A Nurse-led Diabetes Clinic - L'Infirmière Magazine n° 267 du 15/11/2010 | Espace Infirmier
 

L'infirmière Magazine n° 267 du 15/11/2010

 

ANGLAIS

Practice nurses working at a large general practice in London, with 20,000 registered patients, are bringing care in the community to 500 diabetes patients.

In the practice’s Diabetes Clinic, nurses see newly-diagnosed type 2 patients, both type 1 and type 2 patients for regular check-ups, and patients who are experiencing any problems with their condition.

20 minute-long routine check-ups involve blood tests ; blood pressure, weight and foot checks (pulses and sensations) Nurses also check that patients have had their annual eye screening at the hospital. Self-management is discussed and all patients are encouraged to learn how to monitor their blood sugars and administer insulin (if necessary) at home. As a result of specialist training, nurses can initiate and change medication dosage, although doctors must still sign prescriptions. They can also make referrals to hospital and specialists like dieteticians, smoking cessation and exercise educators.

NICE(1) publishes recommendations for the care and treatment of diabetic patients. The local NHS Trust then produces evidence-based regularly updated protocols for patient management and how decisions regarding treatment should be reached. Recently, evidence came to light that the drug rosiglitazone should be withdrawn from use because of its associations with heart failure.(2) As a result, patients on this drug were contacted and their medication was changed according to the new guidelines.

REMERCIEMENTS À SARAH COATES, INFIRMIÈRE DANS UNE CLINIQUE DU DIABÈTE À LONDRES.

1–  The National Institute for Clinical Excellence

2–  Les informations concernant la supression de l’AMM de rosiglitazone en France sont sur le site http ://www.afssaps.fr

MOTS ET EXPRESSIONS

A check-up (n) : une visite de contrôle

To check (v) : vérifier

Condition (n) : situation médicale

Sensations (n) : des sensibilités

A prescription (n) : une ordonnance

A training (n) : une formation

A local NHS Trust : la sous-division locale du département de la Santé.

Questions

1. Where do diabetes patients go for their regular check-up ? They go to the nurse-led diabetes clinic.

2. What autonomy do the clinic nurses have ? They can initiate and change medication dosage, and make referrals to hospital and specialists.

3. Give an example of how evidence-based research has been implemented in this clinic. Patients on rosiglitazone have had their medication changed.

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