Development of a Nurse-led Multidisciplinary Based Program to Improve Glycemic Control for People with Uncontrolled Diabetes Mellitus in a Community Hospital, Thailand

Authors

  • Nongnut Oba PhD, MNS, RN, Associate Professor, Faculty of Nursing, Naresuan University, Thailand.
  • Charlotte D. Barry PhD, RN, NCSN, FAAN, Professor, Florida Atlantic University, Christine E. Lynn College of Nursing, USA.
  • Shirley C. Gordon PhD, RN, NCSN, AHN-BC, Professor, Florida Atlantic University, Christine E. Lynn College of Nursing, USA.
  • Navarat Chutipanyaporn MNS, RN, Bangrahum Hospital, Phitsanulok, Thailand.

Keywords:

Glycemic Control, Multidisciplinary Approach, Nurse, Participatory Action Research, Uncontrolled Diabetes Mellitus

Abstract

               A multidisciplinary approach is strategy for glycemic control management for diabetes care, yet the type of health workforce at each level of the healthcare system is unequal. This participatory action research was designed in three phases and undertaken in a community hospital in Thailand. Phase 1 aimed at discovering the causes of uncontrolled blood glucose by two focus group discussions with healthcare providers and people with diabetes. In Phase 2, focus group discussion with stakeholders were undertaken to learn from the Phase 1 data to build a program for improving glycemic control among uncontrolled diabetes. Phase 3 aimed at implementing and evaluating the effectiveness of the developed program using a quasi-experimental design. Data from focus group discussions were analyzed by content analysis while the data before and after intervention were analyzed by percentages, mean, standard deviation, and paired t-test.

              Four categories related to causes of uncontrolled glycemia: poor hypoglycemic drug adherence, high energy dietary consumption, limitation on physical activity, and vigorous stress in life event. The improving glycemic control program developed in Phase 2 was the Nurse-led Multidisciplinary Based Program for People with Uncontrolled Diabetes. The Program goal was a decreased fasting blood glucose and an A1C of >8% and no hospital admission with either a hypoglycemic or hyperglycemic crisis. Program outcomes included significantly lower A1C compared with baseline levels (p<.01), and no hospital admissions. This Program provides an avenue for nurses to manage glycemic control in diabetes within a cooperative program in the community hospital.

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Published

2020-07-09

How to Cite

1.
Oba N, Barry CD, Gordon SC, Chutipanyaporn N. Development of a Nurse-led Multidisciplinary Based Program to Improve Glycemic Control for People with Uncontrolled Diabetes Mellitus in a Community Hospital, Thailand . PRIJNR [Internet]. 2020 Jul. 9 [cited 2024 Apr. 20];24(3):349-62. Available from: https://he02.tci-thaijo.org/index.php/PRIJNR/article/view/206447

Issue

Vol. 24 No. 3 (2020): July-September 2020

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Original paper

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Copyright: The Pacific Rim International Journal of Nursing Research, Thailand Nursing & Midwifery Council has exclusive rights to publish, reproduce and distribute the manuscript and all contents therein.