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RUNNING A DIABETIC CLINIC IN PRACTICE Dr Stephen Newell Susan Neal, Nurse-practitioner. DIABETICS AT NSMC 12,500 patients Register of 403 (3.2% of list) Type 1 = 40 (10%) Type 2 = 357(90%) Approx 40 Type 2 are insulin treated. WORKLOAD 344 patients attend practice diabetic clinic

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RUNNING A DIABETIC

CLINIC IN PRACTICE

Dr Stephen Newell

Susan Neal, Nurse-practitioner


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  • DIABETICS AT NSMC

  • 12,500 patients

  • Register of 403 (3.2% of list)

  • Type 1 = 40 (10%)

  • Type 2 = 357(90%)

  • Approx 40 Type 2 are insulin treated


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  • WORKLOAD

  • 344 patients attend practice diabetic clinic

  • Type 1 = 31(78%) seen in last 15m

  • Type 2 = 317(90%) seen in last 15m

  • Other 60 mixture of hospital/recidivists/housebound

  • 896 dedicated diabetic or DC/CVS appts (17 appts weekly)

  • 2/3 appts annually on average

  • 4 clinicians



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  • FEMALE

  • BORN 1955

  • OBESE

  • POSSIBLE ANGINA 1991

  • FH OF DM (MOTHER)


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WHAT ARE THE REQUIREMENTS?

  • PROTOCOL FOR ALL NURSES AND DOCTORS

  • AGREED APPROACH TO MANAGEMENT

  • EFFECTIVE USE OF IT – Protocol must include consistent IT entries


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  • TARGETS FOR BP CONTROL

  • TARGETS FOR HbA1c LEVELS

  • AGREEMENT ON OTHER INVESTIGATIONS

  • PROTOCOL MUST FIT WITH NSF & NEW CONTRACT


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  • STEPPED APPROACH TO MEDICATION

  • NOT MAKING THINGS DIFFICULT

  • EXPERTISE AND CONFIDENCE CAN BE DEVELOPED IN HOUSE

  • APPROPRIATE USE OF EXPERTS – DSNs, HOSPITAL CLINICS, DIETICIANS


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Keep it simple build up from basics be prepared to ask for advice l.jpg
KEEP IT SIMPLEBUILD UP FROM BASICSBE PREPARED TO ASK FOR ADVICE


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