| Objective1.Construct the perioperative blood glucose management program for elderly patients with type 2diabetes.2.Evaluate the effect of perioperative blood glucose management in elderly patients with type 2diabetes.MethodsThe first part,based on the concept of evidence,constructs the perioperative blood glucose management program for elderly patients with type 2 diabetes.Search for evidence of perioperative glucose management in older adults with type 2 diabetes.AGREE II and JBI quality evaluation criteria were used to evaluate the quality of the included guidelines and included literatures,and recommendation grades were given according to the JBI evidence recommendation system.Experts in related academic fields were invited to organize expert meetings to analyze and revise the initial plan item by item,and the specific intervention contents of the perioperative blood glucose management plan were finally determined after discussions by experts.In case of problems encountered in the implementation process,the head nurse of endocrinology department organized several meetings for discussion,and constantly improved the intervention process to ensure the applicability of the program.The second part is experimental study.From April 2021 to December 2021,140 elderly patients with type 2 diabetes during perioperative period in a third-class hospital of Zhongshan city were selected as the research object.The patients were selected by convenient sampling method.The control group was given intervention method in conventional mode,and the intervention group was given evidence-based perioperative blood glucose management program.Fasting blood glucose,2h postprandial blood glucose,incidence of hypoglycemia,preoperative average hospital stay,diabetes self-management behavior,diabetes knowledge level and patient satisfaction were used as outcome indicators to compare the differences between the two groups and verify the feasibility and effectiveness of the program.Epidata3.1was used for double data entry and SPSS21.0 was used for statistical analysis.Results1.Form an evidence-based perioperative blood glucose management plan for the elderly with type 2 diabetes.In the process of building the plan,based on the evidence practice path,integrate evidence,combine with the actual clinical situation,and modify and adjust the plan through the expert meeting discussion.Finally,an evidence-based practice program for blood glucose management in elderly patients with type 2 diabetes in the perioperative period was formed.The program mainly includes preparation for inpatients、preoperative、intraoperative、postoperative and discharge guidance.2.After the implementation of the evidence-based practice program,evaluate the effect of the intervention group and the control group.2.1 Blood glucose control results: After intervention,fasting blood glucose was(7.23±0.98)mmol/L in the intervention group and in the control group was(8.05±1.67)mmol/L;Postprandial2h blood glucose intervention group(9.65±1.22)mmol/L,control group(10.09±1.73)mmol/L,the difference of fasting blood glucose and postprandial 2h blood glucose between the two groups was statistically significant(P<0.05).2.2 Incidence of perioperative hypoglycemic events: after intervention,the incidence of perioperative hypoglycemic events in the intervention group(4.5%)was lower than that in the control group(14.7%),and the difference between the two groups was statistically significant(P<0.05).2.3 Average preoperative hospital stay: after intervention,the average preoperative hospital stay of patients in the intervention group(2.96±1.49)was less than that in the control group(5.01±3.24),the difference was statistically significant(P<0.05).2.4 Self-management behaviors of diabetes mellitus: The scores of self-management behaviors of the two groups were compared.The results showed that the scores of the intervention group(22.52±5.39)were higher than those of the control group(19.98±4.71)after intervention,the difference was statistically significant(P<0.05).2.5 Diabetes knowledge score and satisfaction: The results of comparison between the two groups showed that after intervention,the score of diabetes knowledge in the intervention group(16.75±4.10)was higher than that in the control group(11.48±3.93),the difference was statistically significant(P < 0.05),and the score of satisfaction in the intervention group(95.33±1.76)was higher than that in the control group(89.68±1.57).The difference was statistically significant(P<0.05).Conclusion1.Based on evidence and expert meeting discussion,construct perioperative glucose management program for elderly type 2 diabetes mellitus.2.After the implementation of perioperative blood glucose management program in elderly patients with type 2 diabetes,fasting blood glucose and 2h postprandial blood glucose can be better controlled,the incidence of hypoglycemic events can be reduced,and the average preoperative hospital stay can be shortened.3.After the implementation of the perioperative blood glucose management program for elderly patients with type 2 diabetes,it can effectively improve the self-management behavior and diabetes knowledge level of elderly patients with type 2 diabetes during the perioperative period,and improve patient satisfaction. |
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