T2DM Diabetes Care in the Inpatient Setting: New Graduate Nurse Experiences, Knowledge and Cultural Safety Knowledge

Abstract

Introduction: Diabetes affects 537 million adults worldwide, with many requiring hospital care. New graduate (NG) nurses are required to have adequate diabetes-related knowledge and skills to effectively care for these patients, who come from diverse cultural backgrounds. This study explores the experiences, diabetes knowledge, and diabetes-related cultural safety knowledge of NG nurses providing diabetes care in the inpatient setting.

Methods: Underpinned by Dewey’s pragmatic paradigm, this mixed methods study used qualitative interviews and an adapted version of Daly et al.’s (2019) telephone interview questionnaire to explore the diabetes care experiences and knowledge of NG nurses in a South Auckland hospital. Part A was added to the telephone interview questionnaire to assess NG nurses’ diabetes-related cultural safety knowledge. This section consisted of questions developed from literature with input from an expert panel, including cultural advisors. Both Part A and Part B (Daly et al.’s (2019) adapted diabetes knowledge questionnaire) were assessed for content validity using content validity index (CVI) scores. The questionnaire was refined based on the feedback received, resulting in a scale-CVI universal agreement score of >0.9 across all categories. The qualitative data from the study were analysed using Braun and Clarke’s (2012) six phases of thematic analysis, and the SPSS statistical package alongside Microsoft Excel for quantitative analysis.

Results: The study included 22 NG nurses, with 10 participating in qualitative interviews and 12 completing the telephone interview questionnaire. Six main themes emerged: Confidence and Preparation; Diabetes Training; Diabetes Management in the Clinical Area; Challenges in the Provision of Diabetes Care; Guidelines and Protocols for Diabetes Management; and Cultural Safety Related to Diabetes Care. Part A of the telephone interview questionnaire highlighted cultural safety aspects involved in diabetes care, including cultural initiatives and policies, impacts of cultural food on diabetes management, impacts of cultural traditions/beliefs on diabetes management, socioeconomic impacts on diabetes management, whānau inclusion in diabetes care, and health literacy and diabetes management. Part B revealed varying levels of knowledge with gaps apparent in routine diabetes assessment, monitoring and interpreting laboratory results, diabetes pathology, diabetes management, diabetes complications, and diabetes guidelines indicating a need for further diabetes training in these areas.

Conclusion: The study highlights the complexities of diabetes care for NG nurses in New Zealand, especially regarding diverse cultural aspects. The findings emphasise the need for enhanced diabetes training in cultural safety and clinical competence at both preregistration and postgraduate levels. Addressing challenges such as diabetes knowledge gaps, limited training opportunities, and organisational barriers is important for improving clinical readiness and culturally inclusive practices among NG nurses; ultimately fostering patient-centred care and equitable health outcomes for patients within the inpatient setting.