SAT-197 - Optimizing Central Diabetes Insipidus Education for Better Patient Outcomes

Background: Central diabetes insipidus is a rare childhood chronic disorder that can lead to hospitalizations and complications. Unlike the case in other childhood chronic disorders, the rarity of this disorder reduces familiarity of nursing staff with this condition and poses a risk of serious complications. Studies show that nursing education is linked to improvement of hospitalization outcomes.

Objectives: Central Diabetes Insipidus Education Toolkit (cDIET) is a novel standardized curriculum created for inpatient nurses, outpatient endocrine specialty nurses, as well as children and their caregivers. The overall aim is to improve clinical outcomes for children with newly diagnosed and longstanding diabetes insipidus (DI). Here we describe the first phase of this quality improvement project which focuses on inpatient nursing education.

Methods: An innovative multi-pronged education curriculum, DIET was created. Curriculum contents were tailored to inpatient nursing practice and included: DI pathophysiology overview, basic principles of fluid balance, DI presentation, diagnosis, and management. Surveys consisted of questions which assessed different areas of knowledge and the level of comfort with nuances of clinical DI patient management. Knowledge scores were compared, pre- and post-intervention.

Results: Dyads of pre and post intervention surveys were completed by 67 inpatient nurses. Overall, there was a 24% improvement seen in post intervention knowledge scores when compared to those obtained pre intervention. The smallest improvements, 12- 15%, were in basic knowledge scores (DI definition & etiology), whereas the largest improvements were seen in the rating of DI & DDAVP knowledge, and the level of comfort (strong or very strong) in translating theoretical knowledge into practical application, The improvement in these scores were, 35%,35% and 37% respectively.

Conclusion: We describe our institutional effort to create a targeted and standardized inpatient nurses caring for children with central DI. This is the first phase of a multifaceted curriculum created for inpatient and outpatient nursing, as well as children and their caregivers. Our results show that a curriculum such as cDIET can improve nursing comfort in managing patients with DI. Future work could examine if the increased nursing comfort translates to a decrease in adverse patient outcomes.

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