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Improving diabetes care

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A Nursing Times survey indicated most nurses saw the benefits of using a connected meter to manage diabetes, writes Kathy Oxtoby

In the recent National Diabetes Inpatient audit it was shown that 31% of sites had no inpatient DSN which means the diabetes specialist input to each patient is low. People with diabetes now count for more than 15% of all occupied beds and have substantially longer lengths of hospital stay (8 nights instead of 5 nights on average). Additionally, medication errors are worryingly common and are associated with poorer outcomes. This demonstrated a real requirement for a trusted glucose testing system and support for all staff supporting diabetic patients to rely on.

Point of Care Testing (POCT) needs to be fast efficient and cost effective, but more importantly because patient management can be decided but the results from a test, POCT must be safe.  To achieve this hospitals need a system which provides:

Training and education: The hospital should have systems in place to assure that their clinical team is competent to use all equipment needed to deliver the service. The Royal Wolverhampton Hospitals NHS Trust has recently adopted the Roche Training Specialist Service. The Roche Training Specialist Service is well researched and regularly reviewed to ensure that it is relevant, up to date and effective. The training, delivered by experienced Roche specialists in conjunction with cobas® academy e-learning and observed assessment, is accredited by the Royal College of Nursing, allowing nurses to meet CPD (continuing professional development) needs. As training is an on-going process, the hospital required a method to sustain skill levels. With cobas IT 1000, Roche’s POCT data manager, they were able to build in criteria to ensure continued competency on the use of POCT devices.


Fast access to patient results: Diabetes Specialist Fraser Burton uses the Accu-Chek Inform II at Stepping Hill. Knowing that the wireless network is providing up to date patient information, he can see what is happening with the patient’s blood glucose levels before he goes to see them.  Once he is on his rounds, he can check to see whether a patient’s condition is deteriorating on any ward PC via cobas IT 1000. A Nursing times survey of  in 2011 revealed that out of 1000 respondents, 73% of nurses use a stand-alone non connected meter but 76% of these respondent’s said the reason was that a connected meter is not available on their ward.

The evidence of the survey indicates that nurses can see the overall significant benefits of a connected approach to diabetes management within the hospital.

Confidence in accuracy of results: Plymouth Hospitals NHS Trust uses the data extracted from cobas IT 1000 to determine how tight patient glycaemic control has been. This information supports clinical decisions and allows the diabetes team to assess the effectiveness of patient treatment.  An additional benefit of the Roche system is the wide range of Accu-Chek self-monitoring devices available to suit all types of patients. This means that when they are discharged you can be confident that the accuracy continues outside of the hospital.


Easy to use equipment:  Point of Care Testing Manager at Basildon Hospital, Bronwyn Moore, explains, ‘Nursing staff are working in high pressure departments…they have a lot to think about, therefore the easier and safer the system for POC testing is, the better’.

Reduction of paperwork: The wireless transfer of results removes the requirement to manually record this information. Having access to this information can predict trends and identify problems. Diabetes Nurse, Clive Vincent, from Plymouth Hospitals NHS Trust, has found that cobas IT 1000 allows him to recognize potential problems within the MAU quickly.  This allows him to prioritize patients effectively, which in turn improves patient safety within the department.

In summary, the audit corresponds with the recommendations from Commissioning Diabetes Emergency and Inpatient Care which were that nurses require a solution that delivers the ability to analyse data and ensures hospitals ‘have a capable and effective workforce that has the appropriate training and updating and where the staff have the skills competencies in the management of people of diabetes’

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