Quality Standards for Diabetes Care Toolkit

Capital & Coast DHB

Capital & Coast District Health Board has developed a similar practice model designed to take secondary care into the community in the form of upskilling and mentoring practice nurses to increase their support of people with diabetes and do insulin starts. Building on initial outreach work and diabetes services developed by the PHO and Compass Health with nurses and GPs in Newtown and Porirua, the ‘Nursing Practice Partnership – a Diabetes Care Improvement Package’ was trialled with Karori Medical Centre in 2011. At that point, the nurses provided diabetes annual reviews but no additional diabetes services, such as Care Plus, were run by GPs. A Diabetes Clinical Nurse Specialist (DCNS) from the Diabetes Specialist Service started by running specialist clinics in the practice and gradually developed the knowledge and skills of two Practice Nurses to enable them to take on the role of diabetes nurse ‘champions’. This was achieved primarily by working alongside them to build confidence and competence. The online diabetes learning modules provided by Health Mentor Online (http://pro.healthmentoronline.com) were also used to increase the nurses’ knowledge. The DCNS has gradually reduced her personal involvement in the practice but supports the Practice Nurses who now run nurse-led diabetes clinics including insulin starts. The partnership model is currently being rolled out to 15 practices identified as having high numbers of patients with or at risk of developing diabetes, with the hope that all practices in the DHB will be included by next year. The package also involves working with GPs in practices, with endocrinologists holding peer and case reviews with practice teams, including virtual clinics for nurse champions and GPs to attend (www.nursingreview.co.nz/issue/june-2014/close-to-home-better-nurse-led-diabetes-care-on-your-back-doorstep/#.U7iuLSwrjIU).