Reviewing proactive nursing intervention to T2DM patients with history of hospitalization for hypoglycemia in primary care setting: Experience from KCC FM&GOPC

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Authors (including presenting author) :
Yip SW, Yip KY, Kwan YM, Hui LC, Leung S H, Li YC
Affiliation :
Department of Family Medicine and General Out-Patient Clinic (GOPC), Kowloon Central Cluster (KCC)
Introduction :
Introduction: Hypoglycemia is a severe problem for diabetes patients and significantly increases the morbidity and mortality. It also results in emergency and hospital admissions and imposes a heavy burden on the health care system. Nursing assessment; tailored nurse interventions; patient education and empowerment are fundamentally important to reduce the incidence among diabetic patients in our community.
Objectives :
Objectives: Proactive Nursing Intervention program is structured, proactive nursing-based intervention, which aims to reduce incidence of severe hypoglycemia among diabetic patients follow-up in KCC FM &GOPC; secondly to prevent recurrent hypoglycemic attack in the primary health care setting.
Methodology :
Methodology: Type 2 diabetes patients who were regularly followed up in 3 GOPCs of KCC, with history of severe hypoglycemia and admitted to hospital from 1st of July 2018 to 30th of June 2018 were recruited. Proactive Nursing interventions were provided to patients: 1) Information on predisposing factors for hypoglycemia; incidence and frequency of hypoglycemia; patients’ knowledge and skill to manage hypoglycemia was collected by questionnaires. 2) Patients empowerment for early detection of hypoglycemia; skills on the management and prevention of hypoglycemia and self-blood glucose monitoring (SBGM) were taught by nurse in the nursing intervention sessions. 3) Patients, family members and home helpers were empowered for prevention of hypoglycemia according to individualized needs with in-depth knowledge delivery on: diet advice; use of medications; SBGM; exercise prescription and sick day management. The related information was given to patient in the form of booklets and cue cards. 4) Cases were reviewed at 6-month after nursing interventions for any recurrent of severe hypoglycemia.
Result & Outcome :
Results 85 diabetes patients with history of severe hypoglycemic attack and hospital admission were actively identified and recruited. 20 (23.5%) of them had more than one episode of hospitalization due to severe hypoglycemia. Most of the cases (87 %) were elderly patients with age over 65 years old. Major predisposing factors of severe hypoglycemia were sick and infection (41 %); decrease food intake due to sick (26%); and wrong dose of oral hypoglycemic drugs intake (3 %).

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