiness of multidisciplinary health professionals for evidence utilization will be evaluated. Conclusion: The results of this study will provide a better understanding of how to identify and incorporate contextual factors and the real needs of health-care professionals and develop a program tailored to improving their readiness to use evidence. It can subsequently lead to providing quality care to patients with diabetes.
... Continuing education and support has been reported to result in positive practice changes amongst diabetes specialist and generalist HCPs working in rural and remote areas(Giles, Visentin, & Phillips, 2009).Deficits in diabetes knowledge and lack of organizational support to remedy this are not unique to diabetes educators. Wide-spread serious and sustained deficiencies in nurses' diabetes-related knowledge have been reported globally(Alotaibi, Perry, Golizedah, & Al Ganmi, 2016), which has implications for AYAT1D when they present to emergency departments or are hospitalized. Diabetes HCPs should be consulted on educational approaches that would be most useful and acceptable. ...
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Background Adolescence and young adulthood can be a period of significant and unique life changes in which competing demands and challenges distract from disease self‐management. Specific challenges related to the way individual services are configured can also limit the support available. This paper presents a discussion of healthcare service support for adolescents and young adults, using type 1 diabetes as an exemplar. Design Discussion paper. Results A wide variety of issues at the biopsychosocial level of the individual, health services policy and practice pose challenges to effective health support for adolescents and young adults. Intersectoral, multilevel and multicomponent opportunities are available to engage and empower young people to be part of change and accountability mechanisms and to transform the support available and outcomes achievable. A priority research agenda can benefit patients, families and their communities. Conclusion Future policy and practice development may assist clinicians, service providers and managers, policymakers, non‐governmental organizations and community groups to deliver more effective and efficient support to vulnerable adolescent and young adult populations.
... questionnaires) or clinical outcomes by observation. However, existing literature on this topic provides no evidence of any instrument that can be specifically applied to assess DEs' competence [22,23]. While one possibility could be to measure knowledge using validated and reliable tools such as 'Diabetes Basic Knowledge Test' and the 'Diabetes Self-Report Test.' [24], these do not capture all of the competencies required by DEs to deliver diabetes education effectively. ...
Article
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Aims: Diabetes educators (DEs) play a major role in diabetes education and management. The aims of this scoping review were to compile the currently identified core competencies for DEs and, to review the currently used criteria to assess DEs’ core competencies. Methods: A scoping review was conducted using the methodology of the Joanna Briggs Institute. Five databases (Ovid, CINAHL, Scopus, Web of Science and PubMed) were searched. Keywords as well as inclusion and exclusion criteria were identified as search strategies and study selection for this review. Results: A total of (n ¼ 22) publications comprising sixteen peer-reviewed studies and six professionalorganisations (grey literature) were selected for review, as they listed the core competencies of DEs. The most common core competencies were related to knowledge and skills in diabetes self-management education, knowledge of pathophysiology and epidemiology, teaching skills, clinical skills and cultural competency. Evidently, an appropriate tool for assessing DEs’ competencies is currently unavailable. Conclusions: Given the importance of diabetes education in the care of people living with diabetes, it is imperative that DEs possess competencies in diabetes education and management. The review also identified the need to develop a globally applicable core competency assessment tool for DEs.
... So, findings indicated a significant gap between participants' perceived and actual knowledge [16]. All in all, findings indicate widespread serious and persistent deficiencies in the knowledge of nurses in many aspects of diabetes care and about diabetes, and urgent strategies are needed to overcome identified obstacles to acquire knowledge [17]. ...
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Background: Nurses have an important role in the treatment of people with diabetes. However, the information which is transmitted to patients greatly depends on their knowledge of the subject. The aim of this study was to investigate the level of knowledge about diabetes among professional nurses. Method: The survey was conducted as a cross-sectional study in which 80 nursing students participated from high school in Subotica. The level of knowledge was evaluated using the Diabetes Knowledge Test. For statistical analysis, we used SPSS statistical program, methods of descriptive statistics. Results: Respondents have low skills (58.75%) in nutritional needs. Medium knowledge about controlling blood sugar (60%), and intermediate level of knowledge (63%) of chronic complications. The total knowledge about diabetes was 64.36%. Conclusion: The intermediate level of knowledge of diabetes, and low nutrition knowledge, which is the main activity of patient education by nurses, alerts us to possible errors in health educational work.
... 11 A review of studies in Thailand and developed countries, has revealed that most NPs do not feel confident in their abilities to take care of those with diabetes in the community and need to gain more training in DM management. 9,10,[12][13][14][15][16][17] Therefore, strengthening DM care management programs for NPs is necessary, particularly for those who work in remote areas. This study tested the effectiveness of a strengthening diabetes care program (SDCP) based on self-efficacy theory for the development of a DM care program for Thai NPs at primary care units. ...
Article
This randomized control trial examined the effects of a strengthening diabetes care program among Thai nurse practitioners working in a diabetic clinic at primary care units in a province in northern Thailand. The program was developed in three stages: 1) Self-administered questionnaires for analysis of the nurse practitioners’ competency in diabetes care management 2) Development of program contents to strengthen their competencies with five modules for classroom training nd three modules for e-learning program, and 3) A 4-week intervention, which coprised four consecutive days for classroom training and hree weeks for an e-learning prgram. The program was evaluated three times: pre-intervent on and weeks 4 and 8 post-inter ention. Sixty NPs were randomly assigned into experimental group (n=30) and control group (n=30). Data were collected with five self-administered questionnaires on demographic data form, perceived self-efficacy, outcome expectancy, knowledge, and care skills in diabetes care, and analyzed by using descriptive statistics, Repeated Measures ANOVA and Independent t-test.The findings revealed significant increases in mean scores of the experimental group on perceived self-efficacy, outcome expectancy, knowledge and skills in diabetes care higher than the control group at weeks 4 and 8 post-intervention. Based on the findings, the diabetes program can be used to strengthen nurse practitioners’competencies to build their confidence in diabetes care at primary care units with short course training and a subsequent e-learning program suitable for self-directed learning. Supervision should be monitored to help nurse practitioners in effective job performance. © 2019, Thailand Nursing and Midwifery Council. All rights reserved.
... Findings from these studies reported that nurses had inadequate knowledge of several aspects of nutrition management for diabetes, and they generally did poorly in relation to meal planning for diabetic patients. In an integrative review based on 25 related studies, the authors concluded that, generally, findings from the studies indicated wide-spread serious deficiencies in nurses' knowledge of diabetes and diabetes care [14]. ...
... This is consistent with a robust literature on nurses' knowledge of diabetes, which suggests a wide variation in nurses' understanding of diabetes. 15,16 The nurses stated they cur-rently rely heavily on certified diabetes educators for patients who are newly diagnosed or unit level diabetes resource nurses for complex patients, but these resources are often limited. ...
Article
Background: Methods to deliver diabetes education are needed to support patient safety and glycemic control in the transition from hospital to home. Purpose: This study examined barriers and facilitators of integrating web-based, iPad-delivered diabetes survival skills education (DSSE) into the nursing inpatient unit workflow. Methods: Nurses, nurse managers, and patient care technicians (PCTs) from 3 medical-surgical and 2 behavioral health units participated in semistructured interviews and focus groups. Results: Four themes emerged: educational program and content; platform usability; tablet feasibility (eg, theft prevention, infection control, and charging); and workflow considerations. Behavioral health unit-specific concerns were also identified. Findings indicated that nurses and PCTs were eager to find approaches to deliver DSSE. Conclusions: Implementation of a web-based DSSE program for inpatients needs adaptation to overcome challenges at the patient, care team, and process levels.
... questionnaires) or clinical outcomes by observation. However, existing literature on this topic provides no evidence of any instrument that can be specifically applied to assess DEs' competence [22,23]. While one possibility could be to measure knowledge using validated and reliable tools such as 'Diabetes Basic Knowledge Test' and the 'Diabetes Self-Report Test.' [24], these do not capture all of the competencies required by DEs to deliver diabetes education effectively. ...
Article
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Review question/objective: The purpose of the proposed review is, firstly, to map the core competencies for diabetes educators, as reported in the literature, and secondly, to review currently used criteria for core competencies in the assessment of diabetes educators.
... It has been reported that the quality of care and education provided depends on the provider's knowledge and experience [36]. Overall, results from previous studies conducted in both developed and developing countries indicated widespread serious and sustained deficiencies in nurses'knowledge of diabetes and diabetes care [37]. Therefore, public hospitals should aim to give structured educational programs which help people with diabetes to be more empowered to engage in self-care and lifestyle changes. ...
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Introduction Diabetes mellitus (DM) has increased globally, with a significant increase noted in African communities. Self-care health-related behavior is determined by beliefs about health and illness which are based on the person?s knowledge of diabetes. The present study aimed to assess patients' diabetes awareness and level of diabetes knowledge in Zimbabwean adults with diabetes attending an outpatient diabetes clinic at a main referral hospital. Methods In this cross-sectional descriptive study, the Diabetes Knowledge Test (DKT) was used to measure 96 (71 women and 25 men) patients' knowledge of diabetes and their treatment. Both descriptive and analytic statistical methods were used. Results Most respondents had poor knowledge in all the three knowledge categories, total knowledge of diabetes, general knowledge of diabetes and knowledge of insulin use. Major knowledge gaps were noted related to insulin use, glycemic control and diet. Attending DM classes was significantly associated with general knowledge about diabetes (p 0.026) while the level of education was an independent determinant of Total Knowledge and Insulin use knowledge scores. Conclusion The identified knowledge gaps need to be addressed to control and minimize diabetes mellitus-related complications.
... 26 Apreende-se, pelos depoimentos, que o conhecimento dos enfermeiros sobre os direitos da pessoa com DM ainda é incipiente, como exposto a seguir: Português/Inglês Rev enferm UFPE on line., Recife, 12(1):179-88, jan., 2018 186 ele tem, sim, prioridade de atendimento, a gente tem uma agenda programada para esses diabéticos e isso dentro do SUS ele tem, sim, direito de consultas quantas vezes no ano, pedidos de exames isso ele tem, agora direito, assim, outra forma de direito eu não sei, mas dentro do atendimento aqui ele tem. (E7)Por se tratar de uma condição crônica controlável, por meio de tratamento farmacológico e não farmacológico, grande parte das pessoas requer o apoio do Estado para viabilizar o tratamento e dos profissionais para esclarecê-los a fim de lograr esses direitos.Ao informar às pessoas sobre os seus direitos, o enfermeiro tem como propósito auxiliar as pessoas a obter os cuidados de saúde necessários, defender seus direitos, buscando a garantia da qualidade do cuidado servindo, assim, como um elo entre a pessoa que busca atendimento e o ambiente de cuidados de saúde.27 ...
Article
... The findings of this review highlight the importance of introducing measures into the Saudi healthcare system to update the knowledge and skills of all healthcare professionals involved with diabetes management to provide high quality diabetes care [31]. This is particularly important given the knowledge deficits reported in the nursing workforce both internationally and in Saudi Arabia [35,36]. ...
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Objective This study aimed to report on the trends in incidence and prevalence rates of diabetes mellitus in Saudi Arabia over the last 25 years (1990–2015). Design A descriptive review. Methods A systematic search was conducted for English-language, peer reviewed publications of any research design via Medline, EBSCO, PubMed and Scopus from 1990 to 2015. Of 106 articles retrieved, after removal of duplicates and quality appraisal, 8 studies were included in the review and synthesised based on study characteristics, design and findings. Findings Studies originated from Saudi Arabia and applied a variety of research designs and tools to diagnosis diabetes. Of the 8 included studies; three reported type 1 diabetes and five on type 2 diabetes. Overall, findings indicated that the incidence and prevalence rate of diabetes is rising particularly among females, older children/adolescent and in urban areas. Conclusion Further development are required to assess the health intervention, polices, guidelines, self-management programs in Saudi Arabia.
... The nurses' confidence and competence in providing care in diabetology can be affected by a lack of knowledge.Alotaibi et al. (2016) conducted systematic research in English in library databases from 2004 until 2014. The aim of this study was to identify, critically appraise and synthesize evidence of nurses' knowledge of diabetes and identify factors that function as barriers to nurses' acquisition of diabetes knowledge. 25 studies were included in the review and sy ...
... A study on improving healthcare providers' knowledge, attitude and practice found that general practitioners and nurses who have a higher level of knowledge and condence lead to stronger trust, better monitoring, and better adherence to new reproductive health guidelines. Due to the lack of knowledge and low condence in practice, healthcare provider face difculties in prescribing treatment and are reluctant to diagnose, instead they preferred to refer patient to specialist (Himelfarb, 2004;Alotaibi et al., 2016). ...
Article
Rationale, aims, objectives: Around one-third of medication errors resulting in death within 48 h involve insulin therapy. Despite a growing number of interventional strategies that have been published over the past decade, it remains unclear which of these interventions is effective in reducing insulin errors. Therefore, the study aimed to synthesize interventions to reduce the frequency of insulin errors in either home or health care settings. Methods: This integrative review was conducted based on Whittemore and Knafl's four steps, which includes problem identification, literature search, data analysis and presentation. Six databases including Cumulative Index of Nursing and Allied Health Literature (CINAHL), Medline, PubMed, Scopus, PsychInfo and Cochrane were searched from January 2010 through July 2021. The level of evidence quality was assessed according to the Johns Hopkins Nursing Evidence-Based Practice grading scale. Results: Sixteen studies meeting inclusion criteria were reviewed. The results provide strong support for teaching patients how to use automated bolus calculators and educating patients to self-administer insulin to prevent insulin errors in the home setting. Computerized protocols, education and double-checking procedures were also found to be effective strategies for minimizing insulin errors in healthcare settings. Conclusion: While the strategies might be effective in reducing insulin administration errors in the home settings, computerized protocols, continuing education and the manual validation of insulin products appear to be the most effective strategies for reducing such insulin errors in healthcare settings. Understanding these findings may help clinicians and patients to decrease the number of insulin errors administration.
Article
Background: A virtual reality simulation was used to teach treatment of diabetic patients. Methods: This study evaluated the impact of using virtual reality on short term knowledge of hypoglycaemia, via pairing of a randomised controlled trial, analysed via Partial Least Squares-Structural Equation Modelling. The setting was two large lecture theatres based at campuses within the UK. Second year nursing students (n=171) volunteered to take part in the study. Students were randomised into two groups, control (n=88) and experimental (n=83) . The trial enabled comparison, via pre and post-test surveys, of the simulation with normative teaching methods. Results: VR was found to be significantly (p=<.001) better in terms of hypoglycaemia knowledge than normative methods. The method also enabled identification of the key point of action of the simulation, which evidenced that the “engagement to immersion” pathway was responsible for leading to higher knowledge scores in the experimental group. Conclusion: This paper claims addition to knowledge about how the novel approach taken has the potential to deepen understanding of how virtual technologies can affect learning in nurse education.
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BACKGROUND Diabetic ketoacidosis is the cause of a significant number of hospitalisations worldwide, with rates tending to increase with remoteness and socioeconomic disadvantage. Our study aimed to explore healthcare professionals’ perceptions of factors affecting presentation of people with type 1 diabetes in a low socioeconomic area of Queensland, Australia. METHODS This was a qualitative study. Individual semi-structured face-to-face or telephone interviews were completed with patients with type 1 diabetes presenting in diabetic ketoacidosis, and healthcare professionals who have experience in related care. Data were analysed using Gibbs’s framework of thematic analysis. RESULTS Four patients with type 1 diabetes and 18 healthcare professionals were interviewed. Access was described as a factor contributing to diabetic ketoacidosis, and delays in presentation, with ketone testing supplies, continuous glucose monitoring technology and transport considered barriers. Many of these factors were arguably preventable. Opportunities to improve the care available to patients with type 1 diabetes were detailed, with almost all participants supporting a dedicated out of hours telephone support line for adults with type 1 diabetes. CONCLUSIONS Findings indicate a clear need for policy and strategies review, followed by service reconfiguration to support care delivery. Until change is made, people with T1D will continue to have some unnecessary, or possibly delayed Emergency Department presentations.
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Background: Limited research has been conducted in the field of diabetes educator's competency. However, no comprehensive and integrated explanations of educator's competence requirements in treatment centers exist in Iran. The aim of this study is to explain the components of diabetes educator's competence in diabetes self-management education in Iran. Materials and methods: This was a qualitative descriptive-exploratory study. The data were collected through semi-structured and in-depth interviews and using purposeful sampling method in Isfahan University of medical science from April to October 2018. Sampling continued until data saturation. Participants included 20 people who were selected by purposive and snowball sampling method. The interviews were analyzed using content analysis method of Graneheim, Lundman. Results: Data analysis resulted in the emergence of three main categories including (1) Patient and family centered education, (2) process-based education, and (3) continuous progress in profession and also seven subcategories (patient and family activation, empower), facilitating educational process, comprehensive education assessment, development, implementation and evaluation of educational plans, developing educators' educational knowledge and skills, development of creativity and innovation, promote inter-professional cooperation in education. Conclusion: The evaluation of facilitation factors for participation and empowerment patient and family along with creativity and interprofessional collaboration for comprehensive evaluation of patients in designing, implementation of educational programs were mentioned as important competencies of diabetes educators, which can have a significant impact on patients' recovery, treatment, and the promotion of society's health.
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Background Diabetes education provided by qualified and competent diabetes educators (DEs) is effective in reducing risks of diabetes complications. Globally, the DE workforce comprises a mixture of professions, with the majority being nurses. It is necessary to regularly assess DEs’ competence and knowledge to ensure that quality diabetes education is being delivered. Objective This study explored the self-perceived competence and the diabetes knowledge of DEs in the Kingdom of Saudi Arabia (KSA). Methods This study explored the self-perceived competence and the diabetes knowledge of DEs in the Kingdom of Saudi Arabia (KSA), using a quantitative, cross-sectional survey, administered at 20 diabetes centres. A total of 368 DEs were invited to participate in the study. Results Surveys were completed by 324 DEs (response rate = 88%), 84% (n=271) were nurses. From a possible overall range between 63-252, the mean (M) was 168.59 and standard deviation (SD) was (35.6) hence perceived competence of the DEs was low, Of a maximum possible score of 45 for the diabetes knowledge test, response scores ranged from 9 to 40, with M = 26.2 (6.0). Perceived competence and diabetes knowledge varied depending on age, nationality, educational qualification, primary profession, and whether or not the DE held a specialised diabetes qualification. Conclusion DEs in the KSA need to develop and enhance their competence and knowledge in order to provide quality diabetes care and education. The low perceived competence and scores in the knowledge test show that intervention measures are needed to regularly assess and improve the core competencies of DEs. Further research is required to identify DEs’ barriers to having sufficient competencies and knowledge.
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Background: This research investigated prelicensure nursing and physician assistant students' psychological well-being in an interprofessional, diabetic ketoacidosis (DKA) simulation. Method: A mixed-between within-subjects analysis of variance was performed to examine the impact of an interdisciplinary simulation, addressing the needs of a DKA patient, on health care students' perceived psychological well-being across three time periods (before simulation, immediate after the simulation, and after debriefing). Results: Statistically significant changes in psychological well-being were observed throughout the different time periods during the DKA simulation experience, Wilks' Lambda ¼ 0.85, F(2, 66) ¼ 5.732, p ¼ .005, partial eta squared ¼ 0.148. Conclusion: Health care students experience greater levels of psychological well-being when given the opportunity to participate in debriefing. As a result, health care simulation educators must ensure that appropriate debriefing time is allotted.
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Résumé Introduction Le transfert de connaissances de la recherche à la pratique infirmière devient essentiel pour garantir des pratiques soignantes fondées sur des résultats probants. La diffusion des connaissances est un facteur important du processus de transfert. Méthode Cet article propose une revue narrative de littérature sur la diffusion des connaissances scientifiques à la population infirmière. Objectif La recherche effectuée à partir des bases de données (PubMed®, Embase®, Cinahl®, Scopus®) et des moteurs de recherche (Google® et Google Scholar®) avait pour objectif d’établir un portrait global de l’état de la diffusion des connaissances scientifiques dans la population infirmière. Aucune restriction d’inclusion (date, méthodologie de recherche) n’a été opérée. Résultats La revue de la littérature, basée sur 95 articles, a permis de cerner la place de la diffusion dans le processus de transfert de connaissances, les barrières et leviers rencontrés par les infirmières, et le rôle des chercheurs et éditeurs dans la diffusion des connaissances.
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Inpatients with diabetes frequently experience episodes of hypoglycaemia, which are often managed by nurses. The present authors audited their local practice and found several deficits with regard to inpatient hypoglycaemia management. Following this, nurses were trained on the hypoglycaemia management guideline and hypo-boxes were introduced. Subsequent re-audits identified some recurring deficits. Using a questionnaire survey, this study aimed to identify if gaps in nurses' knowledge explain the recurring deficits in the hypoglycaemia management audits. Of 100 nurses who participated in the study, only 51% had formal training in hypoglycaemia management, and only 28% nurses knew the common symptoms of hypoglycaemia listed in the questionnaire. Interestingly, 73% of the hypoglycaemic episodes were detected by routine checks and this was predicted by nurses in the survey. The authors conclude that there is a lack of knowledge among ward nurses regarding hypoglycaemia management and that further training is necessary.
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Bowel management protocols have the potential to minimize complications for critically ill patients. Targeted implementation can increase the uptake of protocols by clinicians into practice. The theory of planned behaviour offers a framework in which to investigate clinicians' intention to perform the behaviour of interest. This study aimed to evaluate the effect of implementing a bowel management protocol on intensive care nursing and medical staffs' knowledge, attitude, subjective norms, perceived behavioural control, behaviour intentions, role perceptions and past behaviours in relation to three bowel management practices. A descriptive before and after survey using a self-administered questionnaire sent to nursing and medical staff working within three intensive care units before and after implementation of our bowel management protocol (pre: May - June 2008; post: Feb - May 2009). Participants had significantly higher knowledge scores post-implementation of our protocol (pre mean score 17.6; post mean score 19.3; p = 0.004). Post-implementation there was a significant increase in: self-reported past behaviour (pre mean score 5.38; post mean score 7.11; p = 0.002) and subjective norms scores (pre mean score 3.62; post mean score 4.18; p = 0.016) for bowel assessment; and behaviour intention (pre mean score 5.22; post mean score 5.65; p = 0.048) for administration of enema. This evaluation, informed by the theory of planned behaviour, has provided useful insights into factors that influence clinician intentions to perform evidence-based bowel management practices in intensive care. Addressing factors such as knowledge, attitudes and beliefs can assist in targeting implementation strategies to positively affect clinician behaviour change. Despite an increase in clinicians' knowledge scores, our implementation strategy did not, however, significantly change clinician behaviour intentions for all three bowel management practices. Further research is required to explore the influence of opinion leaders and organizational culture on clinicians' behaviour intentions related to bowel management for intensive care patients.
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Objective. The objective of this study was to evaluate perceptions regarding current practices in the care of diabetic inpatients as well as the knowledge and attitudes of nursing and medical caregivers at a large secondary hospital.Design and methods. Doctors and nurses taking care of diabetic inpatients were surveyed to assess their knowledge of diabetes inpatient management and their attitudes towards diabetic patients. The survey made use of the diabetes knowledge questionnaire (O'Brien) and the DAS3 scale.Results. The survey group comprised 115 health care providers, of whom 54 were doctors and 61 were nurses. The response rate was 82%. The doctors achieved a mean score of 68.3% (standard deviation (SD) 11.5%) and the nurses 53.9% (SD 16.3%) for the diabetes knowledge questionnaire. The DAS3 questionnaire indicated that 80.9% of health care personnel strongly agree that special training for managing diabetic patients is necessary, 90.5% agree or strongly agree that type 2 diabetes is a serious condition, 92.2% agree or strongly agree that tight glycaemic control is valuable, 85.2% agree or strongly agree that diabetes has a significant psychosocial impact on patients, and 88.7% agree or strongly agree that patients should have autonomy regarding their treatment.Conclusions. Health care workers (doctors and nurses) in a large secondary hospital have average to poor knowledge about the care of diabetic inpatients. The DAS3 questionnaire, however, indicates that health care workers have a good attitude towards diabetic patients and realise that special training is necessary.
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Purpose: To determine the level of diabetes knowledge and knowledge gaps among registered nurses. Methods: We conducted a cross sectional study among four major hospitals located in Benin City. Levels of knowledge were assessed using the 23-item University of Michigan Diabetes Research and Training Centre Knowledge Test questionnaire. Demographic characteristics of the respondents were also outlined. Association and differences between nurses' knowledge scores and relevant demographic variables were carried out using Pearson correlation and Student t-tests as appropriate. Results: The 191 nurses who participated in the study had an average score of 61.9±14.24 on a 100 point scale. No nurse was able to correctly answer all questions. Nurses were able to recognise long term complications of diabetes with 86.9%, 86.4% of the respondents answering correctly questions on symptoms of numbness and tingling, cause of high blood glucose, and problems associated with diabetes respectively. Although, nurses knew that diet plays a great role in management of diabetes mellitus, they were not aware of the effect of "unsweetened" fruit juice on blood glucose (15.2%), a free food for a diabetic (20.9%), and the identification of a proper diabetes diet (42.9%). There was a statistical difference in the knowledge scores of nurses that had a family history of diabetes and those that did not (P < 0.05). Conclusion: The knowledge of the nurses sampled as regards diabetes mellitus was less than satisfactory; areas of knowledge deficits include diet and signs of acute complications of diabetes as well as proper foot care. We suggest regular appraisal of nurses' knowledge requirement followed by educational training tailored to improve nurses' level of knowledge.
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The aim of this study was to describe the perception of nurses regarding educational practices conducted with children with diabetes in a hospital unit. It is a descriptive qualitative study, conducted in an inpatient unit of a public hospital in Fortaleza, state of Ceará, Brazil, between January and February of 2013, with six nurses. Data were collected by means of semi-structured interviews and submitted to content analysis, from which two categories emerged: role of nurses and staff in caring for the child with diabetes: the necessary intersection; and health education directed at the child with diabetes and family members in the hospital context. Nursing professionals acknowledged educational activities as part of an interdisciplinary care strategy which must occur since the moment the child is admitted. However, they displayed a reductionist view, centered on insulin therapy and changes of habit, which indicates the need for more creative approaches, capable of enhancing learning aspects and minimizing the gaps which prevent the disease from being managed appropriately.
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Results from a research project examining nurses' knowledge of diabetes empowered direct-care nurses to develop a hypoglycemia protocol, increasing accountability for the care provided and helping move from tradition-based to evidence-based practice.
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Unlabelled: Integrative review (IR) has an international reputation in nursing research and evidence-based practice. This IR aimed at identifying and analyzing the concepts and methods recommended to undertaking IR in nursing. Nine information resources,including electronic databases and grey literature were searched. Seventeen studies were included. The results indicate that: primary studies were mostly from USA; it is possible to have several research questions or hypotheses and include primary studies in the review from different theoretical and methodological approaches; it is a type of review that can go beyond the analysis and synthesis of findings from primary studies allowing exploiting other research dimensions, and that presents potentialities for the development of new theories and new problems for research. Conclusion: IR is understood as a very complex type of review and it is expected to be developed using standardized and systematic methods to ensure the required rigor of scientific research and therefore the legitimacy of the established evidence.
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Background: Acute hyperglycemia following cardiac surgery increases the risk of deep sternal wound infection, significant early morbidity, and mortality. Insulin infusion protocols that target tight glycemic control to treat hyperglycemia have been linked to hypoglycemia and increased mortality. Recently published studies examining glycemic control in critical illness and clinical practice guidelines from professional organizations support moderate glycemic control. Objectives: To measure critical care nurses' knowledge of glycemic control in cardiac surgery before and after education. To evaluate the safety and effectiveness of an evidence-based insulin infusion protocol targeting moderate glycemic control in cardiac surgery patients. Methods: This evidence-based practice change was implemented in the cardiovascular unit in a community teaching hospital. Nurses completed a self-developed questionnaire to measure knowledge of glycemic control. Blood glucose data, collected (retrospectively) from anesthesia end time through 11:59 PM on postoperative day 2, were compared from 2 months before to 2 months after the practice change. Results: Nurses' knowledge (test scores) increased significantly after education (pretest mean = 53.10, SD = 11.75; posttest mean = 79.10, SD = 12.02; t54 = -8.18, P < .001). Mean blood glucose level after implementation was 148 mg/dL. The incidence of hypoglycemia, 2.09% before and 0.22% after the intervention, was significantly reduced ( $${\hbox{ \chi }}_{1}^{2}$$ [n = 29] = 13.9, P < .001). The percentage of blood glucose levels less than 180 mg/dL was 88.30%. Conclusions: Increasing nurses' knowledge of glycemic control and implementing an insulin infusion protocol targeting moderate glycemic control were effective for treating acute hyperglycemia following cardiac surgery with decreased incidence of hypoglycemia.
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Diabetes is a chronic, progressive disease that affects millions worldwide. The paradigm of diabetes management has shifted to focus on empowering the person with diabetes to manage the disease successfully and to improve their quality of life. Diabetes self-management education is a collaborative process through which people with diabetes gain the knowledge and skills needed to modify their behavior and to self-manage successfully the disease and its related conditions. Diabetes educators are health care professionals who apply in-depth knowledge and skills in the biological and social sciences, communication, counseling, and pedagogy to enable patients to manage daily and future challenges. Diabetes educators are integral in providing individualized education and promoting behavior change, using a framework of seven self-care behaviors known as the AADE7 Self-Care Behaviors™, developed by the American Association of Diabetes Educators. The iterative process of promoting behavior change includes assessment, goal setting, planning, implementation, evaluation, and documentation. Diabetes educators work as part of the patient's health care team to engage with the patient in informed, shared decision making. The increasing prevalence of diabetes and the growing focus on its prevention require strategies for providing people with knowledge, skills, and strategies they need and can use. The diabetes educator is the logical facilitator of change. Access to diabetes education is critically important; incorporating diabetes educators into more and varied practice settings will serve to improve clinical and quality of life outcomes for persons with diabetes.
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Physical health assessment for people with a serious mental illness (SMI) has been a neglected issue, with all the evidence showing that mental health nurses (MHNs) and associated practitioners need to develop such skills. The University of Huddersfield and South West Yorkshire Partnership Foundation Trust collaborated in a Physical Skills Project with the aim of facilitating knowledge and skills for MHNs. The development of the education and training workshop is presented. The results of a pre- and post-test evaluation of diabetes, evaluation of the workshop and, finally, implications for practice with regard to transferable knowledge and skill, are discussed.
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This study aimed to identify areas of deficient knowledge among hospital nurses regarding diabetes management; the ultimate goal was to improve the quality of care for people with diabetes who are admitted to hospital for other medical reasons. Diabetes-related knowledge was assessed in 116 nurses using a 66-item questionnaire; the mean total score was 48.5±15.1. Knowledge was highest for nurses working in paediatrics (62.0±5.5; P<0.05) when compared with nurses working in other specialty wards; the mean knowledge scores of nurses working in medicine units (53.0±12.8) was significantly higher than those working in surgery (43.6±16.2; P<0.01) and dermatology (38.3±15.2; P<0.01) units. However, the overall knowledge of diabetes among the nursing staff was found to be lacking; educational programmes covering diabetes and inpatient diabetes management would be useful to improve nurses’ knowledge.
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This study is drawn from a larger project that aimed to identify the staffing and organisational factors influencing the quality of diabetes care for older people living in residential care in regional Victoria, Australia. The focus of the current study is on medication management for residents with diabetes. With a continuous rise in diabetes in the population, there is an associated increase in the prevalence of diabetes in aged care residential settings. However, there is little specific guidance on how to manage diabetes in older people living in institutional settings who experience multiple concurrent chronic conditions. A triangulation strategy consisting of three phases. A one-shot cross-sectional survey (n = 68) focus group interviews and a case file audit (n = 20). Data were collected between May 2009-January 2010. Staff knowledge of diabetes and its contemporary medication management was found to be suboptimal. Challenges to managing residents with diabetes included limited time, resident characteristics and communication systems. Additionally, the variability in medical support available to residents and a high level of polypharmacy added to the complexity of medication management of resident. The current study suggests administering medicine to residents in aged care settings is difficult and has potentially serious medical, professional and economic consequences. Limitations to staff knowledge of contemporary diabetes care and medications potentially place residents with diabetes at risk of receiving less than optimal diabetes care. Providing evidence-based guidelines about diabetes care in residential care settings is essential to achieve acceptable outcomes and increase the quality of life for residents in public aged care. Continuing education programs in diabetes care specifically related to medication must be provided to all health professionals and encompass scope of practice.
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Objective: To evaluate nurses' perception regarding three different blood glucose control protocols for critically ill patients. Methods: As part of a randomized trial comparing three blood glucose control protocols in critically ill patients (Computer-Assisted Insulin Protocol, Leuven Protocol, and conventional treatment), all nurses participating in the study were asked to fill in a questionnaire to assess their perceptions of efficacy, complexity, feasibility, and safety (as to the occurrence of hypoglycemic episodes), an to indicate which protocol they would like to see adopted as the standard one in the Intensive Care Unit they worked. Results: Sixty nurses answered the questionnaires. Computer-Assisted Insulin Protocol was considered the most efficient protocol to maintain blood glucose levels within the target range by 58% of the nurses, compared to 22% for Leuven Protocol (p<0.001) and 40% for conventional treatment (p=0.04). Computer-Assisted Insulin Protocol was considered easier to use than Leuven Protocol (p<0.001) and as easy as conventional treatment (p=0.78). Out of the nurses, 37% considered Computer-Assisted Insulin Protocol more feasible than Leuven Protocol and conventional treatment. A total of 51% of nurses chose Leuven Protocol as the protocol more often associated with hypoglycemia, while 27% chose Computer-Assisted Insulin Protocol and 8% conventional treatment. Finally, 56% of the nurses selected Computer-Assisted Insulin Protocol as the protocol they would like to see adopted as the standard one in the Intensive Care Unit they were based, as compared to 22% that selected Leuven Protocol and 15% that selected conventional treatment. Conclusion: Computer-Assisted Insulin Protocol was considered more efficacious, easier to use and safer than Leuven Protocol by nurses. The complexity and feasibility of Computer-Assisted Insulin Protocol were considered similar to conventional treatment. Most nurses chose of Computer-Assisted Insulin Protocol as the protocol they would like to see adopted in their Intensive Care Units.
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Background Assessment of knowledge among resident trainees and nurses is very important since majority of patients admitted in hospital have underlying diabetes which could lead to adverse clinical outcomes if not managed efficiently. Therefore, the purpose of this study was to evaluate and compare the knowledge related to the management of diabetes among registered nurses (RN) and trainee residents of internal medicine (IMR), family medicine (FMR) and surgery (SR) at tertiary care hospitals of Karachi, Pakistan. Methods A validated questionnaire consisting of 21 open ended questions related to diabetes awareness was acquired through a study done at Thomas Jefferson University Hospital, Philadelphia with the permission of primary author. Results 169 IMR, 27 FMR, 86 SR and 99 RN completed a questionnaire that assessed the knowledge related to different aspects of management of diabetes. The results were further stratified by participant's specialty and level of training. The percentage of knowledge based questions answered correctly was found to be low. The overall mean correct percentage among all the participants was 50% +/- 21. There was no statistical difference in terms of knowledge between IMR & FMR residents (64% +/- 14 vs. 60% +/- 16, p = 0.47) respectively. The total scores of SR and RN were quite low (40% +/- 16 & 31% +/- 15 respectively).SR and RN were found to have profound deficit in both inpatient and outpatient knowledge of diabetes. We did not observe any improvement in level of knowledge of FMR & SR with increase in duration of their training (p = 0.47 & 0.80 respectively). In contrast, improvement in the level of knowledge of IMR was observed from first to second year of their training (p = 0.03) with no further improvement thereafter. RN's didn't respond correctly on most of the items related to in-patient management of diabetes (Mean score 40% +/- 20). Conclusion As there are no prior studies in our setting evaluating knowledge related to diabetes management among residents and nurses, this study is of paramount importance. Based on these results, considerable knowledge gaps were found among trainee residents and nurses pointing towards need of providing additional education to improve the delivery of diabetes care.
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In order to implement a tight glycemic control protocol in the ICU it is essential to obtain active nurse involvement. Our objective was to evaluate nurse's perception about three different blood glucose control protocols for critically ill patients.
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This study explored the knowledge and attitudes of Jordanian nurses toward patients with HIV/AIDS, particularly in regards to their sources of information and education. This survey utilized a cross-sectional design. A self-administered questionnaire developed by Eckstein was used in collecting the data. A total of 922 nurses completed the questionnaire. Overall, Jordanian nurses expressed negative attitudes toward patients with HIV/AIDS, and their level of HIV/AIDS knowledge was weak. Weak knowledge level was recorded among nurses in the following subsections: agent and immunology; course and manifestation; transmission and incidence; and precaution and prevention. Only in one subsection (risk group), did nurses show a good level of knowledge about HIV/AIDS. More than two-thirds of nurses (84%) refused to provide care to patients who tested positive for HIV/AIDS. Most of the nurse participants believed that currently provided HIV/AIDS information resources were inadequate (81.4 %). The majority of nurses were interested in support groups for staff nurses (96.5%). The major source of HIV/AIDS information obtained by Jordanian nurses was through Internet web sites (52.7%). The majority of nurses (96.2%) ranked their fear of getting AIDS from their nursing practice as overwhelming. The total attitude of participants towards patients with HIV/AIDS in all five subsections (i.e., fear of contagion, social stigma, fatal outcome of the disease, direct care, and education and counseling) was negative (84.3%). Accurate knowledge about HIV/AIDS along with an in-depth understanding of patients? needs can help alleviate much of the fear, anxiety, and stigma associated with caring for patients with HIV/AIDS.
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The diabetic foot project was an initiative designed to help develop a training package for community nurses and podiatrists. It also aimed to evaluate the impact of two days' training on the knowledge and reported practice of nurses and podiatrists in the management of the diabetic foot. The study used a two-group pre- and post-test design, which replicated the work of Luker and Kenrick (1993) and Nelson and Jones (1997). The Wilcoxon signed-rank test was used to determine if there was a difference between the experimental and control group scores. The results reported demonstrate the positive effect of the study days on practitioners' knowledge and reported practice, and the study has highlighted the potential to improve practitioners' knowledge and reported practice.
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This easy-to-read, user-friendly text explores the full range of basic topics typically covered in research courses in exercise science, kinesiology, and physical education. The book provides the information and skills needed to write effective research proposals and theses; read, assess, interpret, and apply published research; and understand how to conduct basic studies in health, physical education, exercise science, athletic training, and recreation. © 2008, 2004, 1994 Lippincott Williams & Wilkins, a Wolters Kluwer business. All rights reserved.
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Objective: Diabetes mellitus is a growing public health problem in the world. Health education by health workers is a key factor in the prevention of this chronic disease. The objective of the study was to determine nurses understanding of diabetes mellitus. Methodology: This was a cross-sectional descriptive study carried out at the University of Uyo Teaching Hospital between June to December, 2008. Registered nurses were questioned about the clinical features, diagnosis, complications and management of diabetes mellitus. The results were analyzed using appropriate statistical method. Results: A total of 113 nurses completed the questionnaire. Majority were below 50 years and were ward nurses. About 86.7% correctly identified the definition of diabetes mellitus (p < 0.01) and 26.7% identified <7mmol/l as the fasting plasma glucose diagnostic cut off for DM. Ninety seven percent agreed that DM is a chronic disease (p < 0.01). Polyuria (63.7%) and polydypsia (90.3%) were the commonest clinical features of DM identified. Insulin therapy was the most common form of management identified by 67.9% of the subjects. Majority (83.2%) agreed that weight reduction is useful. About two-thirds (67.2%) identified two oral hypoglycaemic drugs while 25(22.1%) could not identify any type of insulin. Most subjects (94.7%) could correctly identify treatment for hypoglycaemia, with 7.1% of the nurses saying that insulin can be used to treat hypoglycaemic coma. The eye (82.3%) was the most common organ identified as being complicated with DM. Less than half of the nurses could identify the symptoms of diabetic ketoacidosis while about half (50.9%) of the nurses could identify at least one symptom of diabetic ketoacidosis. Conclusion: Nurses' knowledge of diabetes mellitus in Uyo is adequate; however, there are deficits in certain aspects of diabetes management. Organization of regular diabetes educational programmes for nurses will improve these deficiencies in knowledge.
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Inadequate diabetes knowledge among secondary care staff may lead to poor delivery of inpatient diabetes care. To counter this situation in their institution, the authors developed a competency-based education project to improve the knowledge and skills of secondary care staff. This article describes how the project was set up, and how it improved the self-reported knowledge of secondary care staff.
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An analysis of patient safety incidents has noted that the prescribing and administration of subcutaneous injection (SC) insulin has been performed in an unsafe manner on frequent occasions, resulting in poor diabetes control, increasing hospital admissions and potentially putting lives at risk. The National Diabetes Inpatient Audit of acute hospitals found outcomes for people with diabetes were poorer due to common medication errors, and their hospital stay was on average three nights longer (NHS Diabetes, 2010). This article presents an in-depth examination and critical analysis of the process of safe administration of SC insulin within an acute setting. A pilot study was undertaken to investigate the knowledge of insulin and administration safety in one hospital surgical ward.
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As the prevalence of diabetes continues to rise, it is imperative to provide healthcare professionals with the training they need to manage the disease and to prevent complications. However, preventive care of foot problems can be particularly challenging in the long-term care (LTC) population. In this article, the authors describe a study that evaluated the efficacy of an evidence-based program for training nurses in LTC facilities that had two objectives: (1) to increase the knowledge and skills of nurses about foot care in residents with diabetes to prevent and manage diabetic foot lesions; and (2) to encourage nurses to incorporate regular foot examinations in clinical practice. The results of the study show that implementation of the training program can heighten awareness of the barriers involved when executing quality improvement initiatives in LTC environments.
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This study was conducted to evaluate the level of awareness about diabetes mellitus amongst students at Al-Balqa' Applied University in Al-Zarqa University College in Jordan. A structured questionnaire about the definition, causes and symptoms of DM was administered to college students of Bachelor degree of 4 specialties. The questionnaire comprised two sections about sociodemographics characteristics and general knowledge of diabetes. The response options were yes, no or I do not know. The interpretation of scores was defined as poor if the correct answers were (<50%), fair if the correct answers were (51-80%) and good if the correct answers were (81-100%). A total of 240 students were enrolled for the study. There ages were between 18-25 years. About 33.75% of students know the definition of DM, 31.2% of them considered insulin deficiency in type 1 DM and 41.6% insulin dysfunction in type 2 DM. About 27.5% of all students could correctly identify the cut-off point of 126 mg/dl fasting plasma glucose as being diagnostic for DM. Insulin and diet therapy were identified as the most common method of management of type 1 DM in 27% of the students. 79.2% of the students identified that Polyuria is the most common symptom of diabetes. There is poor of awareness of diabetes amongst college students especially students of the first year. More health education is needed to address these deficiencies in order to equip them with the knowledge to positively help their community to reduce the burden of DM on society.
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Technology can be used to supplement healthcare provider diabetes care by providing both educational and motivational support. Education can be provided using technology allowing patients to learn new practices and routines related to diabetes management. Technology can support daily diabetes self-management activities including blood glucose monitoring, exercising, healthy eating, taking medication, monitoring for complications, and problem-solving. This article describes an integrative review conducted to evaluate the types of technology being used to facilitate diabetes self-management and the effect of that technology on self-management and diabetes outcomes for adults living with type 2 diabetes mellitus. A literature review was conducted by searching Medline, PubMed, and Psych INFO databases using the search terms: diabetes self-management, technology, type 2 diabetes, smartphones, cell phones, and diabetes mellitus covering the years from 2008-2013. Articles relying on secondary data (editorials, systematic reviews) and articles describing study protocol only were excluded. Fourteen studies including qualitative, quasi-experimental, and randomized controlled trial designs were identified and included in the review. The review found that technological interventions had positive impacts on diabetes outcomes including improvements in hemoglobin A1C levels, diabetes self-management behaviors, and diabetes self-efficacy. Results indicate that technological interventions can benefit people living with diabetes when used in conjunction with diabetes care delivered by healthcare providers.
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Background: Diabetes patient education is central to achieving active participation in management of diabetes. This participation is critical to quality and quantity of life among diabetic patients. However, observations show uncontrolled and complicated diabetes; noncompliance with the treatment regimen traceable to poor transfer of knowledge. The study was designed to assess nurses’ knowledge of diabetes patient education in government hospitals in Ondo State. Method: The survey consisted of Four hundred and one registered randomly selected nurses working in various units of the selected hospitals. The instrument was a validated, self administered 44 – item questionnaire developed by the researchers using the professional prompter worksheet for diabetes education and content areas of diabetes education. The questionnaire focused on four content areas of diabetes education- nutrition, exercise and activity, glucose monitoring, and foot and skin care. Result: The result showed that the respondents were majorly females (82.3%). Seventy two percent of the respondents had between 1year and 5years of work experience. Only 8.2% had 1st degree. Respondents demonstrated poor know- ledge in the specified content areas of diabetes patients’ education. Good knowledge of nutrition was only 29.2% while that of exercise/activity was 24.9% of respondents. For glucose monitoring, only 24.9% had good knowledge while that of hygiene/foot care was 34.4% of the respondents. The mean scores for the content areas were nutrition: 5115; exercise/activity: 5014; glucose monitoring: 5014 and foot and skin care: 5316 respectively. Respondents with one to five years work experience performed better than those with longer years of experience in the selected content areas. Conclusion: In view of this result, it is recommended that definitive modules for educating diabetes patient be deve- loped for each health institution and more emphasis placed on continuing education of nurses to update their knowledge about current Diabetes management.
Article
Evidence-based practice (EBP) is used throughout multiple health-care professions and includes the use of best research available, client preferences, and the practitioner’s experience. Occupational therapy educational programs are required to incorporate EBP into their curriculum. A convenience sample of occupational therapy students from a private university completed a survey designed to measure students’ knowledge and confidence in EBP. The survey consisted of the Knowledge of Research Evidence Competencies (K-REC) and the Evidence-Based Practice Confidence (EPIC) scale, as well as demographic questions. Of the respondents (n = 47), third-year students indicated higher confidence in the ability to utilize EBP and higher levels of knowledge related to EBP than second- or first-year students. The more didactic and clinical experience that the students had, the more knowledge related to EBP they had, which increased their confidence in the implementation of EBP. The knowledge and confidence that students gain of EBP within their educational training and clinical experiences can influence their future use and implementation of EBP as clinicians. Without this information, therapists will lack the confidence and ability to apply EBP principles in a changing and demanding health-care environment.
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The aim of this study was to explore the perceived knowledge of diabetes among personnel practising in municipal care. The study was conducted using a qualitative approach through focus group interviews. The study included focus group interviews on three occasions, with a total of 22 enrolled nurses (ENs). The results showed that the ENs' perceived knowledge of diabetes was not optimal. However, the study findings demonstrated that the ENs felt they had sufficient knowledge of nursing interventions, especially in the prevention of foot complications. Nevertheless, they expressed feelings of insecurity about assessing symptoms, treatment, and interventions to be taken with high or low blood glucose levels. When providing opportunities for educating ENs prior to delegating to them the task of insulin administration, the training sessions should be structured and led by a diabetes nurse with pedagogical skills. It is important that the registered nurses who teach have up-to-date knowledge concerning developments and research in diabetes care. The results of the study show that ENs employed within municipal health care lack knowledge regarding the care of older people with type 2 diabetes. Therefore, it is essential that ENs receive structured education and training in diabetes in order to ensure good and safe diabetes care. Copyright © 2012 FEND. Published by John Wiley & Sons, Ltd.
Article
Health care workers employed in nursing homes need sufficient diabetes knowledge to make adequate decisions in order to optimise diabetes management and minimise complications which may arise from poor diabetes control. The aim of this study was to determine levels of diabetes knowledge among health care workers when presented with a case description regarding an older person. Ten health care workers were asked to read a paper copy of the case description, reflect upon it and express their understanding of the case in question. The main results were summarised in two categories: namely, diabetes knowledge in relation to the presented case description and general diabetes knowledge. Some of the respondents considered the symptoms to be related to hyperglycaemia, while others were uncertain. Health care workers' general diabetes knowledge varied. In order to optimise diabetes management and minimise complications, health care workers' knowledge gaps in diabetes need to be reduced through regular diabetes education. Copyright © 2013 FEND. Published by John Wiley & Sons, Ltd.
Article
A randomized controlled study assessed a self-paced, online educational course addressing the complex nursing care of hospitalized patients on basal-bolus insulin. Interactive quizzes and scenarios were used to reinforce learning. Knowledge in the intervention group increased significantly and was retained 3-months postintervention. Nursing professional development educators will find this article useful regarding methods for annual competency evaluation and for increasing staff's knowledge as part of a system approach for safely caring for patients with diabetes.
Article
Purpose: Practice nurses are ideally positioned to provide key aspects of self-management education to a large majority of people with diabetes within a primary care setting. However, practice nurses have seldom had comprehensive training in this field and consequently their role may have limitations. A study was designed to determine the diabetes related knowledge levels of practice nurses in a regional/rural setting in Australia. Methods: A cross-sectional study was undertaken using a questionnaire to identify the knowledge of practice nurses. A convenience sample of PNs (N = 52) was drawn from a Division of General Practice in a regional/rural area of NSW. Data was collected using a 14 item knowledge survey from the National Association of Diabetes Centres. Results: Twenty-nine PNs (55%) responded to the survey; primarily the participants were registered nurses (89.6%), only one had completed a postgraduate qualification in diabetes, although 76% had recently completed one or more short courses in diabetes management. Pathophysiology related knowledge was strong (M = 88%) as was knowledge concerning blood glucose monitoring (87%). Less strong was dietary knowledge (79.5%), although one particular question relating to sources of carbohydrate contributed to the lower score. The weakest knowledge area was medication management, with PNs scoring a mean score of only 54%. Conclusion: These findings suggest that PNs have deficits in the knowledge required for DSME and therefore, this must be addressed through targetting continuing professional development.