DSME in the Hospital Setting – Survival Skills

Cathy Cabanban, RD, LDN, CDEI have happy memories of the diabetes rotation during my dietetic internship program. As an intern, one of my duties was to go from patient room to patient room, gathering participants for diabetes class. We had a spacious classroom available on the unit, complete with a blackboard, teaching materials, and comfortable chairs. Often patients would come to class on Monday, and then return again another day that week for more diabetes education.

I view those days as the “salad days” of inpatient DSME. Hospital stays were much longer, patients on the unit were less critically ill, and they had plenty of time (and energy) to attend a one-hour class prior to discharge.

Fast forward to 2010. The educator is frantically trying to teach the patient healthy eating or use of a blood glucose meter amid multiple interruptions and more often than not, the patient feeling ill. Even though the old days are gone, I am sure you have all witnessed and/or provided effective DSME at bedside, likely “survival skills.”

The 2010 Standards of Medical Care In Diabetes
state that hospitalized patients with diabetes should receive outpatient education in a recognized program after discharge; they should also receive instruction on various survival skills prior to discharge.

In your workplace, how do you provide this education?

Maybe an RD sees the patient for education on healthy eating for improved blood glucose control and weight loss, while a CDE may visit the patient to address hypo/hyperglycemia, correct insulin administration, etc. Often, it is the nurse at bedside who does survival skills teaching in real-time. In other words, instructing the patient the best time to take their medications, while actually administering those meds. Or discussing the importance of regular meal times while breakfast is being served. We all know that patients can watch a diabetes video or tune into a diabetes TV station while hospitalized, but a conversation WITH the patient and/or family member will let you know what your patient most needs and desires to learn.

Another suggestion – tuck a Conversation Starter™ education tool under your arm so when you enter the patient’s room you can cover one or several survival skill topics, depending on how much time you have available. Often a few short, meaningful interactions with your patient will be more effective than covering all these topics at once.

Whatever methods you may employ, I think we would all agree the goal is to get our patients home and able to safely manage their disease.



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