Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic Review

AIM: To examine the efficacy of clinical practice strategies in improving clinical outcomes and reducing length of hospital stay for inpatients with Type 1 and Type 2 diabetes. BACKGROUND: People living with diabetes are at increased risk of being admitted to hospital and to stay in hospital longer...

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Autores principales: Friel, Kathleen Michelle, McCauley, Claire, O’Kane, Maurice, McCann, Michael, Delaney, Geraldine, Coates, Vivien
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012072/
https://www.ncbi.nlm.nih.gov/pubmed/36992734
http://dx.doi.org/10.3389/fcdhc.2022.883283
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author Friel, Kathleen Michelle
McCauley, Claire
O’Kane, Maurice
McCann, Michael
Delaney, Geraldine
Coates, Vivien
author_facet Friel, Kathleen Michelle
McCauley, Claire
O’Kane, Maurice
McCann, Michael
Delaney, Geraldine
Coates, Vivien
author_sort Friel, Kathleen Michelle
collection PubMed
description AIM: To examine the efficacy of clinical practice strategies in improving clinical outcomes and reducing length of hospital stay for inpatients with Type 1 and Type 2 diabetes. BACKGROUND: People living with diabetes are at increased risk of being admitted to hospital and to stay in hospital longer than those who do not have the condition. Diabetes and its complications cause substantial economic loss to those living with the condition, their families, to health systems and national economies through direct medical costs and loss of work and wages. Length of stay is a major factor driving up hospitalisation costs relating to those with Type 1 and Type 2 diabetes with suboptimal blood glucose management, hypoglycaemia, hyperglycaemia, and co-morbidities shown to considerably impact upon length of stay. The identification of attainable evidence-based clinical practice strategies is necessary to inform the knowledge base and identify service improvement opportunities that could lead to improved clinical outcomes for these patients. STUDY DESIGN: A systematic review and narrative synthesis. METHODS: A systematic search of CINAHL, Medline Ovid, and Web of Science databases was carried out to identify research papers reporting on interventions that have reduced length of hospital stay for inpatients living with diabetes for the period 2010–2021. Selected papers were reviewed, and relevant data extracted by three authors. Eighteen empirical studies were included. RESULTS: Eighteen studies spanned the themes of clinical management innovations, clinical education programmes, multidisciplinary collaborative care and technology facilitated monitoring. The studies demonstrated improvements in healthcare outcomes such as glycaemic control, greater confidence with insulin administration and reduced occurrences of hypoglycaemia and hyperglycaemia and decreased length of hospital stay and healthcare costs. CONCLUSIONS: The clinical practice strategies identified in this review contribute to the evidence base for inpatient care and treatment outcomes. The implementation of evidence-based research can improve clinical practice and show that appropriate management can enhance clinical outcomes for the inpatient with diabetes, potentially leading to reductions in length of stay. Investment in and commissioning of practices that have the potential to afford clinical benefits and reduce length of hospital stay could influence the future of diabetes care. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=204825, identifier 204825.
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spelling pubmed-100120722023-03-28 Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic Review Friel, Kathleen Michelle McCauley, Claire O’Kane, Maurice McCann, Michael Delaney, Geraldine Coates, Vivien Front Clin Diabetes Healthc Clinical Diabetes and Healthcare AIM: To examine the efficacy of clinical practice strategies in improving clinical outcomes and reducing length of hospital stay for inpatients with Type 1 and Type 2 diabetes. BACKGROUND: People living with diabetes are at increased risk of being admitted to hospital and to stay in hospital longer than those who do not have the condition. Diabetes and its complications cause substantial economic loss to those living with the condition, their families, to health systems and national economies through direct medical costs and loss of work and wages. Length of stay is a major factor driving up hospitalisation costs relating to those with Type 1 and Type 2 diabetes with suboptimal blood glucose management, hypoglycaemia, hyperglycaemia, and co-morbidities shown to considerably impact upon length of stay. The identification of attainable evidence-based clinical practice strategies is necessary to inform the knowledge base and identify service improvement opportunities that could lead to improved clinical outcomes for these patients. STUDY DESIGN: A systematic review and narrative synthesis. METHODS: A systematic search of CINAHL, Medline Ovid, and Web of Science databases was carried out to identify research papers reporting on interventions that have reduced length of hospital stay for inpatients living with diabetes for the period 2010–2021. Selected papers were reviewed, and relevant data extracted by three authors. Eighteen empirical studies were included. RESULTS: Eighteen studies spanned the themes of clinical management innovations, clinical education programmes, multidisciplinary collaborative care and technology facilitated monitoring. The studies demonstrated improvements in healthcare outcomes such as glycaemic control, greater confidence with insulin administration and reduced occurrences of hypoglycaemia and hyperglycaemia and decreased length of hospital stay and healthcare costs. CONCLUSIONS: The clinical practice strategies identified in this review contribute to the evidence base for inpatient care and treatment outcomes. The implementation of evidence-based research can improve clinical practice and show that appropriate management can enhance clinical outcomes for the inpatient with diabetes, potentially leading to reductions in length of stay. Investment in and commissioning of practices that have the potential to afford clinical benefits and reduce length of hospital stay could influence the future of diabetes care. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=204825, identifier 204825. Frontiers Media S.A. 2022-05-18 /pmc/articles/PMC10012072/ /pubmed/36992734 http://dx.doi.org/10.3389/fcdhc.2022.883283 Text en Copyright © 2022 Friel, McCauley, O’Kane, McCann, Delaney and Coates https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Clinical Diabetes and Healthcare
Friel, Kathleen Michelle
McCauley, Claire
O’Kane, Maurice
McCann, Michael
Delaney, Geraldine
Coates, Vivien
Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic Review
title Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic Review
title_full Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic Review
title_fullStr Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic Review
title_full_unstemmed Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic Review
title_short Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic Review
title_sort can clinical outcomes be improved, and inpatient length of stay reduced for adults with diabetes? a systematic review
topic Clinical Diabetes and Healthcare
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10012072/
https://www.ncbi.nlm.nih.gov/pubmed/36992734
http://dx.doi.org/10.3389/fcdhc.2022.883283
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