Effectiveness of Discharge Planning Program Development for Diabetic Patients with Hyperglycemic Patients for Decrease Readmission Rate at Nonghan Hospital, Udon Thani Province.

Abstract

     This quasi experiment research aimed to: 1) develop a discharge planning program for diabetic patients with hyperglycemia, 2) compare self-care behaviors and blood glucose levels before and after program implementation, and 3) examine the program's effect on 28-day readmission rates. The study was conducted in three phases: Phase 1 - situation analysis and needs assessment, Phase 2 - program development integrating Orem's Self-Care Theory with D-METHOD concept, and Phase 3 - program effectiveness evaluation. Methods: Forty diabetic patients with blood glucose levels >400 mg/dL were purposively selected according to inclusion criteria. Research instruments included: 1) discharge planning program, 2) self-care behavior assessment form, and 3) clinical data record form. Data were analyzed using descriptive statistics and paired t-test.
     Results: After program implementation: 1) Mean self-care behavior scores significantly increased from moderate (63.57±1.18) to good level (86.83±0.73) (p<0.001), with highest improvements in medication adherence (10.35±1.08 to 13.37±0.68), general health care (15.30±1.27 to 21.50±0.81), and dietary control (8.82±1.22 to 12.48±0.83); 2) Mean FBS decreased from 387.5±98.4 to 168.5±42.6 mg/dL (p<0.001) and mean HbA1c decreased from 10.2±1.8% to 8.2±1.4% (p<0.001); and 3) 28-day readmission rate decreased to 15%. Conclusion: The developed discharge planning program effectively improved self-care behaviors, glycemic control, and reduced readmission rates in diabetic patients with hyperglycemia. Continuous implementation is recommended for this patient population.