Transcript Diabetes Nurse Practitioner - Natalie Smith

Diabetes Nurse Practitioner
Prepared by Natalie Smith
Transitional Nurse Practitioner – Diabetes
Mehi/McIntyre Clusters
Hunter New England Health
November 2009
1
Background

Narrabri Shire DE for 10+yrs

Post grad. Cert. in DE in 2000

CDE since 2006

Part time DE & CH NUM 5 years

2008 Masters in Nursing (NP)

August 2009 commenced as DNP
Service Developments
 2004 Healthy Lifestyle Program walking group
continues today.
Service Developments

2007 staff changes &
model of care reviewed

2008 new model
implemented:
- Multidisciplinary
Service Developments
client centred approach
- Outcomes: improved access
reduced waiting time
for high risk foot clients
- Educational opportunities
Engaging & Supportings GP’s & other partners
 Dec 2008 Upskilling
GP’s & other HP’s.
 Working collaboratively
with GP’s & Barwan Div.
 2009 Evaluating Integrated
Care Program
 Improving feedback to GP’s.
Engaging Partners
“Connect the Dots” Narrabri Dec 2008
Diabetes Australia Kids Camp
Morisset Jan 2009
Resource Accountability & Quality
 2008 CHIME
 2008 Abbott Medisense Grant
 2009 Chronic & Complex Care Best Practice Survey
 Health promotions
Workforce Development:
Mehi/McIntyre Diabetes NP
What is a Nurse Practitioner
“A nurse practitioner is a registered nurse educated and
authorised to function autonomously and
collaboratively in an advanced and extended clinical
role. The role includes assessment and management
of clients using nursing knowledge and skills and may
include but is not limited to, the direct referral of
patients to other health professionals, prescribing
medications and ordering diagnostic investigations.”
NP’s are required to submit Clinical Guidelines that
articulate their specific scope of practice.
What does a Nurse Practitioner do?
What does a Nurse Practitioner do?
 Utilise their clinical guidelines to deliver high quality,
patient centred care.
 Provide expert nursing care and high level clinical
decision making.
 Deliver care in collaboration with other health
professionals as part of a multidisciplinary team.
What can’t a Nurse Practitioner do?
 Presently no access to PBS (however recent changes
will facilitate this in the near future).
 Can only practice within the scope of practice outlined
in their clinical guidelines. Presentations outside of
these guidelines should be referred on appropriately.
Focus of Care

Mehi and McIntrye Clusters

Predominantly community health setting & acute hospital sites as
required

Resource person for staff

Clients over 16 years with diagnosed or suspected diabetes mellitus,
including Type 1, Type 2 and gestational diabetes

Managing diabetes related problems including: acute intervention,
ambulatory stabilisation and diabetes education, diabetes complication
screening, gestational diabetes and diabetes in pregnancy

Working collaboratively & referring as necessary
Elements of Care
 Defined by clinical guidelines approved by HNEH and the
NMBNSW.
 The DNP will also practice in accordance with The Australian
Diabetes Educators Association Standards of Practice, the
Code of Professional Conduct for Nurses National Competency
Standards for Registered and Enrolled Nurses and the Code of
Ethics for Nurses in Australia.
 Elements of the DNP role will include:
– Comprehensive assessment
– Diagnosis
– Planning of interventions
– Delivery of care and evaluation
– Health promotion
Formulary
 Diabetes related medications will be included in the
clinical guidelines. It would be limited though to oral
hypoglycaemic agents and insulin therapy.
Collaborative Responsibilities
 The DNP may make referrals to appropriate services
required for the client. They may include, but are not
limited to:
– Specialist physicians
– Dietitian
– Podiatrist
Collaborative Responsibilities
– General Practitioner
– Psychologist
– Social worker
– Non-government organisations, such as Diabetes
Australia.
Accountability
 Provision of advanced nursing care for people with
diabetes.
 Link clients to General Practitioners & other health
care providers & community groups.
 Promote primary prevention and diabetes health
awareness.
 Demonstrate clinical leadership and a high standard
of professional practice including an ongoing
commitment to professional development and quality
improvements in diabetes care.
Professional Role
 Maintain CDE status
 Current best standards of practice will be adhered to
and promoted by the DNP.
Review
 The scope of practice and clinical guidelines will be
reviewed and amended as necessary to facilitate
changes in practice.
 Outcome measures:
– client satisfaction surveys
– survey from referring source to the DNP
– monitoring of occasions of service
– other auditing processes to evaluate the DNP
service.
Recipe for Success
?
Teamwork
Future directions
 Application for local council grant to enable
Aboriginal specific program.
 Mehi Chronic Care Team
 Pilot for transitional care project ???
 Replicate successful programs & health promotional
activities in remote sites
 Support & work collaboratively with GPs.