Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Caring for older people with diabetes: do guidelines help health professionals plan individualised care? (#127)

Trisha Dunning 1 , Sally Savage 1 , Nicole Duggan 1
  1. Centre for Nursing and Allied Health Research, Deakin University and Barwon Health, Geelong, VIC

Background: Increasing age is a risk factor for diabetes.  Age- and diabetes-related changes affect glucose homeostasis, the function of counter-regulatory and other hormones and organs and tissues.  In addition, symptoms of common conditions are often non-specific and atypical, which makes identification and management challenging.

Aim: Develop, implement and evaluatethe McKellar Guidelines for Managing Older People with Diabetes in Residential and Other Care settings (the Guidelines).

Methods: 1.The Guidelines were developed following the National Health and Medical Research (NHMRC) guideline development process.There are 18 individual guidelines and five risk assessment tools (RATS).  2. The Guidelines were implemented in a large and four small Victorian residential aged care facilities (RACF).  The implementation process included a structured education program about and how to use the Guidelines.  3. The evaluation included an audit of OPWDs’ medical records (n = 74 ) at baseline and 3–6 months Self-completed questionnaires (n = 58) or interviews with RACF staff  (n = 22) to determine the clinical utility, acceptability and usability of the Guidelines.  Field notes were compiled to capture anecdotal and observational data. Implementation and evaluation occurred over 12 months in 2013.Findings: The Guidelines address commonly occurring clinical issues that required staff to make decisions about diabetes care not addressed in current guidelines and policies.

Staff indicated the Guidelines were relevant to their work and easy to use; they particularly liked the RATS and indicated they learned ‘a lot about diabetes’ from the Guidelines.  Changes were noted in some care plans at six months e.g. sick day care was individualised and documentation of diabetes care improved. 

Conclusion: Evidence-based guidelines were developed and evaluated in relevant clinical settings.  They resulted in changes in some key care areas but the implementation and evaluation timeframe was too short to enable significant changes to occur.