NURSE ROLE

Nurse Role Promoting Diabetes Self Management

Nurse Role Promoting Diabetes Self Management

Purpose

The purpose of this study was to examine nurse and physician perceptions of nurse involvement and roles in diabetes care.

Methods

The study used a cross-sectional design with face-to-face or telephone interviews of diabetes health care professionals in 13 countries from Asia, Australia, Europe, and North America. This article focuses on the data from US health care providers. The US sample included 51 generalist nurses, 50 diabetes specialist nurses, 166 generalist physicians, and 50 diabetes specialist physicians.

Results

Nurses and physicians agreed that nurses should take a larger role in managing diabetes. Most common differences identified between nurses and physicians were that nurses provide better education, spend more time with patients, were better listeners, and knew their patients better than physicians. All nurses had a high perceived need for better understanding of psychosocial issues and were more likely than physicians to suggest helping patients to take responsibility for their care. Nurses more than physicians also said better communication was needed. Generalist nurses report that they act as intermediaries and facilitate patient appointment keeping. Specialist nurses talk to patients about self-management, teach medication management, have a higher level of involvement in medication prescribing, and are more willing to take on additional responsibilities than generalist nurses.

Discussion

Diabetes Self-Management Education (DSME) is the cornerstone of care for all individuals with diabetes who want to achieve successful health-related outcomes. The National Standards for DSME are designed to define quality diabetes self-management education that can be implemented in diverse settings and will facilitate improvement in health care outcomes. The dynamic health care process obligates the diabetes community to periodically review and revise these standards to reflect advances in scientific knowledge and health care.

Nurses have been utilized most often as instructors in the delivery of formal DSME. Since the emergence of medical nutrition therapy, registered dietitians have become an integral part of the diabetes education team. In recent years, the role of the diabetes educator has also expanded to other disciplines. Although there is no evidence demonstrating that one discipline is more effective than another, the literature review favors current practice that utilizes the registered nurse and registered dietitian as key members of the multidisciplinary team preparing and assisting in the delivery of DSME

Therefore, the Task Force to review the National Standards for DSME was convened to review the current standards for their appropriateness, relevancy, and scientific basis, and to be sure they are specific and achievable in multiple settings.

The Task Force began this task by outlining a process to be used for accomplishing its charge:

1. Examine the adequacy of representation on the Task Force itself to ensure fair, relevant, and impartial revisions of the National Standards (the sponsoring organization for this revision of the National Standards is the American Diabetes Association).

2. Perform an initial review of the current standards to identify areas that need to be addressed.

3. Collect input from individuals and organizations who utilize the current standards?

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