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

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

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

  2. 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

  3. 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

  4. A PATIENT TO ILLUSTRATE THE POINTS

  5. FEMALE • BORN 1955 • OBESE • POSSIBLE ANGINA 1991 • FH OF DM (MOTHER)

  6. WHAT ARE THE REQUIREMENTS? • PROTOCOL FOR ALL NURSES AND DOCTORS • AGREED APPROACH TO MANAGEMENT • EFFECTIVE USE OF IT – Protocol must include consistent IT entries

  7. TARGETS FOR BP CONTROL • TARGETS FOR HbA1c LEVELS • AGREEMENT ON OTHER INVESTIGATIONS • PROTOCOL MUST FIT WITH NSF & NEW CONTRACT

  8. STEPPED APPROACH TO MEDICATION • NOT MAKING THINGS DIFFICULT • EXPERTISE AND CONFIDENCE CAN BE DEVELOPED IN HOUSE • APPROPRIATE USE OF EXPERTS – DSNs, HOSPITAL CLINICS, DIETICIANS

  9. DISEASE REGISTER IS COMPUTER BASED • ADMINISTRATIVE USE OF REGISTER FOR REPORTS AND RECALL • AUDIT QUALITY OF OF CARE BEING DELIVERED

  10. KEEP IT SIMPLEBUILD UP FROM BASICSBE PREPARED TO ASK FOR ADVICE

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