The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services

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dc.contributor.author Riordan, Fiona
dc.contributor.author McHugh, Sheena M.
dc.contributor.author Murphy, Katie
dc.contributor.author Barrett, Julie
dc.contributor.author Kearney, Patricia M.
dc.date.accessioned 2017-10-18T09:40:11Z
dc.date.available 2017-10-18T09:40:11Z
dc.date.issued 2017
dc.identifier.citation Riordan, F., McHugh, S. M., Murphy, K., Barrett, J. and Kearney, P. M. (2017) ‘The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services’, BMJ Open, 7, e015049 (9pp). doi: 10.1136/bmjopen-2016-015049 en
dc.identifier.volume 7
dc.identifier.issn 2044-6055
dc.identifier.uri http://hdl.handle.net/10468/4871
dc.identifier.doi 10.1136/bmjopen-2016-015049
dc.description.abstract Objectives: International evidence suggests the diabetes nurse specialist (DNS) has a key role in supporting integrated management of diabetes. We examine whether hospital and community DNS currently support the integration of care, examine regional variation in aspects of the service relevant to the delivery of integrated care and identify barriers to service delivery and areas for improvement. Design: A cross-sectional survey of hospital and community-based DNS in Ireland. Methods: Between September 2015 and April 2016, a 67-item online survey, comprising closed and open questions on their clinical role, diabetes clinics, multidisciplinary working, and barriers and facilitators to service delivery, was administered to all eligible DNS (n=152) in Ireland. DNS were excluded if they were retired or on maternity leave or extended leave. Results: The response rate was 66.4% (n=101): 60.6% (n=74) and 89.3% (n=25) among hospital and community DNS, respectively. Most DNS had patients with stable (81.8%) and complicated type 2 diabetes mellitus (89.9%) attending their service. The majority were delivering nurse-led clinics (81.1%). Almost all DNS had a role liaising with (91%), and providing support and education to (95%), other professionals. However, only a third reported that there was local agreement on how their service should operate between the hospital and primary care. Barriers to service delivery that were experienced by DNS included deficits in the availability of specialist staff (allied health professionals, endocrinologists and DNS), insufficient space for clinics, structured education and issues with integration. Conclusions: Delivering integrated diabetes care through a nurse specialist-led approach requires that wider service issues, including regional disparities in access to specialist resources and formalising agreements and protocols on multidisciplinary working between settings, be explicitly addressed. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BMJ Publishing Group en
dc.relation.uri http://dx.doi.org/10.1136/bmjopen-2016-015049
dc.rights © 2017, the Authors. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. en
dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
dc.subject Integrated care en
dc.subject Regional en
dc.subject Service delivery en
dc.title The role of nurse specialists in the delivery of integrated diabetes care: a cross-sectional survey of diabetes nurse specialist services en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Fiona Riordan, Epidemiology and Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: f.riordan@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMJ Open en
dc.internal.IRISemailaddress fiona.riordan@ucc.ie en
dc.identifier.articleid e015049


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© 2017, the Authors. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. Except where otherwise noted, this item's license is described as © 2017, the Authors. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
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