Knowledge, Attitudes, and Decision Making in Hospital Glycemic Management: are Faculty up to Speed?

Pichardo-Lowden, Ariana; Kong, Lan; Haidet, Paul

doi:10.4158/ep14246.or

Cited by 14 publications

(17 citation statements)

References 25 publications

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“…Furthermore, deficits are apparent among faculty, nurses, mid-level providers, and residency trainees. These deficiencies are related to limited biomedical and contextual knowledge regarding management of inpatient hyperglycemia and diabetes among providers; inattention to glycemic issues in the hospital and as patients transition home; low confidence in addressing glucose abnormalities, prescribing insulin, or educating patients regarding diabetes; failure to comply with recommended protocols; gaps in clinical decision making; and lack of familiarity with existing resources, among other factors (19–22, 24, 52, 53). Management of hyperglycemia and diabetes in hospitals requires a multidisciplinary approach where adequate communication across disciplines and among members of the clinical teams is promoted (10, 12).…”

Section: Discussionmentioning

confidence: 99%

“…Deficits related to hospital glycemic management can be ascribed to physicians in training as well as faculty (18, 20–22), and this is relevant given the direct role that clinicians from multiple disciplines have in the decision making process to address dysglycemia in the hospital. A common characteristic among the studies included in this review is that all studies achieved some learning and/or patient care goals.…”

Section: Discussionmentioning

confidence: 99%

“…Many gaps exist among healthcare providers in domains such as contextual and biomedical knowledge, attitudes, clinical decision making, confidence, and familiarity with existing hospital resources in regards to hospital diabetes care (17–22). Furthermore, the impact of providers’ knowledge on diabetes care is poorly understood.…”

Section: Introductionmentioning

confidence: 99%

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Perspectives on Learning and Clinical Practice Improvement for Diabetes in the Hospital: A Review of Educational Interventions for Providers

2017

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Objective The management of inpatient hyperglycemia and diabetes requires expertise among many healthcare providers. There is limited evidence about how education for healthcare providers can result in optimization of clinical outcomes. The purpose of this critical review of the literature is to examine methods and outcomes related to educational interventions regarding the management of diabetes and dysglycemia in the hospital setting. This report provides recommendations to advance learning, curricular planning, and clinical practice. Methods We conducted a literature search through PubMed Medical for terms related to concepts of glycemic management in the hospital and medical education and training. This search yielded 1,493 articles published between 2003 and 2016. Results The selection process resulted in 16 original articles encompassing 1,123 learners from various disciplines. We categorized findings corresponding to learning outcomes and patient care outcomes. Conclusion Based on the analysis, we propose the following perspectives, leveraging learning and clinical practice that can advance the care of patients with diabetes and/or dysglycemia in the hospital. These include: (1) application of knowledge related to inpatient glycemic management can be improved with active, situated, and participatory interactions of learners in the workplace; (2) instruction about inpatient glycemic management needs to reach a larger population of learners; (3) management of dysglycemia in the hospital may benefit from the integration of clinical decision support strategies; and (4) education should be adopted as a formal component of hospitals’ quality planning, aiming to integrate clinical practice guidelines and to optimize diabetes care in hospitals.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Perspectives on Learning and Clinical Practice Improvement for Diabetes in the Hospital: A Review of Educational Interventions for Providers

2017

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“…These 14 field documents were transcribed into electronic files and coded. The coding method used was a directed content analysis based on a priori knowledge of existing barriers to diabetes care in the hospital . In addition to known barriers, we coded observations representing newly identified barriers and themes that suggested potential approaches to solve existing or newly identified barriers.…”

Section: Methods: Research Design Setting Participants and Analysismentioning

confidence: 99%

“…A host of barriers related to health care providers and systems of practice seem to perpetuate gaps in care. Many of these barriers to diabetes care have been identified through surveys conducted among health care practitioners, or inferred by findings of quantitative observational studies . However there is limited knowledge related to perspectives or experiences of health care providers on diabetes deriving from qualitative research .…”

Section: Introductionmentioning

confidence: 99%

Overcoming barriers to diabetes care in the hospital: The power of qualitative observations to promote positive change

Pichardo-Lowden

Farbaniec

Haidet

2018

Evaluation Clinical Practice

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Aims Despite advocacy by diabetes societies and evidence about how to prevent the deleterious consequences of dysglycemia among hospitalized patients, deficits in clinical practice continue to present barriers to care. The purpose of this study was to examine inpatient rounding practices using a qualitative research lens to assess challenges on the care of hospitalized patients with diabetes and to develop ideas for positive changes in hospital management of diabetes and hyperglycemia. Methods We conducted an interpretive analysis of qualitative observations during medical and surgical inpatient rounds at an academic institution. We coded, analysed, and reported data as thematic findings. Results Emerging themes include omissions in discussions during rounds; unpreparedness to address diabetes or dysglycemia during rounds; identifying practice improvement opportunities to address diabetes issues: and recognizing accountability within the routine of practice. Conclusions This work guides clinicians and informs systems of practice about improvement strategies that can emerge from within hospital teams. These recommendations emphasize the interconnectedness of practice elements including thoughtful review of glucose status during rounds among patients with and without diabetes; fostering doctors and nurses to work in unison; promoting awareness and integration within and across disciplines; and advocating for better use of existing resources.

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Barriers to High-quality Postoperative Glycemic Management by Surgical Teams: A Theory-informed Qualitative Analysis

Flemons

Cameron

Dossett

et al. 2023

Canadian Journal of Diabetes

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Knowledge, Attitudes, and Decision Making in Hospital Glycemic Management: are Faculty up to Speed?

Cited by 14 publications

References 25 publications

Perspectives on Learning and Clinical Practice Improvement for Diabetes in the Hospital: A Review of Educational Interventions for Providers

Perspectives on Learning and Clinical Practice Improvement for Diabetes in the Hospital: A Review of Educational Interventions for Providers

Overcoming barriers to diabetes care in the hospital: The power of qualitative observations to promote positive change

Barriers to High-quality Postoperative Glycemic Management by Surgical Teams: A Theory-informed Qualitative Analysis

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