Challenges in maintaining satisfactory documentation routines and evidence-based diabetes management in nursing homes

Haugstvedt, Anne; Graue, Marit; Aarflot, Morten; Heimro, Lovise S.; Johansson, Hilde; Hjaltadóttir, Ingibjörg; Sigurðardóttir, Árún K

doi:10.1080/20573316.2016.1262588

Cited by 7 publications

(7 citation statements)

References 21 publications

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“…The present study revealed lack of documentation of diabetes diagnosis in electronic home care records for almost half of the study population. Similar findings have been observed for Norwegian nursing home residents [ 26 ] and home care services in Sweden [ 21 ]. We also observed substantial lack of documentation routines on follow-up of HbA 1c and self-monitoring of blood glucose.…”

Section: Discussionsupporting

confidence: 87%

Documented diabetes care among older people receiving home care services: a cross‐sectional study

et al. 2021

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Background Home care services plays an important role in diabetes management, and to enable older adults remain home-dwellers. Adequate follow-up and systematic nursing documentation are necessary elements in high quality diabetes care. Therefore, the purpose of this study was to examine the diabetes treatment and management for older persons with diabetes receiving home care services. Methods A cross-sectional study was used to assess the diabetes treatment and management in a Norwegian municipality. Demographic (age, sex, living situation) and clinical data (diabetes diagnose, type of glucose lowering treatment, diabetes-related comorbidities, functional status) were collected from electronic home care records. Also, information on diabetes management; i.e. follow-up routines on glycated haemoglobin (HbA1c), self-monitoring of blood glucose, insulin administration and risk factors (blood pressure, body mass index and nutritional status) were registered. HbA1c was measured upon inclusion. Descriptive and inferential statistics were applied in the data analysis. Results A total of 92 home care records from older home-dwelling persons with diabetes, aged 66–99 years were assessed. Only 52 (57 %) of the individuals had the diabetes diagnosis documented in the home care record. A routine for self-monitoring of blood glucose was documented for 27 (29 %) of the individuals. Only 2 (2 %) had individual target for HbA1c documented and only 3 (3 %) had a documented routine for measuring HbA1c as recommended in international guidelines. Among 30 insulin treated older individuals, a description of the insulin regimen lacked in 4 (13 %) of the home care records. Also, documentation on who performed self-monitoring of blood glucose was unclear or lacking for 5 (17 %) individuals. Conclusions The study demonstrates lack of documentation in home care records with respect to diagnosis, treatment goals and routines for monitoring of blood glucose, as well as insufficient documentation on responsibilities of diabetes management among older home-dwelling adults living with diabetes. This indicates that home care services may be suboptimal and a potential threat to patient safety.

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Section: Discussionsupporting

confidence: 87%

Documented diabetes care among older people receiving home care services: a cross‐sectional study

et al. 2021

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“…In a study of Norwegian NHs [ 31 ], 83.8% out of 696 residents were diagnosed with Alzheimer disease but only 55.9% of those with Alzheimer were registered with medical diagnoses in their medical records. It is known that medical diagnosis is not always documented in medical records [ 32 ], but medical diagnosis is the foundation for appropriate treatment.…”

Section: Discussionmentioning

confidence: 99%

Use of psychiatric medication in three Arctic nursing homes: association with dementia and psychiatric symptoms

Gisladottir

Sigurðardóttir

Hjaltadóttir

2021

International Journal of Circumpolar Health

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“…For the study, we used the protocol for assessing diabetes management by Haugstvedt, Graue, et al. (2016), the use of which was permitted by the authors. The questionnaire measures the following available information in medical and nursing records: demographic questions (gender, age, years spent living in a nursing home); other medical diagnoses; the type of diabetes; the recommendations for measuring the levels of HbA1c and blood glucose; the recommended treatment; cognitive processes; mobility; incontinence; hypoglycaemia; and the value of the last three measurements of blood glucose and HbA1c levels.…”

Section: Methodsmentioning

confidence: 99%

Diabetes management of older adults in nursing homes: A retrospective study

et al. 2021

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Diabetes is a significant public health problem worldwide (Corriere et al., 2013;Munshi et al., 2016) and one of the leading causes of morbidity and mortality due to heart disease and chronic kidney disease (American Diabetes Association, 2017). Worldwide, the prevalence of diabetes is increasing at an alarming rate (World Health Organization, 2020), which represents a significant health consequence for the ageing population (Kalyani et al., 2017). Approximately one-quarter of people older than 65 years have diabetes (American

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Challenges in maintaining satisfactory documentation routines and evidence-based diabetes management in nursing homes

Cited by 7 publications

References 21 publications

Documented diabetes care among older people receiving home care services: a cross‐sectional study

Documented diabetes care among older people receiving home care services: a cross‐sectional study

Use of psychiatric medication in three Arctic nursing homes: association with dementia and psychiatric symptoms

Diabetes management of older adults in nursing homes: A retrospective study

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