Enhancing inpatient glycemic education and management with a SMILE SBAR: A quantitative study.

Aim: To examine the effectiveness of a comprehensive diabetes education class on improving nurses' self-efficacy in glycemic management and physician communication, with a focus on using the SMILE (Sugar Trend, Medications, Intravenous fluid, Labs, and Eating) SBAR (Situation, Background, Assessment, Recommendation) as a communication tool. The secondary aim of this study was to investigate the translation of knowledge into practice, in this case, inpatient glycemic control.

Background: Inpatient glycemic management for patients living with diabetes can be challenging. Therefore, as patient advocates, nurses must be able to identify what clinical data warrants a call to the physician to facilitate timely decisions and interventions.

Methods: Data was collected from a purposive sample of 28 registered nurses from a single general medicine unit. A t-test was used to analyze nurses' pretest-posttest perceptions of self-efficacy in nine content areas. Kruskal-Wallis H analysis was also conducted on patients' median blood glucose values over four months (July-October 2023).

Results: The results suggest the class was effective in improving nurses' perceived knowledge and self-efficacy in all nine content areas, with the highest mean difference increase of 1.46 for I have sufficient knowledge regarding the SMILE SBAR and [will] use it as a tool for communicating with the physician, p < 0.05. A comparison of 403 patients' median blood glucose values were also statistically significantly different across four months, χ(3) = 21.088, p < 0.0001.

Conclusions: Continued efforts to prevent and manage inpatient glycemic control should focus on enhancing nurse-physician communication and teamwork with simple yet effective tools such as the SMILE SBAR.