The effect of diabetes management on the workload of district and community nursing teams in the UK

IF 3.2 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Diabetic Medicine Pub Date : 2024-05-27 DOI:10.1111/dme.15367

Lucy Martin, Sue Hill, Richard I. G. Holt

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引用次数: 0

Abstract

Aims

The number of older people with diabetes requiring care from district nursing teams is increasing. The role of district nursing teams in diabetes management has expanded to involve diagnosis, treatment and medication administration. As the complexity of caseloads increases, the current model is likely unsustainable. This study aims to understand the current diabetes workload of district nursing teams.

Methods

An online survey was distributed via social media and key stakeholder networks to district nursing teams. Survey items were designed by the researchers prior to pilot testing with potential participants. Descriptive statistical and qualitative analyses were conducted. Data are median ± IQR.

Results

159 district nursing teams completed the survey. The median caseload per team was 300 (IQR 176–407) patients including 21 with diabetes (IQR 14–40; 8.7% (4–20%)). 1.09 home visits per day per person with diabetes lasting 13.8 minutes (excluding travel time) were needed, with most requiring insulin administration. 96% of nursing teams undertake multiple daily visits for some patients. 91% reported workloads relating to diabetes management had increased over the last 2 years; 76% stated current diabetes workloads were unsustainable. More insulin usage, more referrals and a lack of ability or willingness to self-administer insulin has increased the diabetes workload. Possible solutions include better collaboration between healthcare professionals, simplification of insulin administration and glucose monitoring, better training and upskilling of healthcare assistants and promotion of self-efficacy.

Conclusions

Diabetes management forms an increasing component of district nursing workload and is likely to be unsustainable unless new models are found.

Abstract Image

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糖尿病管理对英国地区和社区护理团队工作量的影响。

目的：需要地区护理团队护理的老年糖尿病患者人数不断增加。地区护理团队在糖尿病管理中的作用已扩大到诊断、治疗和用药。随着工作量的复杂性增加，目前的模式很可能难以为继。本研究旨在了解地区护理团队目前的糖尿病工作量：方法：通过社交媒体和主要利益相关者网络向地区护理团队发放在线调查问卷。调查项目由研究人员设计，然后对潜在参与者进行试点测试。研究人员进行了描述性统计和定性分析。数据为中位数 ± IQR：159 个地区护理团队完成了调查。每个团队的工作量中位数为 300（IQR 176-407）名患者，其中包括 21 名糖尿病患者（IQR 14-40；8.7% (4-20%)）。每位糖尿病患者每天需要进行 1.09 次家访，耗时 13.8 分钟（不包括路途时间），其中大部分需要注射胰岛素。96% 的护理团队每天对部分患者进行多次家访。91% 的人报告说，在过去两年里，与糖尿病管理有关的工作量有所增加；76% 的人表示，目前的糖尿病工作量难以为继。胰岛素用量增加、转诊增多，以及缺乏自我注射胰岛素的能力或意愿，都增加了糖尿病的工作量。可能的解决方案包括加强医护专业人员之间的合作、简化胰岛素管理和血糖监测、加强对医护助理的培训和提高其技能，以及提高自我效能：结论：糖尿病管理在地区护理工作量中所占比例越来越大，除非找到新的模式，否则很可能难以为继。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Diabetic Medicine 医学-内分泌学与代谢

CiteScore

7.20

自引率

5.70%

发文量

229

审稿时长

3-6 weeks

期刊介绍： Diabetic Medicine, the official journal of Diabetes UK, is published monthly simultaneously, in print and online editions. The journal publishes a range of key information on all clinical aspects of diabetes mellitus, ranging from human genetic studies through clinical physiology and trials to diabetes epidemiology. We do not publish original animal or cell culture studies unless they are part of a study of clinical diabetes involving humans. Categories of publication include research articles, reviews, editorials, commentaries, and correspondence. All material is peer-reviewed. We aim to disseminate knowledge about diabetes research with the goal of improving the management of people with diabetes. The journal therefore seeks to provide a forum for the exchange of ideas between clinicians and researchers worldwide. Topics covered are of importance to all healthcare professionals working with people with diabetes, whether in primary care or specialist services. Surplus generated from the sale of Diabetic Medicine is used by Diabetes UK to know diabetes better and fight diabetes more effectively on behalf of all people affected by and at risk of diabetes as well as their families and carers.”