Diabetes Nurse Training
Primary care diabetes course
We have an over-subscribed primary care diabetes course which runs over several days and is highly acclaimed in a formal feedback assessment. This course aims to teach primary care nurses many of the fundamentals of diabetes including home blood glucose monitoring, insulin therapy and injections and adjusting insulin therapy together with the basics of foot care and assessment of the diabetic patient clinically.
The diabetes specialist nurses were heavily involved in producing the Oxfordshire Diabetes Resource Pack in November 2000 which is an educational pack linking primary and secondary care.
Insulin conversion course
We have an annual insulin conversion course aimed at primary care nurses and general practitioners which runs over one day and includes case studies.
InSight
Management of type 1 diabetes depends upon developing a thorough understanding of the condition and the associated self-care skills. In the past, patient education has been largely over-looked. The Diabetes Control and Complications Trial (DCCT) first showed the benefits of tight glycaemic control for people with type 1 diabetes and the challenge for health care professionals is to develop a system of healthcare which improves glycaemic control, minimises the risk of hypoglycaemia, improves quality of life and well-being and which does not require huge resources.
OCDEM have developed a skills training course called InSight and have gained financial support from Diabetes UK to evaluate this programme before applying it in routine clinical practice. InSight is based upon the adult education principles of experiential learning and has been designed to be inter-active and based upon partnership between health professionals and people with diabetes. The main focus of the course is developing skills for self-care by enabling people to match insulin doses to their usual carbohydrate intake. The course was developed partly from the patient empowerment model, partly from observation of a skills-training programme in Arizona and partly from experience in practice with a clinical psychologist.
Insight was initially developed as a pilot scheme in OCDEM and is now being run in other centres; Stoke Mandeville Hospital (Aylesbury), High Wycombe and the Horton Hospital (Banbury). The course runs for one half day each week for 4 weeks and the course programme is as follows:
Week 1
- Introduction
- Explore expectations of subjects
- Discuss the course and explain non-judgemental philosophy
- Analyse diabetes beliefs and myths
- Explain physiology of diabetes and glucose metabolism using interactive Bodylink tool
- Introduce concept of carbohydrate counting and discuss use of self-monitoring diary
- Complete evaluation forms
Week 2
- Informal discussion of self-monitoring diaries
- Discuss and explain carbohydrate content of foods and methods of calculation - utilize food models, nutritional information on packages, food tables, scales
- Calculate individual insulin:carbohydrate ratios and correction doses
- Review injection technique
- Complete evaluation forms
Week 3
- Informal discussion of self-monitoring diaries
- Discuss eating out, takeaways, alcohol, effects of exercise
- Complete evaluation forms
Week 4
- Informal discussion of self-monitoring diaries
- Review hypoglycaemia - symptoms and treatment
- Review DKA and management of illness using Bodylink tool
- Complete evaluation forms