The Library
Effective implementation of peri-operative local guidelines for metabolic surgery in patients with diabetes mellitus in a tier 4 setting demonstrate improved work efficiency and resource allocation
Tools
Shah, Neha, Abraham, Jenny, Goodwin, Wendy, Kahal, Hassan, Menon, Vinod, Lam, F. T. and Barber, Thomas M. (2018) Effective implementation of peri-operative local guidelines for metabolic surgery in patients with diabetes mellitus in a tier 4 setting demonstrate improved work efficiency and resource allocation. Obesity Surgery, 28 (10). pp. 3342-3347. doi:10.1007/s11695-018-3389-3 ISSN 0960-8923.
|
PDF
WRAP-effective-implementation-peri-operative-local-guidelines-Barber-2018.pdf - Accepted Version - Requires a PDF viewer. Download (525Kb) | Preview |
Official URL: https://doi.org/10.1007/s11695-018-3389-3
Abstract
Background
Dynamic changes in glycaemia predominate peri-operatively in patients with type 2 diabetes mellitus (T2DM) undergoing metabolic surgery. There is a lack of consensus and clear guidance on effective glycaemic management of such patients. The aim of this study was to design, pilot, and implement a proforma to improve consistency of glycaemic management and clarity of communication with healthcare professionals following metabolic surgery in patients with T2DM, thereby reducing unnecessary diabetes specialist nurse (DSN) referrals.
Methods
A proforma was designed and piloted for 12 months to guide healthcare professionals on managing glycaemic therapies for T2DM patients undergoing metabolic surgery. Glycaemic control (HbA1c) and glycaemic therapies were reviewed 3 weeks pre-operatively and a proforma was completed accordingly.
Results
Of the patients with T2DM (n = 34) who underwent metabolic surgery prior to the new proforma being implemented, 71% (n = 24) had a DSN referral. Half of these referrals were deemed unnecessary by the DSNs. Of the patients with T2DM (n = 33) who underwent metabolic surgery following implementation of the proforma, 21% (n = 7) had a DSN referral. Only 10% of these were deemed unnecessary. Despite the reduced DSN input, no diabetes-related complications were reported.
Conclusion
Implementation of our proforma effectively halved the proportion of patients with T2DM requiring a DSN referral. Additionally, there was a 40% absolute reduction in the proportion of unnecessary DSN referrals. The proforma improved clarity of communication and guidance for healthcare professionals in the glycaemic management of patients. This also facilitated improved work efficiency and resource allocation.
Item Type: | Journal Article | ||||||||
---|---|---|---|---|---|---|---|---|---|
Subjects: | R Medicine > RC Internal medicine | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
||||||||
Library of Congress Subject Headings (LCSH): | Diabetes -- Surgery -- Standards, Metabolism | ||||||||
Journal or Publication Title: | Obesity Surgery | ||||||||
Publisher: | Springer | ||||||||
ISSN: | 0960-8923 | ||||||||
Official Date: | October 2018 | ||||||||
Dates: |
|
||||||||
Volume: | 28 | ||||||||
Number: | 10 | ||||||||
Page Range: | pp. 3342-3347 | ||||||||
DOI: | 10.1007/s11695-018-3389-3 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Reuse Statement (publisher, data, author rights): | This is a post-peer-review, pre-copyedit version of an article published in Obesity Surgery. The final authenticated version is available online at: https://doi.org/10.1007/s11695-018-3389-3 | ||||||||
Access rights to Published version: | Restricted or Subscription Access | ||||||||
Date of first compliant deposit: | 2 November 2018 | ||||||||
Date of first compliant Open Access: | 19 July 2019 |
Request changes or add full text files to a record
Repository staff actions (login required)
View Item |
Downloads
Downloads per month over past year