Minimizing hospitalization: children with newly diagnosed diabetes

Abstract

Children's recognized vulnerability to the adverse effects of hospitalization has resulted in the firm belief that minimization or avoidance of hospitalization is in children's best interests. For children with newly diagnosed diabetes, minimal hospitalization may be achieved through the flexibility of the paediatric diabetes specialist nurse role, which crosses the boundary between hospital and community. This study was undertaken to evaluate the effectiveness of a paediatric diabetes specialist nurse in reducing the length of hospitalization for newly diagnosed children. Using a quantitative approach, a quasi-experimental research design was chosen, measuring the length of hospitalization at diagnosis for 40 children diagnosed in the 2 years preceding, and 16 children diagnosed in the 9 months following, the commencement of the paediatric diabetes specialist nurse post. The study findings showed a significant reduction in the length of hospitalization, suggesting that paediatric diabetes specialist nurses, by minimizing or avoiding hospitalization for newly diagnosed children, can make a substantial contribution to their emotional wellbeing.

A systematic review of the costs and effectiveness of different models of paediatric home care

“…Three studies reported in four papers are included here by Swift and co-workers, 36 Lowes and Davis, 87 Lowes 88 and Couper and co-workers 89 ). Two were based in the UK 36,87,88 and one in Australia. 89 The studies will be referred to hereafter by the name of the first author.…”

“…Both Swift 36 and Lowes 87,88 report initial length of stay and readmissions ( Table 60). Both suggest that the introduction or promotion of home-based forms of care for children with IDDM leads to significant reductions in length of initial stay.…”

Nurse specialists’ perceptions of their role and function in relation to starting an adult diabetic on insulin

“…Previous studies have considered the contribution of diabetes nurse specialists to diabetes care ( Wade & Moyer, 1989; Lowes & Davis, 1997) and the role of the diabetes nurse has been examined ( Kerrison, 1990; Moyer, 1994). Knowledge regarding diabetes nurse specialists’ perceptions when starting adult patients with insulin dependent diabetes mellitus on insulin seems to be lacking.…”

Changes in pediatric diabetes care throughout a 30-yr period at one institution for pediatric diabetology in Germany

“…The duration of hospital stay is of interest for financial and economic reasons. Health care expenditure can be reduced by lowering the duration of hospital stay but also by an effective adjustment of metabolism (20–23). In Germany, children and adolescents with onset of type 1 diabetes are usually treated in an in‐patient setting.…”