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.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.description.status	Peer reviewed	en
dc.description.version	Published Version	en
dc.format.mimetype	application/pdf	en
dc.identifier.articleid	e015049
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.doi	10.1136/bmjopen-2016-015049
dc.identifier.issn	2044-6055
dc.identifier.journaltitle	BMJ Open	en
dc.identifier.uri	https://hdl.handle.net/10468/4871
dc.identifier.volume	7
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

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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