Diabetes specialist nursing in the UK: the judgement call? A review of existing literature
DOI:
https://doi.org/10.1002/edn.190Keywords:
diabetes specialist nursing, role, clinical effectiveness, cost effectiveness, United KingdomAbstract
AbstractThe role of the diabetes specialist nurse (DSN) has evolved since its inception over 70 years ago. Now, 1363 DSNs work in the UK, in various health care settings. The need to work within a culture of evidence-based practice and clinical and cost effectiveness, along with a perceived lack of evidence within diabetes specialist nursing, has prompted investigation into the role and efficacy of UK-based DSNs.
This review discusses the workforce demographics of DSNs employed in the UK, the evolving specialist nurse role and the clinical and cost effectiveness of specialist nursing. The DSNs’ roles and workforce issues were assessed using existing surveys and reports. Clinical and cost effectiveness of DSNs were explored using a systematic literature review. This article is based on the Janet Kinson Lecture given at the 2010 Diabetes UK Annual Professional Conference in Liverpool, which gave an overview of specialist nursing, current literature supporting DSN practice and insights into challenges facing the profession in the current NHS culture of efficiency savings.
Downloads
References
Castledine G. The Role of the Diabetes Specialist Nurse. Royal College of Nursing (RCN) Nursing Forum Presentation, 1989. Cited in RCN and Diabetes Specialist Nursing Working Party Report. London: RCN, 1991.
Davies M, Dixon S, Currie CJ, et al. Evaluation of a hospital diabetes specialist nursing service: a randomised controlled trial. Diabet Med 2001; 18:301–7.
The Directory of Diabetes Care, 2009. Loughborough: CMA Medical Data.
Department of Health. The NHS Plan: a plan for investment. A plan for reform 2000. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4010198 [accessed 27 May 2010].
Department of Health. National Service Framework for Diabetes: Standards. London: Department of Health, 2001.
Department of Health. Shifting the balance of power: The Next Steps. http:www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/Browsable/DH_4099025 [accessed 27 May 2010].
Health and Social Information Centre. National Quality and Outcomes Framework Statistics for England 2004/05. www.ic.nhs.uk/statistics-and-datacollections/audits-and-performance/the-quality [accessed 25 April 2010].
Department of Health. Our Health, Our Care, Our Say: a new direction for community services, 2006. www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyandGuidance/DH_4127453.
Royal College of Nursing. Specialist nurses targeted to cut NHS costs, 2008. www.rcn.org.uk/newsevents/news/article/uk/specialist_nurses_targeted_to_cutnhs_costs [accessed 27 May 2010].
Royal College of Nursing. Public unaware of scale of NHS cutbacks, 2010. www.rcn.org.uk/newsevents-news/article/uk/public_unaware_of_scale_ofnhs_cutbacks [accessed 25 April 2010].
University of Oxford. Diabetes Stories, 2007. www.diabetes-stories.corn [accessed 27 May 2010].
Winocour P, Ford M, Ainsworth A. Association of British Clinical Diabetologists (ABCD): Survey of specialist diabetes care services in the UK, 2002. 2. Workforce issues, roles and responsibilities of diabetes specialist nurses. Diabet Med 2002; 19 (Suppl 4): 27–31.
James J, Gosden C, Winocour P, et aL Diabetes specialist nurses and role evolvement: a survey by Diabetes UK and ABCD of specialist diabetes services 2007. Diabet Med 2009;26:560–5.
NHS Diabetes. The Diabetes UK and NHS Diabetes workforce database of United Kingdom diabetes specialist nurses and nurse consultants, 2010. www.diabetes.nhs.uk/factsheets_and_case_studiesl/factsheets [accessed 25 April 2010].
British Diabetic Association. Recommendations for the Structure of Specialist Diabetes Services. A British Diabetic Association Report. London: BDA, 1996.
Loveman E, Royle P, Waugh N. Specialist nurses in diabetes mellitus (review): The Cochrane Collaboration, 2003. www.thecochranelibrary.com [accessed 27 May 2010].
Department of General Practice, Glasgow University. Critical appraisal checklist for an article on treatment and prevention, study design: randomised controlled trial 1994. www.gla.ac.uk/media/media_64037_en.pdf [accessed 27 May 2010].
Department of General Practice, Glasgow University. Critical appraisal checklist for economic evaluation. www.gla.ac.uk/media/media_64048_en.pdf [accessed 27 May 2010].
Cavan DA, Hamilton P, Everett J, et al. Reducing hospital inpatient length of stay for patients with diabetes. Diabet Med 2001;18:162–4.
Pledger J. Effect on inpatient care of a dedicated diabetes specialist nurse. J Diabetes Nurs 2005;9:252–6.
Sampson MJ, Crowle T, Dhatariya K, et al. Trends in bed occupancy for inpatients with diabetes before and after the introduction of a diabetes inpatient specialist nurse service. Diabet Med 2006;23:1008–15.
Courtenay M, Carey N, James J, et al. An evaluation of a specialist nurse prescriber on diabetes in-patient service delivery. Pract Diabetes Int 2007;24:69–74.
Flanagan D, Moore E, Baker S, et aL Diabetes care in hospital - the impact of a dedicated inpatient care team. Diabet Med 2008;25:147–51.
New JP, Mason JM, Fremantle N, et al. Specialist nurse-led intervention to treat and control hypertension and hyperlipidaemia in diabetes (SPLINT). Diabetes Care 2003;26: 2250–5.
Wallymahmed M, McCrimmon R, Woodward A. Intensive intervention in specialist nurse-led clinics. J Diabetes Nurs 2003;7:327–31.
Woodward A, Wallymahmed M, Wilding J, et aL Improved glycaemic control - an unintended benefit of a nurse-led cardiovascular risk reduction clinic. Diabet Med 2005;22: 1272–4.
Woodward A, Wallymahmed M, Wilding J, et al. Successful cardiovascular risk reduction in type 2 diabetes by nurseled care using an open clinical algorithm. Diabet Med 2006;23:780–7.
Singh PK, Beach P, Iqbal N, et aL Nurse-led management of uncontrolled hypertension in those with diabetes and high vascular risk. Pract Diabetes Int 2007;24:92–6.
Mason JM, Fremantle N, Gibson JM, et al. Specialist nurse-led clinics to improve control of hypertension and hyperlipidaemia in diabetes. Diabetes Care 2005;28:40–6.
UK Prospective Diabetes Study Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 1998; 317:703–13.
Heart Protection Study Collaborative Group. MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20,536 high-risk individuals: a randomised placebo-controlled trial. Lan cet 2002;360:23–33.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2011 Copyright © 2011 FEND
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
