Effectiveness of Nurse-led Clinic for Diabetes Mellitus Patients: A Systematic Review
Keywords:
effectiveness, nurse-led clinic, diabetic patient, systematic reviewAbstract
In a nurse-led clinic nurses provide and manage services to improve the effectiveness of patient care. This systematic review aimed to summarize the best available evidence related to effectiveness of nurse-led clinics for diabetic patients. The primary research published between 2001 and 2015 were searched using a systematic guideline developed by Joanna Briggs Institute (2014). A total of 11 studies met the review inclusion criteria which included 9 randomized controlled trials and 2 quasi-experimental studies. Meta-analysis could not be applied because of the heterogeneous nature of the interventions and their outcomes. Instead, a narrative summarization was used in this systematic review.
The results of this systematic review were:
- There were four types of interventions of nurse-led clinic for diabetic patients:
1) case management in which the nurse manages patient care. An effective method for controlling blood sugar and blood pressure levels were telephone calls to monitor and modify patients’ behavioral every 2 months for a total of 12 calls; 2) program development for patients which included continued education, monitoring health behaviors and reminding patients of their follow up appointments; 3) discharge planning by a diabetes nurse specialist who plans care from admission through discharge; and 4) outpatient services which included direct patient care, organization and co-ordination of care for individual patients, consultation, and advancement of expertise. - The nurse-led clinics for diabetic patients were found to be effective in 3 domains: 1) clinical outcomes including the controlling of blood sugar and glycohemoglobin (HbA1c), blood pressure, and lipid profile; 2) financial outcomes including improved cost-effectiveness of hospital length of stay and reduce waiting time to see medical doctor; and 3) perceptual outcomes including patient satisfaction with services.
This systematic review suggests that 4 effective services in nurse-led clinic for diabetic patients which representing in clinical, financial and perceptual outcomes. In addition, the systematic review reflects the necessity of replication of experimental and quasi-experimental research to confirm the results of the study by using meta-analysis.
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