DIABETOLOGIC IN-SERVICE EDUCATION FOR HEALTH-PROFESSIONALS FROM NON-DIABETOLOGICAL DEPARTMENTS

In order to test whether or not an in-service requalification course o n diabetes care for health professionals (HP) of nondiabetological dep artments can enhance their level of knowledge about diabetes and the q uality of care for diabetic inpatients admitted for reasons other than diabetes, we carried out a requalification course involving 171 HP (1 61 nurses and 10 midwives) from nondiabetological departments of our h ospital. Areas of intervention were: general knowledge of diabetes (GK D), bedside monitoring of blood glucose (BMG), insulin preparation and administration (IPA), diagnosis and treatment of hypoglycemic crises (DTH), and hospitalization-related problems (HRP). HP divided into gro ups of about 20 each, completed a basal evaluation by means of a 25-it em multiple-choice questionnaire, and then attended six separate educa tive sessions, each focusing on one topic, consisting of a theory less on and an interactive exercise of equivalent length. At the end of the course, HP were re-evaluated with the same questionnaire, and their s kills in BMG, IPA and DTH were tested by means of specific operational checklists, which divided each complex operation into a sequence of s ingle operations, and then compared them with those of a control group of untrained colleagues (CG). The global knowledge of diabetes after the course significantly improved, as gathered from the percentages of correct answers in each questionnaire (61.82%+/-23.64% vs 31.18%+/-20 .00%; P<0.001); separate analysis of different areas evidenced improve ments in GKD (72.28%+/-12.47% vs 31.46%+/-20.56%; P<0.01), BMG (68.77% +/-15.75% vs 37.50%+/-27.75%; P<0.01), IPA (72.02%+/-11.72% vs 33.45%/-21.22%; P<0.05), and DTH (90.76%+/-6.86% vs 49.82%+/-26.68%; P<0.05) , but not in HRP. Professional skills profiles of HP, evaluated by mea suring the number of errors done performing each task, were significan tly (P<0.001) better than those of CG, for BMG (1.09+/-0.73 vs 4.91+/- 2.01), IPA (2.36+/-1.64 vs 5.64+/-2.25), and DHT (1.27+/-0.94 vs 3.82/-1.12). Linear regression showed a significant (P<0.001) correlation of skills and knowledge after the course for BMG (r2=.49), IPA (r2=.53 ), and DTH (r2=.61). Positive although nonspecific indicators of outco mes of the course were the increase (of about 100%) of requests to our metabolic unit for diabetologic consultations from other departments as well as the mentioning of diabetes in the diagnosis of discharge, a nd the 200% increase in the consumption of sticks for BMG. The course produced a significant improvement of knowledge and skills on specific diabetologic items among participants.