RESUMO
BACKGROUND: Uncontrolled diabetes during the perioperative period can result in a variety of adverse postoperative outcomes. OBJECTIVE: Evaluate a nurse-led telehealth preoperative intervention to improve glycemic control. METHODS: Provide telehealth diabetes education prior to surgery and evaluate time spent and pre-/post-glucose levels. Between-group differences were used to assess glycemic control. RESULTS: There was no significant difference in scores for those who received the telephone intervention (M = 167.71, SD = 59.9) and those who did not receive the intervention (M = 171.44, SD = 54.9; t (44) = 0.220, p = .82, two-tailed). The magnitude of the differences in the means was very small (Cohen's d = 0.03). There was a reduction in pre- and post-glucose levels for both groups. CONCLUSIONS: Although the findings were not statistically significant, there may be some clinical significance. IMPLICATIONS FOR NURSING: The clinical significance has implications for nursing due to participants choosing to delay surgery and potentially preventing adverse outcomes.
RESUMO
The purpose of this research was to assess home health nurses' (HHNs) knowledge, comfort levels, barriers, and personal participation in advanced care planning (ACP), a practice that recognizes patient preferences for health care treatment. Licensed nurses who identified home care as their primary area of practice (N = 519) were surveyed about their knowledge of laws governing ACP and their perceptions of patients' preferences for ACP. Most respondents were women (97%), and the average age of the respondents was 54 years. Most nurses felt knowledgeable and capable of educating patients on advance directives (ADs), although the nurses' knowledge of laws governing ACP was limited and often inaccurate. Generally, nurses felt comfortable during ACP discussions with patients and families. HHNs perceived patient or family reluctance as the greatest barrier hindering discussions of ACP. No association was found between level of education and whether a nurse had a personal AD. Twenty percent of the nurses had their valid personal AD. A greater knowledge base concerning ACP would facilitate HHN discussions with patients and families. Recognition of patient preferences can be enhanced by understanding and overcoming barriers that hinder discussions of ACP. Educational opportunities focusing on ACP are encouraged for all health care providers.