Abstract
Background: Type 2 diabetes mellitus (T2DM) is a progressive metabolic disease of tissue insulin resistance and insulin producing ?-cell dysfunction resulting in elevated blood glucose levels. Elevated blood glucose levels are associated with micro and macrovascular complications often resulting in decreased quality of life for patients. Despite this, many patients do not achieve haemaglobin A1c (HbA1c) goals due to clinical inertia. Clinical inertia is defined as the lack of medication initiation or intensification when goals are not achieved. Patient, physician, and healthcare system factors have been identified as contributing to clinical inertia in diabetes. The use of management protocols and/or algorithms are commonly used in the treatment of T2DM.
Aim: To explore the factors contributing to the nurses use of medication algorithms and/or protocols in patients with T2DM, the influence on clinical inertia and patient outcomes.
Method: An integrative review (IR) guided by Whittemore and Knafl (2005), including thematic analysis underpinned by Braun and Clarke s (2006) framework. Quantitative thematic data analysis will be guided by Popenoe et al. (2021) to identify, organise, synthesize, analyse, and present the data.
Result: With the appropriate medication algorithm design and support, nurses are effective and safe at using algorithms and protocols to overcome clinical inertia and improve the outcomes of patients with T2DM.
Discussion: T2DM is on the rise globally, effective prevention and treatment using protocols and algorithms in nurse-led care can be an important tool in preventing the economic and social burdens associated with the disease. Utilising health resources to their fullest potential should be explored to assist with the management of patients with T2DM.