Title:
A Systematic Review Assessing Educational Interventions to Improve Staff Nurses' Knowledge on Diabetic Ketoacidosis Management

Authors:
Madhu Bala¹, Pawan Kumar², Jyoti³, Sunil Kumar Dular, India

Abstract:

Background: Diabetic ketoacidosis (DKA) is a critical emergency requiring prompt and skilled nursing care. Nurses’ knowledge and competency in DKA management directly impact patient outcomes. Various educational training programmes have been implemented globally to enhance nurses’ understanding and clinical practice related to DKA.

Aim: To systematically review and synthesize existing evidence on the effectiveness of educational training programmes in improving knowledge levels regarding diabetic ketoacidosis among staff nurses.

Methodology: A comprehensive literature search was conducted across databases, including PubMed, Scopus, CINAHL, and Google Scholar for studies published from 2015 to 2025. Eligible studies included pre-experimental, quasi-experimental, and experimental designs assessing knowledge outcomes of nurses before and after educational interventions on DKA. Data on study design, sample characteristics, intervention content, assessment tools, and outcomes were extracted. Quality assessment was performed using the Joanna Briggs Institute critical appraisal tools.

Results: Twelve studies from diverse healthcare settings met inclusion criteria. Educational interventions consistently demonstrated statistically significant improvements in nurses' knowledge scores immediately post-training, with mean increases ranging from 25% to 45%. Limited evidence from a few studies indicated retention of knowledge at short-term follow-up (2 weeks to 1 month) and positive effects on clinical adherence to DKA management protocols. However, most studies had methodological limitations, including small sample sizes, lack of control groups, and short follow-up durations.

Conclusion: Educational training programmes are effective in enhancing nurses’ knowledge of diabetic ketoacidosis. Future research should focus on rigorous study designs with longer follow-up and measurement of clinical outcomes to establish sustained impacts on nursing practice and patient care.

DOI: http://dx.doi.org/10.51505/ijmshr.2026.10110