Diabetes care in hospital--the impact of a dedicated inpatient care team

Diabet Med. 2008 Feb;25(2):147-51. doi: 10.1111/j.1464-5491.2007.02326.x. Epub 2008 Jan 14.

Abstract

Aims: At any given time, people with diabetes occupy approximately 5-10% of acute hospital beds. In addition, diabetes is associated with a greater length of stay (LOS). This is partially because of increased complexity of the cases but also because of unfamiliarity of dealing with the condition by other specialist teams.

Methods: In 2002, with increasing pressure on acute hospital beds, a team was established to improve the care of inpatients with diabetes admitted to Derriford Hospital. The team consisted of five diabetes specialist nurses dedicated to inpatient care, supported by a consultant and specialist registrar diabetologist. A link nurse responsible for diabetes was appointed on every ward and each individual with a diagnosis of diabetes was identified on admission. We have compared LOS of all patients with diabetes admitted between January 2002 and December 2006.

Results: LOS fell from a mean +/- se of 8.3 +/- 0.18 days in 2002 to 7.7 +/- 0.10 days in 2006 (P = 0.002). Significant falls were seen for emergency admissions (9.7 +/- 0.23 vs. 9.2 +/- 0.20, P < 0.001) but not elective admissions. The data show significant reductions in LOS for medical admissions (9.2 +/- 0.24 vs. 8.4 +/- 0.20, P < 0.001) but not surgical admissions. Over the same period, LOS for the total hospital population fell by 0.3 days (P < 0.001).

Conclusion: In conclusion, a team specifically employed to focus on inpatient diabetes care has a significant impact on LOS of this patient group.

MeSH terms

  • Diabetes Mellitus / economics
  • Diabetes Mellitus / nursing*
  • Female
  • Humans
  • Length of Stay / economics*
  • Male
  • Middle Aged
  • Patient Care Team / economics
  • Patient Care Team / organization & administration*
  • Pilot Projects
  • Retrospective Studies
  • Treatment Outcome