A study by the Cleveland Clinic in Ohio suggests that more needs to be done to help nurses stay current and eliminate knowledge gaps in the rapidly changing environment of diabetes management.
In the study, 2,250 registered nurses volunteered for a 4-hour diabetes management course. Their level of knowledge about diabetes was assessed via pretest and posttest, using the Diabetes Management Knowledge Assessment Tool (DMKAT). The nurses came from all specialties (except operating room and neonatal intensive care) and all roles—staff nurse, nurse manager, clinical instructor, clinical nurse specialist, full time, and part time. Forty-eight percent of the nurses had > 5 years of experience.
The course, which was offered 32 times over 4 months, covered 4 topics: hyperglycemia, insulin therapeutics, hypoglycemia prevention and management, and diabetes survival skills. The researchers also aimed to find out whether there was a difference in the relationship between nurses’ self-rated comfort and familiarity and their level of knowledge as demonstrated on the DMKAT. Comfort was defined as a sense of confidence in performing a skill or using knowledge. Familiarity was defined as knowledge or mastery of a skill.
Four questions were problematic, even after the course. For example, 870 nurses (38%) did not answer a question about the causes of hyperglycemia in the hospitalized patient correctly, and 68% of nurses missed a question about an insulin order. The researchers say it is possible that the questions may have been worded confusingly or that the nurses hadn’t acquired the knowledge to answer the questions. The 3 insulin questions, for instance, required an understanding of pharmacokinetics and the efficacy of different insulin regimens.
Overall, the level of knowledge of diabetes management was lower than expected. The researchers found no differences based on education level or years of experience, perhaps, they suggest, because of the rapid changes in health care. They also found no correlations between diabetes management knowledge and self-reported comfort (P = .912) or familiarity (P = .556).
However, the researchers did find that participants had high levels of comfort and familiarity despite low levels of knowledge. The finding suggests nurses may not be aware of their knowledge deficits. The researchers say that prior to the course, nurses tended to overestimate their knowledge level, something that has been found in other research as well.
The findings reveal a need for additional resources to help nurses manage the day-to-day clinical questions that may arise when caring for patients with diabetes, the researchers say. They suggest, for instance, accessible resources on the nursing unit that will provide nurses with the “just in time” information they need to make good decisions.
Source
Modic MB, Vanderbilt A, Siedlecki SL, Sauvey R, Kaser N, Yager C. Appl Nurs Res. 2014;27(3):157-161.
doi: 10.1016/j.apnr.2013.12.003.