Authors: James, J.; Gosden, C.¹; Winocour, P.²; Walton, C.³; Nagi, D.⁴; Turner, B.¹; Williams, R.⁵; Holt, R. I. G.⁶

Source: Diabetic Medicine, Volume 26, Number 5, May 2009 , pp. 560-565(6)

Publisher: Wiley-Blackwell

Abstract:

Aims 

To review the working practices of UK diabetes specialist nurses (DSNs), specific clinical roles, and to examine changes since 2000. Methods 

Postal questionnaires were sent to lead DSNs from all identifiable UK diabetes centres (n =  361). Quantitative and qualitative data were collected on the specific clinical roles, employment, and continual professional development of hospital and community DSNs, Nurse Consultants and Diabetes Healthcare Assistants. Results 

159 centres (44%) returned questionnaires. 78% and 76% of DSNs plan and deliver education sessions compared with 13% in 2000 with a wider range of topics and with less input from medical staff. 22% of DSNs have a formal role in diabetes research compared with 48% in 2000. 49% of Hospital DSNs, 56% of Community DSNs and 66% of Nurse Consultants are involved in prescribing. 55% of DSNs carry out pump training, 72% participate in ante-natal and 27% renal clinics. 90% of services have independent diabetes nurse-led clinics. 93% of services have a dedicated Paediatric DSN. The mean number of children under the care of each PDSN is 109 (mode 120), which exceeds Royal College of Nursing recommendations. 48% of DSNs have protected time for continuing professional development of staff and 15% have a protected budget. One third of DSNs are on short-term contracts funded by external sources. Conclusions 

The DSN role has evolved since 2000 to include complex service provision and responsibilities including specialist clinics, education of healthcare professionals and patients. The lack of substantive contracts and protected study leave may compromise these roles in the future.

Keywords: clinical care; diabetes specialist nurses; role development; service fragmentation

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1464-5491.2009.02716.x

Affiliations: 1: Diabetes UK, London 2: QEII Hospital, Welwyn Garden City 3: Hull Royal Infirmary 4: Pinderfields General Hospital, UK 5: Professor of Clinical Epidemiology, Swansea University 6: University of Southampton, Southampton, UK

Publication date: 2009-05-01

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