Quality Standards for Diabetes Care Toolkit

Guidelines

Appropriately trained staff

According to the Health Workforce New Zealand ‘Diabetes workforce service review’ (Health Workforce New Zealand 2011):

Nursing staff

All nurses deliver care to people with diabetes. This National Diabetes Nursing Knowledge and Skills Framework (NDNKSF) has been developed to assist all registered nurses to demonstrate that they are adequately prepared to provide the required care and education for the person with diabetes and related comorbidities, whatever their practice setting. To promote best practice the NDNKSF is linked to national guidelines, standards of practice and the Nursing Council of New Zealand’s competencies for registration: www.nzssd.org.nz/documents/dnss/National%20Diabetes%20Nursing%20Knowledge%20and%20Skills%20Framework%202009.pdf.

Dietitians

Implementation of an integrated knowledge, skills and career framework for New Zealand dietitians is planned: www.health.govt.nz/system/files/documents/pages/diabetes-workforce-service-review.pdf.

Expert diabetes teams

The Australian Diabetes Society (2012) indicates an expert team comprises of diabetes inpatient specialist nurses led by a consultant in diabetes.

The role of the specialist diabetes inpatient team includes:

improving diabetes management expertise throughout the hospital

development and implementation of specific diabetes management protocols

direct management of diabetes with specific referral criteria

ward liaison, troubleshooting, management advice

discharge planning.

Clear guidelines should indicate when the diabetes specialist team should become involved (early involvement = reduced length of stay [LoS]), consider referral.

All hospitals should implement a diabetes inpatient specialist nurse service of 1.0 whole-time equivalent per 300 beds (reduces LoS whatever the reason for admission).

Inpatient education by the diabetes inpatient specialist nurse, with the support of generalist nurses, can provide education improving discharge outcomes and achieving earlier discharge (Dhatariya et al 2012).