scholarly journals Management of diabetes by primary health care nurses in Auckland, New Zealand

2015 ◽  
Vol 7 (1) ◽  
pp. 42 ◽  
Author(s):  
Barbara Daly ◽  
Bruce Arroll ◽  
Timothy Kenealy ◽  
Nicolette Sheridan ◽  
Robert Scragg

INTRODUCTION: The increasing prevalence of diabetes has led to expanded roles for primary health care nurses in diabetes management. AIM: To describe and compare anthropometric and glycaemic characteristics of patients with diabetes and their management by practice nurses, district nurses and specialist nurses. METHODS: Primary health care nurses in Auckland randomly sampled in a cross-sectional survey, completed a postal self-administered questionnaire (n=284) and telephone interview (n=287) between 2006 and 2008. Biographical and diabetes management details were collected for 265 (86%) of the total 308 patients with diabetes seen by participants on a randomly selected day. RESULTS: Nurses were able to access key clinical information for only a proportion of their patients: weight for 68%; BMI for 16%; HbA1c for 76% and serum glucose levels for 34% (for either measure 82%); although most (96%) records were available about whether patients self-monitored blood glucose levels. Most nursing management activities focused on giving advice on dietary intake (70%) and physical activity (66%), weighing patients (58%), and testing or discussing blood glucose levels (42% and 43%, respectively). These proportions varied by nurse group (p<0.05), generally being highest for specialist nurses and lowest for district nurses. DISCUSSION: Most practice and specialist nurses could access patients' weight and HbA1c levels and focused their clinical management on health education to decrease these if indicated. Communication and organisational systems and contracts that allow district nurses to work across both primary and secondary health services are necessary to improve community-based nursing services for patients with diabetes. KEYWORDS: Blood glucose; diabetes mellitus type 1; diabetes mellitus type 2; nurses; primary health care; risk management

2013 ◽  
Vol 5 (1) ◽  
pp. 19 ◽  
Author(s):  
Barbara Daly ◽  
Bruce Arroll ◽  
Nicolette Sheridan ◽  
Timothy Kenealy ◽  
Robert Scragg

INTRODUCTION: There is a worldwide trend for diabetes care to be undertaken in primary care. Nurses are expected to take a leading role in diabetes management, but their roles in primary care are unclear in New Zealand, as are the systems of care they work in as well as their training. AIM: To describe and compare demographic details, education and diabetes experience, practice setting and facilities available for the three main groups of primary health care nurses working in the largest urban area in New Zealand. METHOD: Of the total number of practice nurses, district nurses and specialist nurses working in Auckland (n=1091), 31% were randomly selected to undertake a self-administered questionnaire and telephone interview in 2006–2008. RESULTS: Overall response was 86% (n=284 self-administered questionnaires, n=287 telephone interviews). Almost half (43%) of primary care nurses were aged over 50 years. A greater proportion of specialist nurses (89%) and practice nurses (84%) had post-registration diabetes education compared with district nurses (65%, p=0.005), from a range of educational settings including workshops, workplaces, conferences and tertiary institutions. More district nurses (35%) and practice nurses (32%) had worked in their current workplace for >10 years compared with specialist nurses (14%, p=0.004). Over 20% of practice nurses and district nurses lacked access to the internet, and the latter group had the least administrative facilities and felt least valued. DISCUSSION: These findings highlight an ageing primary health care nursing workforce, lack of a national primary health care post-registration qualification and a lack of internet access. KEYWORDS: Community health nursing; diabetes mellitus; internet; nurses; primary health care


2014 ◽  
Vol 106 (2) ◽  
pp. 212-220 ◽  
Author(s):  
Barbara Daly ◽  
Timothy Kenealy ◽  
Bruce Arroll ◽  
Nicolette Sheridan ◽  
Robert Scragg

Author(s):  
Elizabeth Halcomb ◽  
Christine Ashley ◽  
Sharon James ◽  
Elizabeth Smyth

2006 ◽  
Vol 30 (4) ◽  
pp. 485 ◽  
Author(s):  
Elizabeth J Comino ◽  
Oshana Hermiz ◽  
Jeff Flack ◽  
Elizabeth Harris ◽  
Gawaine Powell Davies ◽  
...  

Objective: Currently, primary health care (PHC) is under-represented in health statistics due to the lack of a comprehensive PHC data collection. This research explores the utility of population health surveys to address questions relating to access to and use of PHC, using diabetes as an example. Methods: Drawing on published material relating to diabetes management, we developed a conceptual framework of access to and use of quality PHC. Using this framework we examined three recent population-based health surveys ? the 2001 National Health Survey, 2002?03 NSW Health Survey, and AusDiab ? to identify relevant information collection. Results: We identified seven domains comprising aspects of quality PHC for people with diabetes. For each domain we proposed associated indicators. In critiquing the three population health surveys in relation to these indicators, we identified strengths and weaknesses of the data collections. Conclusion: This approach could inform the development of questions and extension of population health surveys to provide a better understanding of access to and use of quality PHC in Australia. The additional information would complement other data collections with a communitybased perspective and contribute to the develop- ment of PHC policy.


Curationis ◽  
2004 ◽  
Vol 27 (2) ◽  
Author(s):  
J. Bornman ◽  
E. Alant ◽  
L.L. Lloyd

This article focuses on the importance of primary health care nurses’ involvement in the identification of children with severe disabilities, early and appropriate intervention that includes referral, as well as the provision of support to the children’s caregivers. The use of multiskilling as a strategy to train nurses to fulfil this role is described. The traditional roles of community nurses are explored within the disability paradigm, with specific reference to multi-skilling. Finally, research results following the implementation of the Beginning Communication Intervention Protocol (BCIP), which uses multiskilling as a training strategy, are described. Recommendations for further research are then provided.


Author(s):  
Annica Lagerin ◽  
Lena Törnkvist ◽  
Johan Fastbom ◽  
Lena Lundh

Abstract Aim: The present study aimed to describe the experience of district nurses (DNs) in using a clinical decision support system (CDSS) and the safe medication assessment (SMA) tool during patient visits to elderly care units at primary health care centres. Background: In Swedish primary health care, general practitioners (GPs) prescribe and have the responsibility to regularly review older adults’ medications, while DN (nurses specialised in primary health care) play an important role in assessing older adults’ ability to manage their medications, detecting potential drug-related problems and communicating with patients and GPs about such problems. In a previous feasibility study, we found that DNs who use a combination of a CDSS and the SMA tool identified numerous potentially harmful or dangerous factors and took a number of nursing care actions to improve the safety and quality of patients’ medication use. In telephone interviews, patients indicated that they were positive towards the assessment and interventions. Methods: Individual interviews with seven DNs who worked at six different primary health care centres in Region Stockholm were carried out in 2018. In 2019, an additional group interview was conducted with two of the seven DNs so they could discuss and comment on preliminary findings. Qualitative content analysis was used to analyse the interview transcripts. Findings: Using the tools, the DNs could have a natural conversation about medication use with older adults. They could get a clear picture of the older adults’ medication use and thus obtain information that could facilitate collaboration with GPs about this important component of health care for older adults. However, for the tools to be used in clinical practice, some barriers would have to be overcome, such as the time-consuming nature of using the tools and the lack of established routines for interprofessional collaboration regarding medication discussions.


2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Kristina Lundberg ◽  
Mats Jong ◽  
Miek C. Jong ◽  
Lisbeth Porskrog Kristiansen

Abstract Background Previous studies have reported that organizational structures and cultures in primary health care are obstacles to district nurses doing successful work in health promotion practice (HPP). Because organizational structures are not easily changed, Jean Watson’s Attending Nurse Caring Model (ANCM) was introduced and piloted at a primary health care center in Sweden, aiming to transform HPP so as to empower district nurses and increase their work satisfaction. Aim To investigate patients’ experiences of the caring encounter in HPP after introduction of the ANCM in Swedish primary health care, the aim being to explore the essential components of the caring encounter between patients and district nurses. Methods A descriptive and qualitative research design was used. Data collection was performed using individual face-to-face interviews with twelve patients at risk for developing CVD. Data analysis consisted of both deductive content analysis, using a categorization matrix based on the ANCM and, subsequently, inductive latent content analysis. Results The findings were abstracted into three themes: 1.‘Feeling the deepest essence of being cared for’: to be respected and being put at the center of the encounter; 2. ‘Feeling acceptance and worth’: being treated with openness and permissive attitudes, 3. ‘Being in a supportive atmosphere that promotes hope’: to feel trust and being trusted in the encounter, and being empowered by hope. The unifying main theme of the caring encounter was abstracted as ‘Experiencing human dignity’. Conclusion The present study revealed that the essence of the caring encounter between patients and district nurses in HPP is to be unconditionally accepted in an environment that inspires hope and encouragement. The ANCM seems to be a promising model to use for strengthening the caring encounter and supporting CVD patients in making healthy lifestyle choices. However, further studies of qualitative and quantitative designs are needed to investigate what the ANCM can contribute to HPP in Swedish primary health care.


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