Reducing hospital inpatient length of stay for patients with diabetes

Aims To ascertain the effect of routine review by a diabetes nurse advisor on length of stay for medical and surgical inpatients with diabetes. Methods Inpatients with diabetes were identified prospectively from January 1997 until December 1998 (792 in 1997 and 819 in 1998). A new post of diab etes nurse advisor was introduced in January 1998 to optimize diabetes mana gement. Length of stay was calculated retrospectively from hospital compute r records. Results Median length of stay in 1997 was 11 days in medicine and 8 days in surgery. In 1998, the nurse advisor made 1936 visits to 819 patients; medi an length of stay fell to 8 days in medicine and 5 days in surgery (P < 0.0 01). Bed occupancy by patients with diabetes fell from 6.8 to 4.0%. Mean le ngth of stay across the hospital remained unchanged. Conclusions The introduction of a ward-based diabetes nurse advisor was ass ociated with significant reductions in length of stay in inpatients with di abetes. Since this study was not a randomized study, other factors may have contributed to this change. However, the consistency of the reduction acro ss specialities suggests the post itself had an important effect.