EFFECT OF PRACTICAL GUIDELINES ON NURSES PERFORMANCE REGARDING INSULIN PUMP FOR CHILDREN WITH TYPE 1 DIABETES IN A LIMITED RESOURCES SETTING

Abstract

Background: Insulin pump therapy is proven safe and effective for individuals with diabetes, including children, adolescents, and adults. It has become the cornerstone of advanced insulin delivery methods and gained popularity, particularly among youth with type 1 diabetes at the turn of the century. Studies consistently demonstrate its ability to reduce HbA1c levels and the occurrence of hypoglycemia without increasing BMI z-scores. Aim: This study aims to evaluate the effect of using insulin pump guidelines on nurses’ performance in caring for children with type 1 diabetes. Setting: This study was conducted at the specialized diabetes outpatient clinic for pediatric patients, pediatric and adolescent diabetes unit, Children Hospital. In Shams University's Children’s Hospital. Sampling A purposive sample consisted of 100 nurses working in the previously mentioned settings with more than 6 months of experience who were allowed to perform care for children with type 1 diabetes .Tools: Three tools were used in this study for data collection. First: A structured interview questionnaire. (Pre/post application of the guideline) divided into two parts: Part I demographic characteristic data for nurses, Part II nurses knowledge regarding the insulin pump for children with type 1 diabetes. Second: Children's observational checklists based on International Society for Pediatric and Adolescent Diabetes (ISPAD) guidelines: (pre- and post-guideline implementation).Third: Likert attitude scale to assess nurses’ attitude regarding the use of insulin pumps for children with type 1 diabetes. Results: Showed that there was a statistically significant improvement in the total level of nurses’ knowledge about using the insulin infusion pump for children with type 1 diabetes mellitus post-educational program compared with pre-educational program (p<0.05*). Illustrates that there was a statistically significant improvement in total practice parts post-intervention compared with pre-intervention, as evidenced by the fact that 76.0% of them had incompetent total practice levels about the use of insulin pumps based on the ISPAD strategy pre-intervention, which improved to 83.0% of them having competent total practice post-intervention. Reveals that there was a highly statistically significant improvement in total nursing attitude about using the insulin infusion pump for children with type 1 diabetes mellitus post-educational program compared with pre-educational program (p<0.001**). Only 36.0% of them had a positive attitude pre-intervention, which improved to 64.0% of them having a positive attitude post-intervention. Conclusion: Intervention of program targeting nurse’s performance and practice on using insulin pump had a positive effect on overall nurses’ performance, knowledge and practice. Recommendations: Regular training programs targeting both health care professionals and allied care professional should be part of the clinical practice to improve outcomes and adherence to treatment.