research presentation 2014
DESCRIPTION
Insulin-related knowledge among healthcare providers in HSNZTRANSCRIPT
by:
AILEEN TAY CHOO AI KHAIRUNNISA ZAMRI
MARILYN TAN MAY YEEN
INSULIN-RELATED KNOWLEDGE AMONG HEALTHCARE PROVIDERS IN
HOSPITAL SULTANAH NUR ZAHIRAH
PI :
IDA AFDZAN BINTI AWANG @ ROZALLI
Co - PI :
NOOR RODHIAH BINTI ABDUL RAHMAN
• The prevalence of diabetes mellitus is increasing around the world resulting in higher healthcare system costs and substantial premature mortality (Jill et al., 2012)
• The progressive decline in beta cell function ultimately renders oral agents ineffective and the majority of patients with diabetes will require exogenous insulin treatment (Vincent P et al., 2008)
• Insulin is widely accepted as the most effective treatment option available in diabetes management to achieve treatment targets for glycemic control (Schreiber SA et al., 2008).
INTRODUCTION
• This study will help healthcare provider to identify their level of insulin related knowledge and help the future researcher as a guide.
• Identification of areas of knowledge among different professions could provide a vital step towards implementation of educational diabetes programme and improvement of care standards for diabetes patients.
SIGNIFICANCE OF STUDY
• To evaluate insulin-related knowledge among different professions in HSNZ
• To identify the relationship between professional categories in HSNZ with insulin-related knowledge
• To identify the relationship between staff’s comfortability in managing diabetes with insulin related knowledge
• To identify the relationship between working experience with insulin-related knowledge
OBJECTIVES OF STUDY
• Material:
- A validated questionnaire (self-answered but guided)
used in a similar study by Derr et al. (2007)
- Consists of 16 multiple-choice questions with single best
answer (Question 5 – 20)
- questionnaire
MATERIALS & METHODS
• Method:
- Observational study
- Convenient sampling for all professional categories
- Location of survey :
* Neurology Clinic / Auditorium(for medical officers/ &
nurses)
* Main Pharmacy (for pharmacists)
- Duration of survey : May – July 2014
- Participants were not allowed to refer to any reference
materials or consult others
MATERIALS & METHODS
• INCLUSION:
All staffs who were attending medical CME
Medical officers
Nurses
Pharmacists
INCLUSION CRITERIA
SURVEY WORK FLOW Questionnaire comprised of 20 multiple-choice questions.
1) 4 background-related question and
2) 16 knowledge-based questions
-7 questions on insulin nomenclatures & characteristics
-9 questions on insulin use.
Questionnaires were distributed to respondents during medical CME sessions
All questionnaires were completed in one sitting
Completed questionnaires were scored manually
STUDY ANALYSIS
•Statistical analysis were performed using SPSS Version 17.0
•A value of p<0.05 was considered as statistically significant
DATA ANALYSIS & RESULTS
Statistical Test Significance value
Normality test
- Shapiro-Wilk
Population distribution p > 0.05
-the data is normal
One-way
analysis of
variance
(ANOVA)
Association between
scores of various
categories
Significant when p<0.05
-Professional categories
-Comfort levels
-Working experiences
A. Study population – Gender and Profession category(n=197)
Figure 1
DEMOGRAPHIC DATA
21
79
GENDER (%)
Male
Female
Figure 2
31
24
45 Medical officer
Pharmacist
Nurse
PROFESSION CATEGORY (%)
DEMOGRAPHIC DATA– COMFORT LEVEL
Figure 3
Reported comfort levels in managing diabetes
STUDY RESULTS- LEARNING MEDIUM A. Learning medium among medical doctors, nurses and pharmacists
Table 1
STUDY RESULTS – KNOWLEDGE SCORES B. Mean scores according to professional categories (between groups)
Table 2
Professional category
Mean scores
Insulin nomenclatures &
characteristics
Insulin use
Total score
Medical doctors 41.06 40.43 41.73
Nurses 27.81 35.98 34.29
Pharmacists 62.24 50.60 51.00
P value < 0.05 < 0.05 <0.05
There were statistically significant differences between profession
categories for both scores on insulin nomenclatures & characteristics (p <
0.05) and insulin use (p < 0.05)
* Statistical test done using One-way ANOVA
C. Comparison between comfort levels and knowledge scores
There was no significant difference between reported comfort levels and
insulin related knowledge (p >0.05)
STUDY RESULTS – COMFORTABILITY
Table 4
STUDY RESULTS – WORKING EXPERIENCE
Working experience
(years)
Mean scores
Insulin nomenclatures &
characteristics
Insulin use
0-5 41.06 42.43
6-10 37.12 38.50
11-20 33.50 36.21
21-30 49.50 33.00
p value > 0.05 > 0.05
D. Comparison between working experience and knowledge scores
(between groups)
Table 5
There was no significant difference between insulin related knowledge with working years among all profession categories (p>0.05)
* Statistical test done using One-way ANOVA
Profession category
Working experience
(years)
Mean scores
P value Insulin
nomenclatures &
chracteristics
Insulin
use
Medical officer
0-5 36.98 38.30
p < 0.05 6-10 39.0 33.0
11-20 71.00 55.00
21-30 42.00 -
Nurse
0-5 25.06 41.80
p > 0.05 6-10 29.29 38.79
11-20 26.88 29.94
21-30 57.00 33.00
Pharmacist
0-5 61.81 52.25
p > 0.05 6-10 63.80 44.00
E. Comparison between working experience of different profession
categories and knowledge scores (within groups)
Table 6
* Statistical test done using One-way ANOVA
RESULTS SUMMARY
Statistical Tests P value
Professional category vs scores P <0.05
Comfort levels vs scores P>0.05
Working experience vs scores P>0.05
•Working experience (medical officer) vs.
scores
P <0.05
•Working experience (nurse) vs. scores P>0.05
•Working experience (pharmacist) vs.
scores
P>0.05
• It was found that there were significant differences (p<0.05) in insulin – related knowledge among different professions in HSNZ.
• Pharmacists scored highest in both categories (insulin nomenclatures & characteristics - 62.24% and insulin use-50.6%) . This may be caused by their theoretical and practical training in medication use and better exposures to insulin therapy
• This finding is similar to other studies done by Melvin et al. (2013).
• Medical doctors are having similar score in both categories of insulin knowledge (insulin nomenclatures & characteristics- 41.06% and insulin use-40.03%).
DISCUSSIONS
• Nurses scored higher percentage in areas of insulin use(mean score 35.98%) compared to insulin nomenclatures & characteristics (mean score 27.81%)
• This difference reflects the role of the nurses in handling and using insulins in the medical wards.
• However, a study done by Derr et al. (2007) found that nurses scored higher in the latter aspect.
DISCUSSIONS
• Only 34% of participants reported “very comfortable” in managing patients with DM although majority are directly involved in patient management.
• There was no association between their comfort levels in managing diabetes and knowledge scores (p >0.05) although insulin is very commonly used in the treatment of hospitalized patients
• These results were in concordance to other studies by Derr et al. (2007) and Melvin et al. (2013).
DISCUSSIONS
• This study also showed there was no association between working experience with their insulin-related knowledge when compared among all profession categories(p>0.05).
• This shows that length of working experience do not equate the levels of insulin related knowledge among healthcare providers.
• However, there was an association between working experience of medical officers in both knowledge areas when data was analyzed within groups (p< 0.05).
• So far, there were no other studies that showed association between working experience and insulin-related knowledge.
DISCUSSIONS
• The level of insulin related knowledge is different among medical officers, pharmacists and nurses in HSNZ. Pharmacist scored highest followed by medical officers and lowest score was achieved by nurses.
• Insulin – related knowledge was associated with profession categories in both insulin nomenclatures & characteristics and insulin use.
• However, there was no association between insulin-related knowledge and reported comfort levels or working experience of all groups
CONCLUSIONS
• Besides continuous medical education, more efforts should be done to facilitate the communication among medical officers, pharmacists and nurses.
• Interrelated roles among healthcare providers and specific skill set are essential for safe insulin use to achieve better glycaemic control and desirable clinical outcome.
RECOMMENDATION
1. Kamal M, El-Deirawi and Nashat Zuraikat. Registered nurses’ actual and perceived knowledge
of diabetes mellitus. Journal of vascular dressing 2011: 19:95-100
2. Melvin KSL, Zhenghong L, Timothy PLQ, Daniel EKC, Insulin related knowledge among
healthcare professionals at a tertiary hospitals. Diabetes Spectrum; Summer 2013: 26, 3.
3. Practical Guide to Insulin Therapy in Type 2 Diabetes Mellitus. 2011.
4. Rachel L. Derr, MD; Mala S. Sivanandy, MD; Lauren Bronich-Hall, RD, CDE; and Annabelle
Rodriguez, MD. Insulin-Related Knowledge Among Health Care Professionals in Internal
Medicine. Diabetes Spectrum, 20(3), 2007.
5. Roman Trepp, Tonio Wille, Thomas Wieland, Walter H. Reinhart. Diabetes-related knowledge
among medical and nursing house staff. Swiss Med Wkly 2 010 ; 14 0 ( 2 5 – 2 6 ) : 3 7 0 – 3 7
REFERENCES
6. Asma A, Abdul J, Lubna Z, Muhammad I, Khusro S. Diabetes Related knowledge
among residents and nurses. BMC Endocrine disorder 2012; 12 (19)
7. Baxley SG, Brown ST, Pokorny ME, Swanson MS: Perceived competence and actual
level of knowledge of diabetes mellitus among nurses. J Nurses Staff Dev 13:93–98,
1997.
8. Clement S. Better glycemic control in the hospital: beneficial and feasible. Cleve Clin J
Med. 2007;74(2):111–20.
9. Gore MO, McGuire DK: The 10-year post-trial follow-up of the United Kingdom
Prospective Diabetes Study (UKPDS): cardiovascular observations in context. Diab Vasc
Dis Res 2009, 6(1):53–55.
REFERENCES