Structural and process quality in the management of diabetic emergencies in Germany.
Int J Qual Health Care
; 14(1): 33-8, 2002 Feb.
Article
en En
| MEDLINE
| ID: mdl-11871627
ABSTRACT
OBJECTIVE:
Although acute complications of diabetes account for approximately 3% of all emergency calls, clinically relevant indicators of structural and process quality in the management of diabetic emergencies have not yet been studied. The purpose of this investigation was, therefore, to collect representative data on these indicators for the whole of Germany.METHODS:
Standardized questionnaires comprising 20 items were sent to all 312 emergency medical services in Germany. Apart from demographic data, information was obtained about the diagnostic materials and drugs carried by the ambulances, methods of blood glucose measurement, the level of qualification of the emergency teams, the frequency of diabetic emergencies, and the need for further training.RESULTS:
The return rate of the questionnaires was 55%, corresponding to 172 emergency medical service districts serving a total population of 45.3 million. The data revealed deficits with regard to structural and process quality. Thus, only 6% of ambulances carried glucagon and only 11% ketone test strips. In 57% capillary blood was used for glucose determination, in 17% visually read test strips were still used. While in some districts hospital admission after hypoglycaemic episodes was mandatory even for patients well educated about their diabetes, in other districts multimorbid patients on oral antidiabetics were sometimes only treated at the emergency scene. Emergency medical technicians increasingly carried out both the diagnosis and treatment of diabetic emergencies.CONCLUSIONS:
The structural and process quality of the management of diabetic emergencies in Germany is in need of improvement. The most important factor is continuing education of the entire emergency team.
Buscar en Google
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Evaluación de Procesos, Atención de Salud
/
Complicaciones de la Diabetes
/
Diabetes Mellitus
/
Servicios Médicos de Urgencia
/
Medicina de Emergencia
Tipo de estudio:
Etiology_studies
Límite:
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Int J Qual Health Care
Asunto de la revista:
SERVICOS DE SAUDE
Año:
2002
Tipo del documento:
Article
País de afiliación:
Alemania