A nurse-guided, basal-prandial insulin treatment protocol for achieving glycaemic control of hospitalized, non-critically ill diabetes patients, is non-inferior to physician-guided therapy: A pivotal, nurse-empowerment study

Gad Segal, Eli Karniel, Ahmed Mahagna, Fadi Kaa'dan, Zehava Levi, Chaya Balik

Research output: Contribution to journalArticlepeer-review

Abstract

Basal-prandial insulin is established for glycaemic control for hospitalized, type 2 diabetes patients. Empowering nurses to guide such protocols could be advantageous.The study aims to comparatively assess the efficacy and safety of glycaemic control by a nurse-guided protocol with physician-guided therapy. It also aims to assess the impact of empowerment on the nurses' sense of competence. This is a prospective, controlled, randomized, single-blinded study. Validated protocol utilizing basal-prandial insulin was used. Glycaemic control was the primary efficacy outcome, whereas hypoglycaemia and laboratory parameters were followed for safety. Assessment of nurses' psychological empowerment was done. One hundred fifty-eight treatment days of 53 patients were included. Patients were randomized to either study group (n=27) or control group (n=26). Glycaemia deviation from liberal range (60-300mg/dL) was 7.4% of days for nurse-guided, basal-prandial insulin treatment protocol (NGP) and 7.84% for physician-guided therapy (PGT), P=0.901. Rate of glycaemia deviation from the strict range (100-180mg/dL) was 49.76% for NGP and 47.38% for PGT, P=0.703. Mean range of daily deviation was similar (77.05mg/dL for NGP and 76.04mg/dL for PGT, P=0.93). There were no significant differences in safety parameters. An empowerment questionnaire showed tendency for increased nurses' sense of competence. Nurse-guided protocol is non-inferior to physician-guided treatment in efficacy and safety parameters. Nurses' sense of competence was positively influenced.

Original languageEnglish
Pages (from-to)790-796
Number of pages7
JournalInternational Journal of Nursing Practice
Volume21
Issue number6
DOIs
StatePublished - 1 Dec 2015

Keywords

  • Diabetes
  • Empowerment
  • Glycaemia control
  • Internal medicine

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