Improving Management with Point of Care for Children with Diabetic Ketoacidosis in Emergency Care in Northwest Bank رسالة ماجستير

Abstract

BACKGROUND: The most prevalent complication in children with T1DM is DKA, which leads to a high mortality rate among children. Prompt Nursing care intervention provision and early management are important alongside continuous follow-up and treatment of DKA patients. Point of care (POC) is the point in time when clinicians and nurses deliver healthcare products and services to patients at the time of care. Early intervention at the point of care at ER units help Palestinian children with DKA at emergency units to have better health outcomes; starting the point of care among children with T1DM and who become with DKA. Detecting early intervention will enhance the outcome of DKA degree children and will add to the body of nursing knowledge about the outcomes and develop DKA management protocol in pediatric units. AIM: The purpose of this study is to assess and improve DKA management, starting of the point of care among children with DKA in emergency care units in Northwest Bank. Methods The author used a quasi-experimental study that assessed the improvement of DKA management among children upon the point of care in emergency care in Northwest Bank. Result: Sixty children with DKA participated in the study. The average age of the children was 9.38 ± SD=3.1 year. The sample consisted of 29 (48.3%) males and 31(51.7%) females, of those 46 (76.7%) of participants were newly diagnosed with type 1 DM and 46 (76.7%) were diagnosed at earlier times. Two third of the children haven’t history of type 1 DM in first degree relative. At arrival the average of HbA1C was 11.74 (2.042). Approximately 75.0% of children haven’t other health problems while 1(1.67%) have tonsillitis, epilepsy, or CHD, ASD, VSD. The investigator found that there is significant differences in the vital signs at different point times (p= 0.05), the VI Clinical Pattern of DKA at different point times were significant (p= 0.05). The ABG’s differences were also significant at different point times (p= 0.05), RBS differences is significant at different point times (p= 0.05) among children with DKA. The severity of dehydration were significant differences at different point times (p= 0.05), and finally the biochemical Parameters were significant differences in at different point times (p= 0.05) among children with DKA admitted to emergency department. Conclusion: The study confirmed that DKA management protocol progress in emergency department was beneficial. Also, the study confirmed that physiologic parameters, clinical features, and lab results were improved in different points of time after DKA management protocol intervention.