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RUNNING A DIABETIC CLINIC IN A LARGE GROUP PRACTICE SUSAN NEAL NURSE PRACTITIONER

RUNNING A DIABETIC CLINIC IN A LARGE GROUP PRACTICE SUSAN NEAL NURSE PRACTITIONER. DIABETICS AT NSMC 12,500 patients Register of 403 (3.2%) Type 1 = 40 (10%) Type 2 = 357(90%) Approx 40 Type 2 are Insulin dependant. WORKLOAD 344 patients attending DC

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RUNNING A DIABETIC CLINIC IN A LARGE GROUP PRACTICE SUSAN NEAL NURSE PRACTITIONER

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  1. RUNNING A DIABETIC CLINIC IN A LARGE GROUP PRACTICE SUSAN NEAL NURSE PRACTITIONER

  2. DIABETICS AT NSMC • 12,500 patients • Register of 403 (3.2%) • Type 1 = 40 (10%) • Type 2 = 357(90%) • Approx 40 Type 2 are Insulin dependant

  3. WORKLOAD • 344 patients attending DC • Type 1 = 31(78%) seen DC in last 15m • Type 2 = 317(90%)seen DC in last 15m • Other 60 mixture of hosp/recidivists/housebound • 896 dedicated diabetic or DC/CVS appts (17 appts weekly) • 2/3 appts annually on average • 4 clinicians

  4. USING A PATIENT TO ILLUSTRATE THE POINTS

  5. FEMALE • BORN 1955 • OBESE • POSSIBLE ANGINA 1991 • FH OF DM (MOTHER)

  6. WHAT ARE THE REQUIREMENTS? • PROTOCOL FOR ALL NURSES AND DOCTORS • AGREED APPROACH TO MANAGEMENT • EFFECTIVE USE OF IT – Protocol to include consistent IT entries

  7. TARGETS FOR BP CONTROL • TARGETS FOR HbA1c LEVELS • AGREEMENT ON OTHER INVESTIGATIONS • FIT WITH NSF / NEW CONTRACT?

  8. STEPPED APPROACH TO MEDICATION • NOT TO MAKE THINGS DIFFICULT • EXPERTISE AND CONFIDENCE CAN BE DEVELOPED IN HOUSE • APPROPRIATE USE OF EXPERTS – DSNs, HOSPITAL CLINICS, DIETICIANS

  9. DISEASE REGISTER • ADMIN USE OF REGISTER/RECALL • MONITOR LEVEL OF CARE BEING DELIVERED • AUDIT AND QUALITY CONTROL

  10. Keep things simple & straightforwardDoes not need to be done all in one go!Use advice and support

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