Determination of Diabetes Knowledge Level in Intensive Care Unit Nurses

Abstract

Objective: The knowledge level of intensive care nurses, primarily responsible for follow-up and treatment in intensive care units, about general diabetes and insulin applications is significant for good glucose regulation. This study aimed to examine the knowledge levels of intensive care nurses about diabetes and the factors affecting them. Method: The descriptive study was conducted with 328 (n=328) nurses between February 2021 and June 2021. Demographic questionnaires and the Diabetes Knowledge Test developed by the Michigan Diabetes Research and Education Center were administered after obtaining the voluntary consent of the participants. The data obtained were evaluated by applying Kruskal Wallis, Mann Withney U, and Wilcoxon W tests in SPSS 25.0 program, and statistical significance was defined as p˂0.05. Results: When the answers given to the questionnaires according to the demographic data of the nurses were compared, it was found that the most important factors affecting the level of diabetes knowledge were the level of education and the number of relatives with diabetes. In our study, the level of diabetes knowledge in intensive care nurses was 74.8%. However, no statistically significant difference was found between nurses with and without intensive care certificates and nurses with and without previous diabetes education. Conclusion: In order to evaluate intensive care nurses, it is recommended that the content of diabetes education given in the in service and intensive care certificate programs and the survey questions be reviewed, planned and implemented for intensive care services.

Keywords

• Diabetes
• Intensive-care
• Knowledge
• Nurse

References

1. Abdullah, L., Margolis, S., & Townsend, T. (2001). Primary health care patients’ knowledge about diabetes in the United Arab Emirates. Eastern Mediterranean Health Journal = La Revue De Sante De La Mediterranee Orientale = Al-Majallah Al-Sihhiyah Li-Sharq Al-Mutawassit, 7(4–5), 662–670.
2. Adam, K. D., Wendel, C. S., Solvas, P. A., Hoffman, R. M., Duckworth, W. C., Murata, G. H., Shah, J. H., & Bokhari, S. U. (2003). Factors affecting diabetes knowledge in Type 2 diabetic veterans. Diabetologia, 46(8), 1170–1178.
3. Alotaibi, A., Al-Ganmi, A., Gholizadeh, L., & Perry, L. (2016). Diabetes knowledge of nurses in different countries: An integrative review. Nurse Education Today, 39, 32–49.
4. American Diabetes Association. (2021). 1. Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes—2021. Diabetes Care, 44(Supplement 1), S7–S14.
5. American Diabetes Association Professional Practice Committee, ElSayed, N. A., Aleppo, G., Bannuru, R. R., Bruemmer, D., Collins, B. S., Ekhlaspour, L., Galindo, R. J., Hilliard, M. E., Johnson, E. L., Khunti, K., Lingvay, I., Matfin, G., McCoy, R. G., Perry, M. L., Pilla, S. J., Polsky, S., Prahalad, P., Pratley, R. E., … Gabbay, R. A. (2024). Diabetes Care in the Hospital: Standards of Care in Diabetes—2024. Diabetes Care, 47(Supplement_1), S295–S306.
6. Anderson, R. M., Funnell, M. M., Fitzgerald, J. T., & Marrero, D. G. (2000). The Diabetes Empowerment Scale: A measure of psychosocial self-efficacy. Diabetes Care, 23(6), 739–743. https://doi.org/10.2337/diacare.23.6.739
7. Arda Dağdelen, Z. (2012). Aydın merkezde diyabet bilinci: Diyabetle ilgili bilgi düzeyi ve ilişkili faktörler, Tıpta Uzmanlık Tezi, Adnan Menderes Üniversitesi.
8. Aydoğan, A. (2005). Hemşirelerin Diyabet İle İlgili Bilgi Düzeylerinin Tespiti, Yüksek Lisans Tezi, Afyon Kocatepe Üniversitesi.

9. Bansal, V., Mottalib, A., Pawar, T. K., Abbasakoor, N., Chuang, E., Chaudhry, A., Sakr, M., Gabbay, R. A., & Hamdy, O. (2018). Inpatient diabetes management by specialized diabetes team versus primary service team in non-critical care units: Impact on 30-day readmission rate and hospital cost. BMJ Open Diabetes Research & Care, 6(1), e000460.
10. Canbolat, Ö., & Kapucu, S. (2021). The Effect of Computer Assisted Glycemic Monitoring Protocol on Workload of Intensive Care Nurses. Hacettepe Üniversitesi Hemşirelik Fakültesi Dergisi, 8(3), 293–298.
11. Canbolat, O., Kapucu, S., & Kilickaya, O. (2019). Comparison of Routine and Computer-Guided Glucose Management for Glycemic Control in Critically Ill Patients. Critical Care Nurse, 39(4), 20–27.
12. Chianca, T. C. M., Lima, A. P. S., & Salgado, P. D. O. (2012). Diagnósticos de enfermagem identificados em pacientes internados em Unidade de Terapia Intensiva Adulto. Revista Da Escola de Enfermagem Da USP, 46(5), 1102 1108.
13. Collins, G. S., Mughal, S., Barnett, A. H., Fitzgerald, J., & Lloyd, C. E. (2011). Modification and validation of the Revised Diabetes Knowledge Scale. Diabetic Medicine, 28(3), 306–310.
14. Corrêa, T. D., Almeida, F. P. D., Cavalcanti, A. B., Pereira, A. J., & Silva, E. (2012). Avaliação da percepção de enfermeiros sobre três protocolos para controle glicêmico em pacientes críticos. Einstein (São Paulo), 10(3), 347–353.
15. Coursin, D. B., Coursin, D. B., & Unger, B. (2002). Endocrine complications in intensive care unit patients. Seminars in Anesthesia, Perioperative Medicine and Pain, 21(1), 59–74.
16. Daly, B., Arroll, B., Sheridan, N., Kenealy, T., & Scragg, R. (2014). Diabetes knowledge of nurses providing community care for diabetes patients in Auckland, New Zealand. Primary Care Diabetes, 8(3), 215–223.
17. Drass, J. A., Muir-Nash, J., Boykin, P. C., Turek, J. M., & Baker, K. L. (1989). Perceived and Actual Level of Knowledge of Diabetes Mellitus Among Nurses. Diabetes Care, 12(5), 351–356.
18. Draznin, B., Gilden, J., Golden, S. H., Inzucchi, S. E., & for the PRIDE investigators. (2013). Pathways to Quality Inpatient Management of Hyperglycemia and Diabetes: A Call to Action. Diabetes Care, 36(7), 1807–1814.
19. El-Deirawi, K. M., & Zuraikat, N. (2001). Registered nurses’ actual and perceived knowledge of diabetes mellitus. Journal of Vascular Nursing, 19(3), 95–100.
20. Ergan, M., Başkurt, F., & Başkurt, Z. (2018). Fizyoterapi Öğrencilerinin Diyabet ve Risk Faktörleri Bilgi Düzeylerinin Belirlenmesi. 31, 1–7.
21. Evans, L., Rhodes, A., Alhazzani, W., Antonelli, M., Coopersmith, C. M., French, C., Machado, F. R., Mcintyre, L., Ostermann, M., Prescott, H. C., Schorr, C., Simpson, S., Wiersinga, W. J., Alshamsi, F., Angus, D. C., Arabi, Y., Azevedo, L., Beale, R., Beilman, G., … Levy, M. (2021). Surviving sepsis campaign: International guidelines for management of sepsis and septic shock 2021. Intensive Care Medicine, 47(11), 1181–1247.
22. Fitzgerald, J. T., Funnell, M. M., Anderson, R. M., Nwankwo, R., Stansfield, R. B., & Piatt, G. A. (2016). Validation of the Revised Brief Diabetes Knowledge Test (DKT2). The Diabetes Educator, 42(2), 178–187.
23. Fitzgerald, J. T., Funnell, M. M., Hess, G. E., Barr, P. A., Anderson, R. M., Hiss, R. G., & Davis, W. K. (1998). The Reliability and Validity of a Brief Diabetes Knowledge Test. Diabetes Care, 21(5), 706–710.
24. Futatsugi, H., Iwabu, M., Okada-Iwabu, M., Okamoto, K., Amano, Y., Morizaki, Y., Kadowaki, T., & Yamauchi, T. (2020). Blood Glucose Control Strategy for Type 2 Diabetes Patients With COVID-19. Frontiers in Cardiovascular Medicine, 7, 593061.
25. Gupta, T., & Hudson, M. (2017). Update on Glucose Management Among Noncritically Ill Patients Hospitalized on Medical and Surgical Wards. Journal of the Endocrine Society, 1(4), 247–259.
26. Hall, A. P., & Davies, M. J. (2008). Diabetic emergencies in acute/critical care. The Foundation Years, 4(6), 230–233.
27. İdiz, C., Çelik, S., Bağdemir, E., Dişsiz, M., & Satman, İ. (2020). Turkish Adaptation of Michigan Diabetes Research and Training Center’s Revised Diabetes Knowledge Test and Determination of Factors Affecting the Knowledge Level of Diabetic Individuals. The Turkish Journal of Endocrinology and Metabolism, 24(1), 38–46.
28. Khalaila, R., Libersky, E., Catz, D., Pomerantsev, E., Bayya, A., Linton, D. M., & Sviri, S. (2011). Nurse-Led Implementation of a Safe and Effective Intravenous Insulin Protocol in a Medical Intensive Care Unit. Critical Care Nurse, 31(6), 27–35.
29. Kim, H., & Oh, J. (2003). Adherence to diabetes control recommendations: Impact of nurse telephone calls. Journal of Advanced Nursing, 44(3), 256–261.
30. Leggett-Frazier, N., Turner, M. S., & Vincent, Paulinea. (1994). Measuring the Diabetes Knowledge of Nurses in Long-Term Care Facilities. The Diabetes Educator, 20(4), 307–310.
31. Livingston, R., & Dunning, T. (2010). Practice nurses’ role and knowledge about diabetes management within rural and remote Australian general practices. European Diabetes Nursing, 7(2), 55–62.
32. Magliano, D. J., Boyko, E. J., & IDF Diabetes Atlas 10th edition scientific committee. (2021). IDF Diabetes Atlas (10th ed.). International Diabetes Federation.
33. Modic, M. B., Albert, N. M., Nutter, B., Coughlin, R., Murray, T., Spence, J., & Brosovich, D. (2009). Diabetes Teaching Is Not for the Faint of Heart: Are Cardiac Nurses Up to the Challenge? Journal of Cardiovascular Nursing, 24(6), 439 446.
34. Modic, M. B., Vanderbilt, A., Siedlecki, S. L., Sauvey, R., Kaser, N., & Yager, C. (2014). Diabetes management unawareness: What do bedside nurses know? Applied Nursing Research, 27(3), 157–161.
35. Nash, M. (2009). Mental health nurses’ diabetes care skills – a training needs analysis. British Journal of Nursing, 18(10), 626–630.
36. Olsen, M., Granath, A., Wharén, P., Blom, T., & Leksell, J. (2012). Perceived knowledge about diabetes among personnel in municipal care: A qualitative focus group interview study. European Diabetes Nursing, 9(2), 52–55.
37. Ostling, S., Wyckoff, J., Ciarkowski, S. L., Pai, C.-W., Choe, H. M., Bahl, V., & Gianchandani, R. (2017). The relationship between diabetes mellitus and 30-day readmission rates. Clinical Diabetes and Endocrinology, 3,3.
38. Oyetunde, M. O., & Famakinwa, T. T. (2014). Nurses’ knowledge of contents of diabetes patient education in Ondo – state, Nigeria. Journal of Nursing Education and Practice, 4(4), p91.
39. Patterson, C. C., Karuranga, S., Salpea, P., Saeedi, P., Dahlquist, G., Soltesz, G., & Ogle, G. D. (2019). Worldwide estimates of incidence, prevalence and mortality of type 1 diabetes in children and adolescents: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice, 157, 107842.
40. Saeedi, P., Salpea, P., Karuranga, S., Petersohn, I., Malanda, B., Gregg, E. W., Unwin, N., Wild, S. H., & Williams, R. (2020). Mortality attributable to diabetes in 20–79 years old adults, 2019 estimates: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Research and Clinical Practice, 162, 108086.
41. Scheiderich, S. D., FreiBaum, C. N., & Peterson, L. M. (1983). Registered Nurses’ Knowledge About Diabetes Mellitus. Diabetes Care, 6(1), 57–61.
42. Shiu, A. T., & Wong, R. Y. (2011). Diabetes foot care knowledge: A survey of registered nurses. Journal of Clinical Nursing, 20(15–16), 2367–2370.
43. Soysal, A. (2019). Tip 2 diyabetli hastalarda diyabet bilgi düzeyi, sağlık okuryazarlığı ve diyabet öz yönetiminin glisemik kontrole etkisinin değerlendirilmesi, Uzmanlık Tezi, Eskişehir Osmangazi Üniversitesi.
44. Sucu, G., Dicle, A., & Saka, O. (2012). Decision Making in Clinical Nursing: Decision-Making Models and Affecting Factors. 9(1), 52–60.
45. The NICE-SUGAR Study Investigators for the Australian and New Zealand Intensive Care Society Clinical Trials Group and the Canadian Critical Care Trials Group. (2015). Intensive versus conventional glucose control in critically ill patients with traumatic brain injury: Long-term follow-up of a subgroup of patients from the NICE-SUGAR study. Intensive Care Medicine, 41(6), 1037–1047.
46. Thomas, E. (2004). Survey reveals shortfall in paediatric nurses’ knowledge of diabetes. 8(6), 217–221.
47. Toraman, K. (2019). İç hastalıkları kliniklerinde çalışan hemşirelerin diyabet farkındalığı ve diyabetli hastalara yaklaşımlarının incelenmesi, Yüksek Lisans Tezi, Sakarya Üniversitesi.
48. Valk, T., & McMorrow, C. (2020). Managing hyperglycemia during the COVID-19 pandemic: Improving outcomes using new technologies in intensive care. SAGE Open Medicine, 8, 2050312120974174.