Setting the Trend for Diabetes Nursing in the Future
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Training, Research and Education for Nurses in Diabetes (TREND-UK) was launched in 2010 when the then National Tsar for Diabetes, Dr Sue Roberts, stated that she didn’t know who to contact if she needed a nursing opinion, as there were so many disparate groups representing nursing in diabetes care. The idea for TREND-UK came from four senior nurse consultants who believed there was an opportunity to represent all views, from the unregistered practitioner to the Nurse Consultant. TREND-UK has become a conduit for nursing views from groups such as the Diabetes Inpatient Nurses group, the Practice Nursing group and the Nurse Consultant group. The team is recognised for providing high quality, practical resources for both diabetes HCPs and people with diabetes. TREND-UK is also known for developing high quality, topical, free-to-attend educational meetings and is recognised as a ‘diabetes brand’.
"TREND is a fantastic achievement. All four diabetes nurse consultants are in full time posts and in a decade have shaped an organisation that raises the profile of DSNs and provided a fantastic range of resources. TREND has not only produced a lot of high quality material, but the application suggests they are continuously moving forward looking at new collaborations and areas of development. Without a doubt they have risen to the challenge set by Dr Sue Roberts."
Changing the Landscape for Delivery of Type 2 Diabetes Care – Midland Diabetes Structured Care Programme 1999 – 2017
by Midland Diabetes Structured Care Programme
The HSE Midland Diabetes Structured Care Programme (MDSCP) is the longest-established primary care-based diabetes care programme in Ireland, operating in Longford, Westmeath, Laois and Offaly. Participating practices receive clinical support via diabetes nurse specialists (DNS), dietetics, podiatry/chiropody, plus educational and administrative support.
While the proportion of patients with T2D achieving HbA1c <6.5% remained stable over time (37.6% in 1999 vs. 34.1% in 2016), there was evidence of a significant increase in the proportion of patients meeting the total cholesterol target of <4.5mmol/L (22.9% in 1999 vs. 70.4% in 2016) and triglycerides <2.0mmol/L (46.4% vs. 75.5%).
"This project has benefited from a strong leader who has managed to improve quality under extremely challenging conditions, e .g. lack of access to dietetic resources, no consultant resource. It is a remarkable achievement that something that started off being supported by funds from drug savings has become part of the national cardiovascular disease secondary prevention programme."
VRIII: Getting it Right with JBDS Recommended Fluid
by Queen Elizabeth Hospital Birmingham
Variable rate intravenous insulin infusions (VRIII) are frequently used to manage blood glucose in inpatients. They are often used inappropriately and are associated with significant harm to patients.
Following publication of new guidelines on VRIII, a practice review found that the fluid was poorly managed across the Trust, resulting in high levels of hypokalaemia. A quality improvement project (QIP) was set up at Queen Elizabeth Hospital Birmingham (QEHB) to improve the outcomes of patients and to allow a consistent standard of care in keeping with JBDS guidelines. The QIP led to a significant improvement in clinical outcomes in patients on VRIII, brought cost savings (over £600,000 per year) and provided the first evidence of the cost effectiveness of the fluid along with VRIII in the NHS.
"The VRIII project has excellent outcomes which proves that what NICE says should be done is cost effective and best practice. Many hospitals are still not following the protocol because they believe it is too expensive and this elegantly showed that this isn’t the case. This is an excellent piece of quality improvement work."