Document Detail


Structural and process quality in the management of diabetic emergencies in Germany.
MedLine Citation:
PMID:  11871627     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
A Holstein; A Plaschke; H Schlieker; E H Egberts
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua     Volume:  14     ISSN:  1353-4505     ISO Abbreviation:  Int J Qual Health Care     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-03-01     Completed Date:  2002-04-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9434628     Medline TA:  Int J Qual Health Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  33-8     Citation Subset:  IM    
Affiliation:
1st Department of Medicine, Klinikum Lippe-Detmold, Detmold, Germany. Andreas.Holstein@t-online.de
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Blood Glucose / analysis
Diabetes Complications*
Diabetes Mellitus / therapy*
Diabetic Coma / etiology,  therapy
Emergencies
Emergency Medical Services / standards*
Emergency Medicine / education,  standards*
Germany
Humans
Hypoglycemia / etiology,  therapy
Process Assessment (Health Care)* / statistics & numerical data*
Questionnaires
Chemical
Reg. No./Substance:
0/Blood Glucose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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