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Diabetes Specialist Nurse (diabetes + specialist_nurse)
Selected AbstractsA pilot randomized trial in primary care to investigate and improve knowledge, awareness and self-management among South Asians with diabetes in ManchesterDIABETIC MEDICINE, Issue 12 2003A. Vyas Abstract Aims To investigate whether a secondary,primary care partnership education package could improve understanding of diabetes care among South Asians. Methods In a pilot randomized controlled trial, in the setting of eight general practices randomized to intervention or control, patients were invited to four or more rotating visits per year by one of a diabetes specialist nurse, dietician or chiropodist working with general practice staff. Participants were from lists of South Asian patients with known Type 2 diabetes in each (general) practice. Results Patients and practice scores at baseline and 1-year follow-up, from an interview using a questionnaire on knowledge, awareness and self-management of diabetes. Responses were developed into educational packages used during intervention. Of the 411 patients listed at baseline only 211 were traced for interview (refusal only 4%). Mean age was 55.4 years, age of diabetes onset 47.1 years. Fourteen percent were employed and 35% were able to communicate in English fluently. Only 118 could be traced and interviewed at 1 year, although there was no significant difference in demography between those who completed the study and those who did not. Despite a mean of four visits/patient, intervention had no impact on scores for diabetes knowledge, or awareness [score change 0.14, 95% confidence interval (CI) ,0.20, 0.49] or self-management (,0.05, 95% CI ,0.48, 0.39) between baseline and 1 year. Conclusions This form of secondary/primary care support did not transfer information effectively, and we suspect similar problems would arise in other similar communities. Different methods of clinician/patient information exchange need to be developed for diabetes in this South Asian group. [source] A pilot study comparing a type 1 nurse-led diabetes clinic with a conventional doctor-led diabetes clinicEUROPEAN DIABETES NURSING, Issue 1 2004J Charlton Diabetes Nurse Specialist Abstract A prospective comparative pilot study was designed to assess and compare care delivered by a diabetes specialist nurse (DSN) and standard doctor-led care for patients with type 1 diabetes. The philosophy was to provide an individualised, patient-centred, lifestyle-based approach. In all, 60 patients with type 1 diabetes were randomised to either the nurse-led clinic (NLC) or a conventional clinic. NLC patients received medical input during their annual screening appointment. In the nurse-led system patients prioritised relevant issues with the aid of a ,Waiting Area Menu'. The menu consisted of pertinent topics relevant to living with diabetes. Care interventions were then agreed and targets discussed. To date the results of DSN intervention include: 60% of patients changing to a more appropriate insulin regimen; 36% changing equipment following update from the DSN; 20% needing initiation of cardiovascular medication; and 26% being referred to other health care professionals. The mean HbA1c changed by -0.25% in the NLC group and by -0.06% in the control group (ns). During the pilot there were several barriers which we had not anticipated. These included staffing resources, and organisational and time management issues. However, feedback from patient questionnaires demonstrated that the majority of patients preferred the NLC. Copyright © 2004 FEND. [source] Evaluation of glargine group-start sessions in patients with type 2 diabetes as a strategy to deliver the serviceINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 2 2007A. A. Tahrani Summary Improving glycaemic control in patients with type 2 diabetes reduces microvascular complications. The national service framework for diabetes and the new general medical service contract have been aiming to direct more focus on improving HbA1c. These measures have resulted in increasing number of patients being initiated on insulin therapy, which increases the workload of diabetes specialist nurses (DSNs). Initiating insulin on a one-to-one basis is time consuming. As a result DSN-led insulin group-start sessions were introduced. To evaluate DSN-led glargine group-start and self-titration as a strategy of providing service. We assessed the impact of this method on the use of DSNs time, HbA1c and on patients' satisfaction. A prospective audit in a district general hospital. Groups of 5,7 patients received two 2-h sessions at weeks 0 and 2. During these sessions, patients were initiated on insulin glargine and received an educational package and a self-titration protocol. DSNs did not see patients after week 2. Patients were able to phone the DSNs for advice till the end of the titration period. Patients completed Diabetes Treatment Satisfaction Questionnaire (DTSQ) at baseline, week 2 and 12 months. Weight and HbA1c were assessed at base line and 12 months later. Twenty-nine consecutive patients were included. Baseline HbA1c improved at 6 months and remained stable at 12 months (medians 10.0, 8.7 and 8.9 respectively, p < 0.001). DTSQ score improved between week 0 and 2 and this was maintained at 12 months (medians 26, 35 and 34 respectively, p < 0.001). After week 2, the DSNs spent a median of 21 min advising patients by phone during the titration period. Weight did not increase significantly. In our centre, DSN-led insulin group-start sessions and self-titration improved glycaemic control. Patients were satisfied with this method of starting insulin. This was achieved with minimal DSNs time and input and proved to be effective, yet less time consuming. [source] Attitudes to prescription of antiplatelet drugs by diabetes health workersPRACTICAL DIABETES INTERNATIONAL (INCORPORATING CARDIABETES), Issue 8 2007A Woodward RN, MPhill Diabetes Specialist Nurse Abstract The aim of this survey was to explore the attitudes to antiplatelet drug use amongst a group of UK diabetes specialist medical and nursing personnel. A postal questionnaire survey was circulated to all consultant diabetologists, specialist registrars in diabetes and diabetes specialist nurses working in the Mersey Deanery area. Seventy-eight questionnaires were sent out, 63 (81%) returned. The perceived use of antiplatelet therapy was significantly higher for type 2 diabetes compared with type 1 diabetes, especially in the absence of complications or cardiovascular risk factors (52% vs 21%, p = 0.0004). Responses were more variable for type 1 diabetes: more nurses than doctors advised antiplatelet drugs in the absence of risk factors (46% vs 5%, p = 0.0002) and in the presence of smoking (79% vs 51%, p = 0.034). Aspirin was first-line choice of antiplatelet drug; clopidogrel was generally used for gastric intolerance and aspirin allergy. We conclude that the combination of limited evidence base and imprecise guidelines is not favouring proper usage of antiplatelet drugs and that more evidence-based didactic guidelines are required. Copyright © 2007 John Wiley & Sons. [source] |