TY - JOUR
T1 - Can Clinical Outcomes Be Improved, and Inpatient Length of Stay Reduced for Adults With Diabetes? A Systematic Review
AU - Friel, Kathleen Michelle
AU - McCauley, Claire
AU - O’Kane, Maurice
AU - McCann, Michael
AU - Delaney, Geraldine
AU - Coates, Vivien
N1 - Publisher Copyright:
Copyright © 2022 Friel, McCauley, O’Kane, McCann, Delaney and Coates.
PY - 2022
Y1 - 2022
N2 - Aim: To 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. Background: People 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 Design: A systematic review and narrative synthesis. Methods: A 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. Results: Eighteen 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. Conclusions: The 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 Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=204825, identifier 204825.
AB - Aim: To 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. Background: People 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 Design: A systematic review and narrative synthesis. Methods: A 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. Results: Eighteen 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. Conclusions: The 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 Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=204825, identifier 204825.
KW - clinical outcomes
KW - clinical practice
KW - diabetes mellitus
KW - inpatient
KW - length of stay
UR - http://www.scopus.com/inward/record.url?scp=85147942633&partnerID=8YFLogxK
U2 - 10.3389/fcdhc.2022.883283
DO - 10.3389/fcdhc.2022.883283
M3 - Review article
AN - SCOPUS:85147942633
SN - 2673-6616
VL - 3
JO - Frontiers in Clinical Diabetes and Healthcare
JF - Frontiers in Clinical Diabetes and Healthcare
M1 - 883283
ER -