oa Improving Insulin Therapy Related Knowledge in Type 2 DM Among Physicians in West-Bay Health Center

Background

Studies show that diabetics are in high risk for complications, hospitalization, and death from uncontrollability.

Good Glycemic control is an important part of preventive services for diabetic complications. One of the most important treatment options for Diabetic patient is insulin therapy, however there is evidence of poor physician knowledge about types and modalities of insulin therapy. Lack of knowledge will increase the likelihood of medication errors; contribute to poor glycemic control in diabetic patient and increased morbidity and mortality

- Our aim is to improve Insulin therapy related knowledge in type 2 DM Among Physicians in West-bay health center by 20% above baseline by January 2013 and To raise the awareness of that problem among our physicians.

Subjects, Materials & Methods

- The project began on November 2012 with baseline Questionnaire survey as pilot for our study. Followed by This Pre-intervention insulin knowledge Questionnaire conducted to Identify deficient areas in the insulin-Related knowledge with the results showed Mean Percentage of incorrect answers is 62%.

- For more on which brainstorming session was done to identify the root causes of such problem, and depicted using the fish bone diagram.

- A survey questionnaire was designated to assess the main causes of the problem and distributed to nurses and physicians working in NCD clinics.

Prioritization of Reasons of insufficient insulin therapy knowledge demonstrated in Paretto chart.

According to analysis we found three main causes of the problem:

1. a – No Training Program for physicians.

2. No specific form or Ineffective Auditing

3. Less Exposure to Patient with T2DM.

- Our intervention was in the form of:

1- Training program: conducted on December 2012 and it is include a PowerPoint presentation, problems solving cases, and group discussion about insulin types and Pharmacokinetics, concerns about insulin therapy, initiation, titration, and monitoring of insulin therapy, and insulin regimens in PHC setting.

2- Post intervention insulin knowledge Questionnaire: distributed after conducting training program.

- Two audits done retrospectively before intervention & one done after to show average percentage of improvement in knowledge to assess effect of intervention.

- All data was demonstrated using run chart.

Results

Improvement of insulin therapy-related knowledge reflected by mean percentage of correct answers in pre & post questionnaire conducting before and after training program. showed mean correct answers improved from 38% to 78 % in physician in West Bay H.C.

Conclusions

The results of the pre and post questionnaire analyses clearly showed an improvement in the level of insulin therapy knowledge among physicians.

The study indicates the areas that need to be addressed with greater emphasis.

The post test analysis shows that the training program has been successful in significantly improving knowledge of insulin therapy that may help to improve patient safety in PHC.

Next Steps

Share results with training and development dept.

Expansion of insulin therapy training program to include All PHC to transfer the knowledge.

Continue process of education (twice annually).

To analyses the segmented data to see where the improvement can be happen.