Diabetes self-management education training for community health center nurses in Indonesia: a best practice implementation project.

Background: Diabetes complications can increase progressively, leading to morbidity and mortality among diabetes sufferers. To address this, diabetes self-management education is a strategy to increase patients' knowledge and awareness in self-care. However some issues related to diabetes self-management education have emerged for health care providers and patients.

Objectives: The objective of this project was to improve nurses' skills and confidence in delivering diabetes self-management education among type 2 diabetes patients by promoting evidence based practice in community health centers, thereby enhancing patients' knowledge and skills in performing self-care.

Methods: The Joanna Briggs Institute three-phase Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool were utilized in this project for promoting evidence utilization and changes in the community health setting. In phase 1 of the project, stakeholders were engaged and 12 evidence-based audit criteria were developed. A baseline audit was conducted by the project team in 41 community health centers. In phase 2, barriers underpinning areas of noncompliance found in the baseline audit were identified and strategies developed to target three key areas - staff, administration and patients. In phase 3, a follow-up audit was conducted.

Results: The baseline audit results showed that eight of the 12 criteria recorded zero percent compliance, with the remaining four recording below 50%, representing poor compliance with the current evidence. Strategies implemented during phase 2 of the project included a diabetes educator training program, development of diabetes education curriculum and media, and a patient's logbook. After implementation of the strategies, the follow-up audit showed that all 12 criteria achieved 100% compliance.

Conclusions: The diabetes training program for community health center nurses increased their skills and confidence in delivering diabetes self-management education to patients.