Increasing numbers of patients with poorly controlled Type 2 Diabetes (T2DM) are being admitted through the Emergency department (ED) at our health service via General Practitioners (GPs). A Medicare Local has provided funding to employ two Diabetes Nurse Educators (DNEs) each for 35 hours per week within our health service.
To decrease the number of avoidable presentations to ED, shorten the length of stay for patients that are admitted and facilitate discharges from our Specialist Diabetes Outpatient Service by supporting GPs to manage T2 DM in primary care.
A clinical pathway has been developed and Practices within the Medicare Local have been invited to submit an Expression of Interest to participate in the pilot program. GPs from all practices within the Medicare local have access to a phone service to provide advice on managing patients with diabetes and 20 have access to in-practice visits from the DNE if required. A database will record statistics on the use of the service.
GPs report that they send patients with hyperglycaemia to the hospital because they do not have the experience or the resources to deal with the issue within their practice. The Endocrinology team identified that patients with T2 DM could be managed in primary care if GPs and Practice Nurses (PNs) were resourced and had the opportunity to ring the hospital for advice. The DNEs are liaising with the GP practices to ensure that they have access to a reliable blood glucose meter and samples of insulin when required. Education sessions for the GPs and PNs will be provided by the Endocrinology team and the DNEs. A dedicated phone line is provided for the GPs or PN.
Employment of DNEs and the development of a clinical pathway have been completed.