Page 51 - Q BULLETIN, Ministry of Health Malaysia, VOLUME 1, NO. 31 (SUPPLEMENT 1), JAN-DEC 2022

Q Bulletin, Volume 1, No. 31 (Supplement 1), Jan - Dec 2022
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11 National QA Convention, 4 – 6 October 2022
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Improve Dietetic Care for Dietary Consultation among Gestational Diabetes Mellitus
(GDM) Inpatients in Hospital Tuanku Ja’afar Seremban (HTJS), Negeri Sembilan

Fadhlina AS, Nik Nur Izzati NMF, Basmawati B, Norazizah M, Noorzarirah J, Lydianis B, Sarah Khalilah K
Dietetic and Food Services Department, Hospital Tuanku Ja’afar Seremban, Negeri Sembilan

SELECTION OF OPPORTUNITIES FOR IMPROVEMENT:
GDM patients should receive individualised Medical Nutrition Therapy to control their blood sugar profile
and reduce complications. From 2018-2019, the number of GDM inpatients seen by the dietitian and time
consumption for individual dietary consultation increased to 19.8%. As a part of the improvement in dietetic
care, this study aimed to reduce time consumption for dietary consultation.

KEY MEASURES FOR IMPROVEMENT:
The indicator was the total monthly time consumed for dietary consultation among GDM inpatients with the
standard of ≤2100 minutes per month which is 50% of the average time consumption in the past two years as
agreed by the Department Head and group members.

PROCESS OF GATHERING INFORMATION:
A cross-sectional study was conducted among GDM patients in the Obstetrics and Gynaecology wards in two
phases. Data was collected from the monthly dietetic census, and a data collection form was created to identify
contributing factors.

ANALYSIS AND INTERPRETATION:
From January-March 2020, an average of 98 GDM patients were seen for individual dietary consultations with
total time consumption of 4395 minutes per month.

STRATEGIES FOR CHANGE:
Three standardised modules were developed and implemented from July-November 2020 for GDM structured
focus group (SFG). The patients were given a meal plan and pictorial handout and needed to answer the
knowledge assessment questionnaire. A simplified version of Dietetic Care Notes was attached to the bed head
ticket and antenatal book.

EFFECT OF CHANGE:
The average time consumed for dietary consultation per month was reduced to 1782 minutes (59.5%). On
average, GDM patients who received dietary consultation increased to 128 patients (30.6%). The impact of
SFG GDM has proven a good result, with an average percentage of 83.2% of patients achieving knowledge
assessment ≥ 60%.

THE NEXT STEP:
During the pandemic, a virtual structured focus group is expanded to the whole Negeri Sembilan. Another
research is conducted to determine the effectiveness of SFG modules among GDM patients via focus group
education versus individual counselling (NMRR-20-2467-5665).

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