Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
Koo YW (1),Li CC(1)(2),Lau WH (1)(2). Yip KYL(1)(2), Leung SH (1)(2), Lam TM (1)(2), Tse TK (1)(2),Ko SH (1)(2), Li YC (1)(2)
Affiliation :
KCC Department of Family Medicine& General Outpatient Clinic
Introduction :
In response to the high-risk acute complications of hypoglycemia in Type 2 diabetes (T2DM) patients, Kowloon Central Cluster General Outpatient Clinics (KCC GOPCs) have implemented proactive strategies aimed at improving glycemic control and reducing associated risks. Hypoglycemia, a significant barrier to optimal glycemic control, is linked to cardiovascular complications, cognitive impairment, falls, and mortality, affecting the quality of life for T2DM patients. Statistics reveal that 43% of 1510 cases with recent hypoglycemia hospital admissions from 3Q2019-4Q2022 had regular follow-up in KCC GOPCs. The primary predisposing factors for these admissions were identified as medication (28%) and sick day (15%). Considering the large number of T2DM patients—approximately 58,000—under the care of KCC GOPCs in 2022, addressing hypoglycemia is crucial for overall healthcare outcomes.
Objectives :
1. **Empowerment:** Empower T2DM patients, family members, and caregivers on the prevention and management of hypoglycemia. 2. **Service Quality:** Enhance service quality in T2DM management.
Methodology :
The methodology involves individual nursing counseling, with a focus on those with recent hypoglycemia history or related admissions. Proactive strategies include providing hypoglycemia management education during annual DM risk assessments and screenings by GOPC nurses, especially for patients on oral hypoglycemic agents (particularly Sulphonylurea) or insulin therapy. Nurse counseling sessions cover general hypoglycemia risk education, detailed information on diabetes medications, and emphasize hypoglycemia awareness by teaching signs and symptoms. Emergency preparedness is highlighted to ensure patients have basic knowledge of handling hypoglycemic episodes, complemented by the distribution of hypoglycemia pamphlets for reference at home. All GOPC nurses have received training on enhanced hypoglycemia patient education, ensuring a standardized and clear communication approach, avoiding medical jargon, and presenting information in simple language to enhance patient understanding.
Result & Outcome :
The results and outcomes indicate progress, with 2221 diabetes nurse assessments conducted in KCC community-based GOPCs with enhanced patient hypoglycemia education in November 2023. The monthly quota of 1570 diabetic risk assessments will continue on a regular basis. These proactive strategies aim to empower patients to prevent medication-related hypoglycemia and encourage self-management, ultimately avoiding severe consequences and related hospitalizations. The focus on a proactive approach to disease and complication prevention, coupled with a humanistic approach in health education, is expected to enhance primary healthcare service quality in the long run. Future studies will be crucial for program evaluation, ensuring continuous improvement and sustained positive outcomes.
