Development and application of an evidence-based three-dimensional, four-phase discharge preparation plan for type 2 diabetes patients.

OBJECTIVE

To develop an evidence-based "three-dimensional integrated" four-stage discharge preparation plan for patients with type 2 diabetes mellitus (T2DM), and to investigate its effects on discharge readiness, glycemic control, self-management ability, prognosis, and to evaluate its health economic value.

METHODS

An evidence-based nursing approach was adopted to retrieve, appraise, and synthesize relevant evidence, forming an intervention program integrating three dimensions (evidence, process, and tools) across four stages: admission assessment, inpatient intervention, discharge reinforcement, and post-discharge follow-up. A total of 120 hospitalized patients with T2DM admitted to the endocrinology department of our hospital from April 2025 to October 2025 were randomly assigned to an intervention group and a control group, with 60 patients in each group. The control group received routine discharge guidance, while the intervention group was treated with the discharge preparation plan. Discharge readiness (RHDS scores), glycemic control indicators, self-management ability (SDSCA scores), readmission rates, and medical costs were compared between the two groups at baseline and at 1 and 3 months post-discharge, and a cost-effectiveness analysis was conducted.

RESULTS

After the intervention, the intervention group demonstrated significantly higher RHDS total scores at discharge (75.4 ± 7.1 vs. 62.6 ± 6.8, p < 0.001) and at 3 months (87.4 ± 8.0 vs. 67.2 ± 7.6, p < 0.001). SDSCA total scores were also significantly higher in the intervention group at 3 months (78.0 ± 9.0 vs. 60.7 ± 8.5, p < 0.001). Levels of fasting blood glucose, 2-h postprandial blood glucose, and glycated haemoglobin were significantly lower in the intervention group compared with the control group (p < 0.05). Glycemic control rate at 3 months was 80.0% in the intervention group versus 46.7% in the control group (p < 0.001). The 3-month all-cause readmission rate was significantly lower in the intervention group (5.00% vs. 16.67%, p = 0.040). The average direct medical cost per patient was reduced by 633.9 yuan compared with the control group, and the cost-effectiveness ratio was more favorable (53.23 vs. 104.83 CNY/unit effect).

CONCLUSION

The evidence-based three-dimensional integrated four-stage discharge preparation plan for patients with T2DM can effectively improve discharge readiness and self-management ability, optimize glycemic control, reduce readmission rates, and demonstrate clear health economic advantages, indicating that it is worthy of clinical promotion.