The impact of the Diabetes Inpatient Care and Education (DICE) project on patient care outcomes

Akiboye, Funke (2021). The impact of the Diabetes Inpatient Care and Education (DICE) project on patient care outcomes. University of Birmingham. Ph.D.

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Abstract

Diabetes is a common disease with an increasing prevalence, however its management in the hospital setting is often a secondary concern with poorer outcomes in this group. The aims of this research were to 1) explore the impact of a nurse delivered whole systems approach, the Diabetes Inpatient Care and Education (DICE) project on diabetes inpatient care, examining the role of diabetes inpatient specialist nurses in the current health service, (2) examine the impact of diabetes and hyperglycaemia in patients attending for orthopaedic surgery and develop guidance for optimising care for these patients on this pathway; (3) explore the barriers and facilitators for staff in the implementation of a diabetes empowerment tool in the surgical pathway. The description, development and delivery of the DICE project are outlined in Chapter 1. In Chapter 2 the impact of the DICE project on length of stay, mortality and readmissions is examined using both before and after measurements and the quasi-experimental technique of interrupted time series analysis. A systematic review exploring the existing literature on the impact of diabetes inpatient nurses on patient care comprises Chapter 3, and Chapter 4 goes on to address some of the gaps highlighted in the systematic review by examining the impact of the DICE project on in-hospital complications and patient harms. Chapter 5 provides a review of the evidence for diabetes and hyperglycaemia in orthopaedic surgery, examining each stage of the perioperative pathway. It goes further to describe guidance for optimising care for patients along the pathway. Chapter 6 explores the reasons for the variable uptake of a pilot for a patient held passport by two groups of preassessment nurses. Finally, Chapter 7 summaries the lessons learned during this study and suggests areas for further research. My personal journey and the impact of undertaking the PhD are also discussed.

Type of Work:	Thesis (Doctorates > Ph.D.)
Award Type:	Doctorates > Ph.D.
Supervisor(s):	Supervisor(s) Email ORCID Nirantharakumar, Krishnarajah UNSPECIFIED UNSPECIFIED Marshall, Tom UNSPECIFIED UNSPECIFIED Lindenmeyer, Antje UNSPECIFIED UNSPECIFIED Adderley, Nicola UNSPECIFIED UNSPECIFIED Rayman, Gerry UNSPECIFIED UNSPECIFIED Rudge, Gavin UNSPECIFIED UNSPECIFIED
Licence:	All rights reserved
College/Faculty:	Colleges (2008 onwards) > College of Medical & Dental Sciences
School or Department:	Institute of Applied Health Research
Funders:	None/not applicable
URI:	http://etheses.bham.ac.uk/id/eprint/11738

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