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Redesigning Hospital Diabetes Education

A Qualitative Evaluation With Nursing Teams

Smith, Kelly M., PhD; Baker, Kelley M., MA; Bardsley, Joan K., MBA, RN, CDE; McCartney, Patricia, PhD, RN; Magee, Michelle, MD

doi: 10.1097/NCQ.0000000000000349

Background: Methods to deliver diabetes education are needed to support patient safety and glycemic control in the transition from hospital to home.

Purpose: This study examined barriers and facilitators of integrating web-based, iPad-delivered diabetes survival skills education (DSSE) into the nursing inpatient unit workflow.

Methods: Nurses, nurse managers, and patient care technicians (PCTs) from 3 medical-surgical and 2 behavioral health units participated in semistructured interviews and focus groups.

Results: Four themes emerged: educational program and content; platform usability; tablet feasibility (eg, theft prevention, infection control, and charging); and workflow considerations. Behavioral health unit-specific concerns were also identified. Findings indicated that nurses and PCTs were eager to find approaches to deliver DSSE.

Conclusions: Implementation of a web-based DSSE program for inpatients needs adaptation to overcome challenges at the patient, care team, and process levels.

MedStar Institute for Quality and Safety, Columbia, Maryland (Dr Smith and Ms Baker); MedStar Health Research Institute, Hyattsville, and MedStar Corporate Nursing, Columbia, Maryland (Ms Bardsley); Department of Nursing Quality, Safety, and Education, MedStar Washington Hospital Center, Washington, District of Columbia (Dr McCartney); and MedStar Diabetes Institute, MedStar Health Research Institute, and Georgetown University School of Medicine and Healthcare Sciences, Washington, District of Columbia (Dr Magee).

Correspondence: Kelly M. Smith, PhD, Quality and Safety Research, MedStar Institute for Quality and Safety, 10980 Grantchester Way, 7th Floor Quality & Safety, Columbia, MD 21044 (

This research was funded by the National Institutes of Health—National Institute of Diabetes and Digestive and Kidney Diseases (R34: R34DK109503). Dr Smith also received funding from the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR001409. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for Publication: June 1, 2018

Published ahead of print: July 18, 2018

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