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Article ; Online: A learner-centered diabetes management curriculum: reducing resident errors on an inpatient diabetes pathway.

Desalvo, Daniel J / Greenberg, Larrie W / Henderson, Celia L / Cogen, Fran R

Diabetes care

2012  Volume 35, Issue 11, Page(s) 2188–2193

Abstract: Objective: Diabetes errors, particularly insulin administration errors, can lead to complications and death in the pediatric inpatient setting. Despite a lecture-format curriculum on diabetes management at our children's hospital, resident diabetes- ... ...

Abstract Objective: Diabetes errors, particularly insulin administration errors, can lead to complications and death in the pediatric inpatient setting. Despite a lecture-format curriculum on diabetes management at our children's hospital, resident diabetes-related errors persisted. We hypothesized that a multifaceted, learner-centered diabetes curriculum would help reduce pathway errors.
Research design and methods: The 8-week curricular intervention consisted of 1) an online tutorial addressing residents' baseline diabetes management knowledge, 2) an interactive diabetes pathway discussion, 3) a learner-initiated diabetes question and answer session, and 4) a case presentation featuring embedded pathway errors for residents to recognize, resolve, and prevent. Errors in the 9 months before the intervention, as identified through an incident reporting system, were compared with those in the 10 months afterward, with errors classified as relating to insulin, communication, intravenous fluids, nutrition, and discharge delay.
Results: Before the curricular intervention, resident errors occurred in 28 patients (19.4% of 144 diabetes admissions) over 9 months. After the intervention, resident errors occurred in 11 patients (6.6% of 166 diabetes admissions) over 10 months, representing a statistically significant (P = 0.0007) decrease in patients with errors from before intervention to after intervention. Throughout the study, the errors were distributed into the categories as follows: insulin, 43.8%; communication, 39.6%; intravenous fluids, 14.6%; nutrition, 0%; and discharge delay, 2.1%.
Conclusions: An interactive learner-centered diabetes curriculum for pediatric residents can be effective in reducing inpatient diabetes errors in a tertiary children's hospital. This educational model promoting proactive learning has implications for decreasing errors across other medical disciplines.
MeSH term(s) Curriculum ; Diabetes Mellitus ; Humans ; Inpatients ; Internship and Residency ; Medical Errors/prevention & control ; Pediatrics/education
Language English
Publishing date 2012-08-08
Publishing country United States
Document type Journal Article
ZDB-ID 441231-x
ISSN 1935-5548 ; 0149-5992
ISSN (online) 1935-5548
ISSN 0149-5992
DOI 10.2337/dc12-0450
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