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RUNNING A DIABETIC CLINIC IN PRACTICE Dr Stephen Newell Susan Neal, Nurse-practitioner

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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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slide1
RUNNING A DIABETIC

CLINIC IN PRACTICE

Dr Stephen Newell

Susan Neal, Nurse-practitioner

slide2
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
slide3
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
slide5
FEMALE
  • BORN 1955
  • OBESE
  • POSSIBLE ANGINA 1991
  • FH OF DM (MOTHER)
slide9
WHAT ARE THE REQUIREMENTS?
  • PROTOCOL FOR ALL NURSES AND DOCTORS
  • AGREED APPROACH TO MANAGEMENT
  • EFFECTIVE USE OF IT – Protocol must include consistent IT entries
slide13
TARGETS FOR BP CONTROL
  • TARGETS FOR HbA1c LEVELS
  • AGREEMENT ON OTHER INVESTIGATIONS
  • PROTOCOL MUST FIT WITH NSF & NEW CONTRACT
slide16
STEPPED APPROACH TO MEDICATION
  • NOT MAKING THINGS DIFFICULT
  • EXPERTISE AND CONFIDENCE CAN BE DEVELOPED IN HOUSE
  • APPROPRIATE USE OF EXPERTS – DSNs, HOSPITAL CLINICS, DIETICIANS
slide18
DISEASE REGISTER IS COMPUTER BASED
  • ADMINISTRATIVE USE OF REGISTER FOR REPORTS AND RECALL
  • AUDIT QUALITY OF OF CARE BEING DELIVERED
ad