Diabetes mellitus has been diagnosed in more than 34 million individuals in the United States, and another 88 million adults are classified as ‘prediabetic,’ according to the Centers for Disease Control and Prevention. Many additional health concerns, including renal failure, skin problems, neuropathy, and visual difficulties, might arise if diabetes mellitus is detected early enough in the course of treatment. Diabetes symptoms may go undiagnosed for a long time, causing patients to put off making necessary lifestyle adjustments until it is too late and irreversible harm has been done (Rubin, 2018). Thorough diabetes education and adequate disease care are essential to avoid future problems since this population’s symptoms might go undiagnosed for so long.
Three qualitative research studies on diabetes and readmission prevention will be discussed in this presentation. In addition, an identified nursing issue will be addressed, as well as the methodology and findings of research given in these publications and any ethical problems that may arise. Finally, to further support the PICOT question posed by its author, this paper will examine whether or not providing diabetic education to patients with diabetes mellitus during each hospitalization reduces readmissions over six months compared to the first hospitalization for patients aged twelve to 65.
Article 1: Risk Factors, Trends, and Preventive Measures for 30-Day Unplanned Diabetic Ketoacidosis Readmissions in the Pediatric Population
Background of the study
In the US, the incidence of diabetes has steadily increased since 2001. A frequent and avoidable symptom of both kinds of diabetes mellitus is diabetic ketoacidosis. As per the U. S. Diabetes Surveillance System of CDC, DKA hospitalization rates increased by 59.5 percent between 2004 and 2019, with those under 45 having the highest rates. Patients’ and families’ experiences with readmissions directly reflect the effectiveness of the treatment provided (Vasireddy et al., 2021). Specifically, this research examines the patterns and risk variables associated with 30-day unscheduled DKA readmissions in the geriatric population and examines feasible preventative methods to reduce them
This paper supports the PICOT issue since it identifies if education may reduce the risk of readmissions among diabetes patients. The patient must learn and implement specialized education to their illness care to reduce readmission rates. However, because patients cannot put the knowledge into practice if they do not comprehend what is being said, the whole educational process is rendered ineffective.
National Readmission Database data from January through December 2017 were examined in retrospective research. ICD code was used to identify patients at 18 years or below with labeling of DKA in this population of children and adolescents. This study’s statistical findings were compiled using IBM SPSS Statistics as the primary statistical analysis tool. Pearson’s chi-square examination was utilized for data sets, while Mann-Whitney U examination was used for constant data. Multiple logistic regressions with odds ratios (OR) and 95% standard errors were used to find predictive factors of readmission in each clinical variable.
Using the 2017 NRD, 19,519 DKA-related pediatric file hospitalizations were found. A total of 831 (4.3 percent) of these children experienced 30-day DKA readmissions. With an interquartile range of 0 to 18, a kid’s median age of readmission was 16 years. For patients 16 and older, a significant increase in month DKA readmissions was seen. This study indicated that women in the 0-25th percentile of median family salary with Medicaid, extensive urban regions with one million people, and urban instruction hospitals were more likely to be re-hospitalized. DKA readmissions resulted in an average duration of stay of 2.06 days with a standard variation of 1.84 days. DKA readmissions cost an average of $20,339.70 in hospital fees.
Article 2: Risk factors for readmission of inpatients with diabetes: A systematic review
Background of the study
In the case of persons with diabetes who have been released from the hospital, there is little knowledge of the risk factors that lead to increasing readmission rates. Therefore, to finish the first evaluation, the project will identify potential risk aspects for hospital readmission among patients with diabetes in a systematic approach to comprehend this expensive consequence.
This study examines if a diabetic patient’s ability to self-manage their condition is improved by education, crediting the PICOT hypothesis. You will not have to worry about significant problems with good disease self-management (Robbins et al., 2021). Lower hospitalizations will be the result in the long run if illness complications are avoided.
The review was speculatively entered into the PROSPERO database. Factors were determined thru a comprehensive review of the literature in the PubMed, EMBASE, and SCOPUS databases, which was carried out separately by different writers before data retrieval, with quality evaluation and semi-quantitative formulation carried out following PRISMA recommendations.
Eighty-three research were chosen for inclusion, with the majority of them originating in the United States and relying on the retrospective review of local or regional data sets to accomplish so. Throughout 48 research, 76 unique statistically significant risk variables were found. The most often recognized risk variables were: co-morbidity load, age, race, and insurance type, to name a few examples. Power computations were done in just a few research, and unstandardized impacts sizes were derived for the greater part of statistically significant risk variables.
In any research project, it is critical to adhere to ethical principles to be considered trustworthy. Therefore, it is crucial to consider two key considerations: secrecy and permission. The participants’ identities in each of the studies presented were kept strictly secret. At no time throughout the research were names or any other information relevant to an individual’s identity disclosed. In addition, each subject gave informed permission before participating in the study. This enables the researchers to utilize the interviews and suggestions from the participants to further their research on a particular issue.
Considering the large number of individuals who have been diagnosed with diabetes, they must understand their illness entirely to live a long and healthy life. Therefore, it is essential to maintain a high level of education. When it comes to diagnosis, education is the most significant factor. However, this should never be the end of the story. Diabetes patients will benefit from ongoing education because they will be better able to control their diabetes and have fewer complications. In addition, because diabetes individuals can better manage their illness, hospitalizations will be reduced due to all of these factors.
Robbins, T. D., Keung, S. L. C., Sankar, S., Randeva, H., & Arvanitis, T. N. (2019). Risk factors for readmission of inpatients with diabetes: a systematic review. Journal of Diabetes and its Complications, 33(5), 398-405.
Rubin, D. J. (2018). Correction to: hospital readmission of patients with diabetes. Current diabetes reports, 18(4), 1-9.
Vasireddy, D., Sehgal, M., & Amritphale, A. (2021). Risk factors, trends, and preventive measures for 30-day unplanned diabetic ketoacidosis readmissions in the pediatric population. Cureus, 13(11).