The effects of an integrated education programme on the management of diabetic ketoacidosis

✍ Scribed by Thompson, C J ;Cummings, F ;Jung, R T ;Newton, R W

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 380 KB
• Volume: 12
• Category: Article
• ISSN: 1357-8170
• DOI: 10.1002/pdi.1960120518

✦ Synopsis

Abstract

A twelve month retrospective case note audit of the management of 35 episodes of diabetic ketoacidosis revealed deficiencies in the delivery of intravenous fluid and potassium chloride administration and in the rate of nasogastric intubation. These defects were addressed in a structured education programme for junior medical staff. A subsequent twelve month case note audit of 30 cases of diabetic ketoacidosis was conducted to evaluate changes in practice. Following introduction of the treatment protocol and education programme, patients were treated with larger volumes of intravenous fluid (median 5.8 v 3.6 litres, p=0.0001) and potassium chloride (150 v 60 mmol, p=0.0001), were more likely to have nasogastric intubation where clinically indicated (68% v 0%, p<0.001) and were less likely to become hypokalaemic (13% v 63%, p=0.001). Patients were returned more rapidly to subcutaneous insulin (20 v 29 hours, p=0.0005), though duration of hospital stay and complication rates were unchanged. Management of diabetic ketoacidosis can be successfully changed after introduction of an integrated postgraduate education programme.