Research presentation 2014

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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

description

Insulin-related knowledge among healthcare providers in HSNZ

Transcript of Research presentation 2014

Page 1: Research presentation 2014

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

Page 2: Research presentation 2014

• 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

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• 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

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• 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

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• 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

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• 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

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• INCLUSION:

All staffs who were attending medical CME

Medical officers

Nurses

Pharmacists

INCLUSION CRITERIA

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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

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STUDY ANALYSIS

•Statistical analysis were performed using SPSS Version 17.0

•A value of p<0.05 was considered as statistically significant

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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

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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 (%)

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DEMOGRAPHIC DATA– COMFORT LEVEL

Figure 3

Reported comfort levels in managing diabetes

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STUDY RESULTS- LEARNING MEDIUM A. Learning medium among medical doctors, nurses and pharmacists

Table 1

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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

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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

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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

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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

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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

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• 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

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• 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

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• 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

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• 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

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• 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

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• 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

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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

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7. Baxley SG, Brown ST, Pokorny ME, Swanson MS: Perceived competence and actual

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8. Clement S. Better glycemic control in the hospital: beneficial and feasible. Cleve Clin J

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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.

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