Determinants of insulin-related knowledge among healthcare providers at a county referral hospital in Kenya

Monicah W Karara, Fredrick C Otieno, Faith A Okalebo, Elizabeth Lamos, Isaac O Kibwage

Abstract


Background: Insulin is a high alert medication with potential to cause hypoglycaemia if used incorrectly. Inadequate healthcare provider knowledge regarding insulin contributes to errors in its use that may cause patient harm.

Objective: To identify the determinants of healthcare provider knowledge regarding insulin use in type 2 diabetes.

Methodology: A cross-sectional study was conducted at Thika Level V Hospital in March 2015. A 20-item questionnaire was used to assess insulin knowledge in pharmaceutical, nursing and medical staff working in the outpatient department and the medical wards. The outcomes of interest were the scores on types, prescribing, administration and monitoring of insulin. Descriptive and regression data analyses were performed using IBM SPSS Statistics Version 20.

Results: The participants’ mean (±SD) age was 32.6±10.2 years. The mean (±SD) duration of clinical practice was 8.3±9.03 years. Nurses formed the largest (36, 40%) cadre in the study. Determinants of the overall score in the insulin knowledge test were professional cadre (p<0.0001), in-patient care (p=0.044) and reading of journals (p=0.005). Insulin pharmacology scores were correlated with younger age (21-30 years, (p=0.02), clinical experience of <5 years, (p=0.013), use of information from drug representatives (p=0.023) and being a pharmacist intern or medical officer (p=0.002). Good prescribing scores were found among the medical officers, consultants and the clinical pharmacist (p=0.035).

Conclusion: Several factors account for the differences in insulin-related knowledge among the healthcare providers evaluated in this study. Interventions are required to address these variations and equip the health workers with knowledge on all areas related to insulin use. Such interventions should include development of a curriculum on certified diabetes education, improved access to journals, collaboration with pharmaceutical companies in provision of drug-related information, continuing medical education and staff duty rotation to ensure that the healthcare providers gain experience in in-patient diabetes care.

Keywords: diabetes, healthcare provider, insulin-related knowledge


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