EFFECTIVENESS OF MULTIDISCIPLINARY NURSING CARE ON SURGICAL OUTCOMES IN DIABETIC PATIENTS
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Keywords
Diabetes, multidisciplinary care, surgical outcomes, glycemic control, wound care, elective surgery, patient satisfaction, surgical site infections, hospital stay, perioperative care
Abstract
Background: Patients with diabetes experience higher complications rates and worse surgical outcomes such as SSIs, delayed wound healing, and longer hospital stay. These risks are as a result of factors that include; immune system compromised state and insufficient circulation during the diabetic patient’s surgery. These risks may not be adequately addressed by standard protocols of pre, intra and postoperative care. A combination of the input from nurses, endocrinologists, and surgeons may provide better solutions to these problems.
Objective: The purpose of this research was to assess the impact of Multidisciplinary Nursing Care on the surgical outcomes such as SSI, wound healing, glycemic
Methods: For this study, an open prospective cohort design was applied, including 280 diabetic patients, who were divided into two groups: a multidisciplinary care group (n=140) and a standard care group (n=140). The multidisciplinary care group had additional perioperative care such as, tight glycemic control, specialised wound care and interdisciplinary management, while the standard care group was managed within the general care setting. Postoperative infection incidence, wound complication, hospital stay duration, glycemic control, and patient satisfaction were obtained and evaluated.
Results: The multidisciplinary care group had a better outcome in comparison with the control group: fewer postoperative infections (10% vs. 21%, p=0.018), faster wound healing (85% vs. 70% by day 10, p=0.012), shorter hospital stay (4.7 vs. 6.2 days, p=0.001), improved glycemic control (postoperative blood glucose: 143 mg/dL vs. 155 mg/dL, p=0.029), higher patient satisfaction
Conclusion: Diabetic patients have better surgical results when they receive multidisciplinary nursing care. With a focus on expert care for nursing, endocrinology, and surgery, this approach decreases adverse events, improves healing, and increases patient satisfaction. Expanded use of multidisciplinary models in the care of the surgical patient with diabetes may enhance results and decrease the healthcare costs related to diabetic surgery.
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Dr. Sandip Kumar Parui
MBBS, MD, MRCP(UK), FRCP(Edinburgh) , Assistant Professor, Department of Medicine, JIMSH, Kolkata,
Dr. Peekesh Kumar
Principal, Nursing, Affiliation Institute: ASMC Firozabad UP ,
Dr Bhawna
Assistant Professor, Anatomy department, ASMC Firozabad,
Dr Iram T Pasha
Senior Resident in Institute of Gastroenterology Sciences & Organ Transplant (IGOT Hospital), Bangalore.