THE ROLE OF NURSES IN DIABETES CARE AND EDUCATION By Prof. Morsi Arab IDF Chair EMME Region University of Alexandria

1. THE ROLE OF NURSES IN DIABETES CARE AND EDUCATIONByProf. Morsi ArabIDF Chair EMME RegionUniversity of Alexandria

2. The Diabetes Care TeamThe Nurse is a member of the Diabetes Health Care Team which requires: - complementation - integration - no contradictions - strict job description ( without overdoing)

3. A special Member The nurse is a privileged member of the team. Why ? 1. Has more time ( to listen and to educate) 2. can replace the doctor’s ‘orders’ by ‘instructions and guidance’ : a psychol. value ? 3. Female nurses understand and communicate better with ( a female pt. or mother of a diab. child ) Sympathy and Care is a feminine specialty……

4. Positive and Negative Aspects of Historical Significance in the ME1. Islamic history supported the role of woman nurses.** 2. Cultural factors delayed women’s development . In the region X 3. Poor reputation about the standard of nursing in Arab hospitals X 4.Establishment of Higher schools of Nursing (Alexandria early 1960 ) ** 5. First recognition & a parallel international course (Alexandria 1991) **

5. Cont.(Historical …) 6. Developing National Diab. Nurse Training Programs ** 7. A generation of high-standard specialized educators with a nursing background **

6. The Diabetes Nurse gets international recognition

7. Notional Programme for Nurses Training

8. Nurse Training Workshops

9. Requirements to Perfect The General Requirements for a nurse to perfect her role in diabetes care and education : I. Knowledge -in diabetes and related sciences. -in basic principles in education II. Skills -clinical : history taking , examination ,etc. -educational :skills of teaching knowledge and skills , and changing attitudes of pts. III.Special talents (Attitude) : interest, team working, respecting limitations,etc

10. Specific Considerations Specific role in “ Acute complications” 1. Knowledge of causes, symptoms and signs, diagnosis, prevention and principles of management . 2. Clinical Skills :e.g. history, exam. (P & BP, urine test, bld sugar, acetone breath, etc) follow-up observations…………. 3. Educational Skills e.g. instructing prevention , diagnosing and immediate management. 4. Taking appropriate decisions

11. The Diabetes Nurse in Foot CareKnowledge: foot anatomy, vulnerability, types of injuries (mechanical, thermal, chem.) weight bearing walking dynamics ,etc. Clinical examination Skills : pulses, sensation, dryness, colour changes, points of stress , etc ), Management skills according to her training. Level I : e.g. dressings, nail cut, etc. Level II : e.g. ulcer debridement , etc Education Skills for patients on : self inspection, shoes , stockings,, preventing mech., thermal and chemical injuries, etc

12. In the Absence of the Physician The Diabetes Nurse : - At School - As Health Visitor to Homes - At Far Rural Centres

13. The Diabetes Nurse at School - Keeps records of children with diabetes - checks times for insulin intake and snacks - manages acute episodes e.g. hypoglycemia - educates school staff to:- - consider the needs of the diab child - manage emergencies - avoid discrimination

14. The Diabetes Nurse at Homes - Encourages pt. compliance to: - regular check of glycem. Control - periodic checks e.g. ,ophthalmoscopy, e.c.g. ,etc - Monitors early develop. of complications - Guidance (Education) about special needs of : the Elderly ,the Isolated , and the Handicapped diabetic.

15. The Diabetes Nurse at Far Rural Centres - Keeps sound balance between active management of diab care or referral ( to physicians and specialists) in due time. - Manages immediate care in emergencies - Checks sufficient stores of medications and equipment for emergencies. - Checks readiness of fast means for transportation in emergencies