Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic Review
AimTo 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. BackgroundPeople living with diabetes are at increased risk of being admitted to hospital and to stay in hospital longer than...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Clinical Diabetes and Healthcare |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fcdhc.2022.883283/full |
| _version_ | 1818231559880179712 |
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| author | Kathleen Michelle Friel Claire McCauley Maurice O’Kane Michael McCann Geraldine Delaney Vivien Coates Vivien Coates |
| author_facet | Kathleen Michelle Friel Claire McCauley Maurice O’Kane Michael McCann Geraldine Delaney Vivien Coates Vivien Coates |
| author_sort | Kathleen Michelle Friel |
| collection | DOAJ |
| description | AimTo 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. BackgroundPeople 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 DesignA systematic review and narrative synthesis.MethodsA 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.ResultsEighteen 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.ConclusionsThe 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 Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=204825, identifier 204825. |
| first_indexed | 2024-12-12T10:52:19Z |
| format | Article |
| id | doaj.art-e292d6291d7a4dc691549390a2bb981d |
| institution | Directory Open Access Journal |
| issn | 2673-6616 |
| language | English |
| last_indexed | 2024-12-12T10:52:19Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Clinical Diabetes and Healthcare |
| spelling | doaj.art-e292d6291d7a4dc691549390a2bb981d2022-12-22T00:26:44ZengFrontiers Media S.A.Frontiers in Clinical Diabetes and Healthcare2673-66162022-05-01310.3389/fcdhc.2022.883283883283Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic ReviewKathleen Michelle Friel0Claire McCauley1Maurice O’Kane2Michael McCann3Geraldine Delaney4Vivien Coates5Vivien Coates6Department of Health and Life Sciences, Institute of Nursing and Health Research, Ulster University, Derry/Londonderry, Northern IrelandDepartment of Health and Life Sciences, Institute of Nursing and Health Research, Ulster University, Derry/Londonderry, Northern IrelandClinical Chemical Laboratory, Altnagelvin Hospital, Western Health and Social Care Trust, Derry/Londonderry, Northern IrelandDepartment of Computing, Letterkenny Institute of Technology, Donegal, IrelandDepartment of Health and Life Sciences, Institute of Nursing and Health Research, Ulster University, Derry/Londonderry, Northern IrelandDepartment of Health and Life Sciences, Institute of Nursing and Health Research, Ulster University, Derry/Londonderry, Northern IrelandAltnagelvin Hospital, Western Health and Social Care Trust, Derry/Londonderry, Northern IrelandAimTo 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. BackgroundPeople 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 DesignA systematic review and narrative synthesis.MethodsA 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.ResultsEighteen 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.ConclusionsThe 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 Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?RecordID=204825, identifier 204825.https://www.frontiersin.org/articles/10.3389/fcdhc.2022.883283/fulldiabetes mellituslength of stayinpatientclinical practiceclinical outcomes |
| spellingShingle | Kathleen Michelle Friel Claire McCauley Maurice O’Kane Michael McCann Geraldine Delaney Vivien Coates Vivien Coates Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic Review Frontiers in Clinical Diabetes and Healthcare diabetes mellitus length of stay inpatient clinical practice clinical outcomes |
| 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 | diabetes mellitus length of stay inpatient clinical practice clinical outcomes |
| url | https://www.frontiersin.org/articles/10.3389/fcdhc.2022.883283/full |
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