Application of FOCUS- PDCA model in hypoglycemia management during hemodialysis in patients with diabetic nephropathy / 中国实用护理杂志

ABSTRACT

Objective To evaluate the effect of FOCUS- PDCA model in hypoglycemia management during hemodialysis in patients with diabetic nephropathy. Methods Totally 107 patients with diabetic nephropathy were divided into two groups. Patients in the control group received traditional hypoglycemia management, while FOCUS- PDCA model was implemented in the experimental group in hypoglycemia management, including reducing insulin dosage before hemodialysis,injecting 50%glucose and taking hyperglycemia food during hemodialysis,enhancing the monitoring of blood glucose and health education. Compared the incidence of blood glucose levels and hypoglycemia in two groups of patients at different time of dialysis. Results The frequency of hypoglycemia in the experimental group at the beginning of dialysis [ (9.04±2.08) mmol/L ], 2 hours after dialysis[ (5.78±1.82) mmol/L ]and at the end of dialysis[ (6.94±2.04) mmol/L ] were significantly lower than that in the control group[ (8.60±2.02) mmol/L, (5.20±1.62) mmol/L, (4.97±1.05) mmol/L ], (P <0.05), and the total incidence rate of hypoglycemia was 1.6%(61/3 889), which significantly lower than that 4.8%(185/3 816) in the control group, the difference was statistically significant (χ2=5.288, P < 0.05). Conclusions The application of FOCUS- PDCA model in the hypog1ycemia management of patients with diabetic nephropathy can reduced the incidence of hypoglycemia during hemodialysis. It deserves to be widely used in clinical practice to improve the patients′quality of life.