Transcript Whitiora Diabetes Service

Whitiora Diabetes
Service
Gill Aspin CNS –Diabetes
How Can we Help?
O We are a team consisting of
Endocrinologists, SMOs, Registrar, Clinical
Nurse Specialists that are mostly designated
Prescribers in Diabetes Health, Dietitians,
Health Psychologists, Podiatrist with vast
experience in managing people with
diabetes across the lifespan and who have
multiple morbidity. We can help with many
aspects of diabetes management
Integration -an idea that’s time
has come
O Vision of improved collaboration between
primary and secondary services has been active
for some time
O Increased prevalence of Diabetes makes this an
imperative – neither primary or secondary care
can manage the numbers alone, we need to
work together for the best outcomes for people
with DM
O Recent Kaitiaki Nursing journal has focussed on
this with articles from Mid Central, Waikato, Hutt
Valley and with a review of our own Healthy
Together program at CMH
Where to gain the knowledge
and skills to help management
of people with DM
O MIT - Short Course of Diabetes Management – Level
7 paper-currently running for a class of 19, covers the
practical skills and knowledge needed to enable DM
management with confidence and competence
O Auckland Uni – Level 8 Advanced DM nursing
practice
O On-line - HealthMentorOnline
O Ongoing mentorship from Whitiora Diabetes Service
Ways that we can work
together
O Virtual Reviews – discussion and case
review with a DNS and PN for 5-10 cases.
Time needed for the DNS to review the
electronic records prior to meeting. This
could take place at our office or yours
O MDTs both locality and practice based ones
have already been a forum that many of you
will have regular participation in and has
had many virtual reviews and case
discussion
Ways to Collaborate continued
O Physical reviews – Again if we work together this
could take place at your practice, or at the
locality hub, or outpatient clinic. For patients
where you would like us to review a client with
you . Can be for both patient and health
professional education
O Structured education sessions as you require –
an hour at your practice on things like -diet and
healthy eating, exercise, medications, Insulin
initiation and dose titration, foot checks
Team Counties- here is how
we roll
O Mentorship – this can be formal – regular
meeting- time and place, with a DNS/PN
and a structured review of agreed diabetes
management aspects
O Informal – phone contact for a quick review
of patients and issues as they arise
O Day with the service – in the past we have
had some PN come and spend a day or half
a day with the DNS at clinic or with us in
MMH
Discharge planning for
Inpatients
O Currently Diabetes nurse team ~35-40
inpatients with diabetes M-F at MMH ( 200 pts
with DM most days) We proactively triage the
admission list and review those people who have
A1c > 75. These people are also the ones that
the mDCIP project has targeted. As we often
target education and change the medications for
these people it would be great opportunity to
hand back to the primary care team at
discharge. We can do this visa the Shared care
plan , an email or phone call to a named
coordinator/ champion from your practice.
DNS/SMO Locality Contact
List
Locality
Consultant
Ph
DNS
Ph
Mangere
Zaven Panossian
Diana McNeil
027 416 1861
021 1417 653
Otara
Zaven Panossian
Diana McNeil
027 416 1861
021 1417 653
Manukau
John Griffiths
Pui Ling Chan
Carl Eagleton
02102971331
021 2632 254
027 3620 056
East
Renate Koops
021 0773 204
Iris Blowers
Gill Aspin
Indra Dutt
Hannah Cattaway
Claire O’Brien
Elham Hajje
Ashley Gage
Kate Smallman
Bobbie Milne
Imelda Milich
Roshni Prakash
Sally Morgan
Simran Haer
Ashley Gage
Harpreet Kaur
Bobbie Milne
021 633 748
021 784 052
021 2417 636
021 724 893
021 224 3240
021 590 296
021 784 023
021 2222 261
021 2414 820
021 811 448
021 784 315
021 2249 696
021 2729 290
021 784 023
021 2802 905
021 2414 820
Gill Aspin
Joyce Roberts
Hannah Cattaway
021 784 052
021 564 541
021 724 893
Pukekohe/ Rural
Franklin
Community
Coordinator
Caran Barratt-Boyes
021 784 025
And so…
O We look forward to hearing from you and
working with you to improve the
management of Diabetes in our patch.
O Talk to us about what would work best for
you and where you have gaps in your
knowledge or skills