Diabetes care, mental health, flu jab

Nurse-led diabetes care shows value

Family Practice (2014), doi: 10.1093/fampra/cmt085

A nurse-led programme helps clinicians and practice systems 'overcome clinical inertia' and supports patients with type 2 diabetes to make a 'timely transition to insulin', an Australian feasibility study has suggested.

The programme aimed to improve insulin initiation in routine diabetes care in general practice by clarifying healthcare professionals' roles, developing systems and using 'simple' tools. The feasibility study included seven GPs and five practice nurses at five practices, and enrolled 18 patients.

Nurses were central to the programme. For example, patients initially received appointments with the GP and nurse on the same day. GPs reviewed diabetes management and, if appropriate, recommended insulin. The nurse performed an 'insulin initiation assessment' and worked through resources in a 'patient pack'. If the patient agreed, the nurse gave the first dose of glargine insulin. The following day, the nurse reviewed the patient, guided by a checklist, and observed the patient administer a second dose.