院内专科一体化围术期血糖管理模式的构建与实施

Construction and implementation of hospital specialized integrated perioperative blood glucose management model

目的构建院内专科一体化围术期血糖管理的模式,分析其对非内分泌专科围术期患者血糖管理的效果。方法2017年3月,护理部主导组建专科一体化糖尿病护理小组,选拔各科骨干48名作为联络护士,成立院内糖尿病护理小组。2017年4—7月,对联络护士进行糖尿病管理知识培训,制定并督导试行科室对围术期患者血糖实施全程管理。比较培训前后糖尿病专科护士理论知识得分情况,专科一体化围术期血糖管理实施前后45个非内分泌专科病区胰岛素管理质量和床旁血糖检测质量,统计专科一体化围术期血糖管理实施后无糖尿病史妇科患者围术期血糖异常发生情况。结果培训后糖尿病联络护士糖尿病基础知识得分、胰岛素注射相关知识得分、血糖检测相关知识得分分别为(79.60±6.56)、(80.57±7.77)、(81.15±6.21)分,与培训前相比,差异均有统计学意义(P<0.01);专科一体化围术期血糖管理实施后非内分泌专科病区胰岛素管理质量得分、床旁血糖检测质量得分分别为(93.42±3.92)、(93.51±2.73)分,较实施前提高,差异均有统计学意义(P<0.01);专科一体化围术期血糖管理实施后,无糖尿病史妇科患者围术期术后血糖异常的检出率较高,达38%。结论专科一体化血糖管理提高了联络护士的糖尿病相关知识,提高了非内分泌专科病房糖尿病护理质量,促进了围术期患者血糖管理系统化、规范化。

Objective To construct an hospital specialized integrated perioperative blood glucose management model, and analyze its effects on perioperative blood glucose management of non-endocrine patients. Methods In March 2017, under the leadership of Nursing Department, a specialized integrated diabetes nursing team was established, with 48 nurses from various departments as liaison nurses setting up the hospital diabetes nursing team. From April to July 2017, diabetes management knowledge was given to the liaison nurses, and the whole course management of blood glucose in patients during perioperative period were formulate and supervised to carry out in departments. The theoretical knowledge scores of diabetic nurses before and after training, and the quality of insulin management and bedside blood glucose detection in 45 non-edocrine wards before and after the implementation of integrated perioperative blood glucose management were compared. The incidence of abnormal blood glucose in gynecologic patients without diabetes mellitus history after the implementation of integrated perioperative blood glucose management was analyzed. Results After training, the scores of diabetes basic knowledge, insulin injection related knowledge and blood glucose detection related knowledge of diabetes liaison nurses were (79.60±6.56),(80.57±7.77) and (81.15±6.21) respectively, with statistically significant differences compared with those before training (P<0.01). After the implementation of integrated perioperative blood glucose management, the scores of insulin management quality and bedside blood glucose detection quality in non-endocrine specialty ward were (93.42±3.92) and (93.51±2.73) respectively, which were higher than those before the implementation of integrated perioperative blood glucose management, and the differences were statistically significant (P<0.01). After the implementation of integrated perioperative blood glucose management, the detection rate of abnormal blood glucose in gynecologic patients without diabetes mellitus history was higher, reaching 38%. Conclusions Specialized integrative blood glucose management has improved the diabetes-related knowledge of liaison nurses, improved the quality of diabetes care in non-endocrine specialty wards, and promoted the standardization of blood glucose management system in perioperative patients.