Slides current until 2008 Role of the healthcare professional in diabetes care, education and...

Slides current until 2008

Role of the healthcare professional in diabetes care, education and management

Section 1 | 2 of 4

Curriculum Module I-1 | The role of the diabetes educator


Role of the healthcare professionalCurriculum Module I-1

Slide 2 of 30ACTIVITY

What is your role in diabetes education?

What do you think your role should be?

What are the challenges?

Self-reflection



Slide 3 of 30

Historical review

18?? - Diabetes education first mentioned in France

1918 - Joslin states the educated patient is the one who does the best

1930s - Patient advocacy bodies develop

1940s - Education in the UK primarily for gestational diabetes

1960s - Role increases in importance and recognition

1970s - Diabetes educator/specialist nurse associations being formed

1970s - Technology develops to allow people with diabetes to self-care

1980s - Diabetes being recognized as a specialty by many professions




What is the status of diabetes education and care in your country?

What are the benefits of training professionals in diabetes education?

If there are benefits, what is the role of the health professional in diabetes education?



Slide 5 of 30

The role of the healthcare professional

It is the responsibility of all healthcare professionals working in the diabetes field to acquire the knowledge, skills and competencies to undertake diabetes education?

The key element is the quality of the education provided, not the professional who provides the education



Slide 6 of 30

Scope of practice

The healthcare professionals work with individuals, families, groups and communities to:

• Assess diabetes clinical status and educational needs

• Develop appropriate interventions and behavioural change processes

• Implement mutually agreed individual educational plans

• Document the education process, including follow-up

• Evaluate outcomes of care and education

• Contribute to and influence strategic planning and health policy relevant to diabetes prevention, care, education, management and research



Slide 7 of 30

Multidisciplinary role

Various healthcare professionals can assume the role including – but not limited to:• Nurses• Dietitians• Pharmacists• Physicians• Psychologists• Exercise physiologists• Mental health professionals• Podiatrists



Slide 8 of 30

• Not just different disciplines coming together

• Blending and complementing

• Blurring professional boundaries

• Interdependent

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Teams



Slide 9 of 30

Becoming a specialist in diabetes

Prerequisite knowledge (i)

• Core knowledge and skills in biological and social sciences:

– understanding chronic disease– importance of continuity– basic pathophysiology– psychological, spiritual, and socio-

economic aspects



Slide 10 of 30

Becoming a specialist in diabetes

Prerequisite knowledge (ii)

• Teaching and learning principles

• Communication skills

• Behavioural and psychological strategies

• Understanding and appropriate use of research processes



Slide 11 of 30

Increasing diabetes knowledge

Diabetes-specific knowledge

• Experiential learning common and essential – should have mentor component and review process

• Reflective practice should be a component of experiential learning

• Structured training programmes in many places

• Continuing professional education essential



Slide 12 of 30

What is a mentor relationship?

• Formal or informal

• Enable collaboration

• Mutually beneficial

• Opportunities for reflection

• Facilitate growth and development



Slide 13 of 30

What is a mentor relationship?

Reflective practice

• Continuous self-examination of vision, behaviour, experience and results

• After each intervention, ask yourself:– How did it go?– Should I have done something

differently?– Are the results as I expected?



Slide 14 of 30

Core role of health professionals

Diabetes education is an integral part of patient care and self-management, provision of care and systems of care.

Healthcare professionals in diabetes must:• Participate in patient management

and decision-making• Facilitate optimum self-management• Educate people to achieve optimal

outcomes



Slide 15 of 30


• Agree on principles and practice of care, review and update regularly

• Contribute to shared documentation

• Communicate with team members

• Mentor and support

• Participate in peer education

• Annual review of ongoing learning objectives for team members



Slide 16 of 30


External relations• Education• Lobbying• Advocacy• Awareness• Policy development

Within organization or community• Health professionals or management• Schools, patient or community groups,

NGOs, pharmacies, industry, government



Slide 17 of 30

Pandemic of diabetes

By 2025, there will be more than

350 million people diagnosed with

diabetes; the role of healthcare

professionals in diabetes will change.



Slide 18 of 30

Expanding and evolving role

• The increasing number of people with diabetes worldwide will require more health professionals knowledgeable in the scope of diabetes management

• The education of health professionals must keep pace with evidence-based research, evolving and improving diabetes care systems

• Blurring of professional roles occurs as part of the expanding role of a cohesive and effective multidisciplinary team



Slide 19 of 30

Professional responsibilities

• Practise within legal framework

• Understand responsibilities in relation to professional practice, knowledge and skills

• Practise within levels of knowledge and experience

• Maintain quality evidence-based practice

• Continually update knowledge, skills and competency




What is your professional responsibility?

What are the best evidence–based standards?

How will you ensure that you can achieve these standards?



Slide 21 of 30

Advanced practice

• In some countries

• Roles carry extra legal and professional responsibilities which encompass professional and patient safety

• Autonomous and collaborative within a multidisciplinary team

• Independent practice is undesirable



Slide 22 of 30

Advanced practice

The advanced role of the non-physician team member includes some of the physician’s responsibilities

• Managing medicines including prescribing

• Clinical management• Referral to other healthcare

professionals• Ordering and undertaking investigative

procedures• Admitting people with diabetes to

hospital• Non-physician-led clinics



Slide 23 of 30

Formal recognition of health professionals

Some countries have a process of accreditation of healthcare professionals in diabetes care

Others are striving towards such a process



Slide 24 of 30

Formal recognition of health professionals

• Usually by a professional body

• Highly desirable but not essential

• A recognition that certain criteria have been met

• Not permanent; must be renewed regularly



Slide 25 of 30

Accessing healthcare

Accessibility to healthcare may depend on:

• Number and types of providers• Distance to area of service• Access to education materials and

medical supplies• Funding inequities




What are the challenges to accessibility to healthcare in your area?

How might these challenges be overcome?

Challenges




Who pays for diabetes care and management in your country?

Who do you think should pay?

Diabetes care and management



Slide 28 of 30

Summary (i)

• Diabetes care and management is best achieved by the person with diabetes and a multidisciplinary team

• Healthcare professionals are responsible for their own continuous learning

• Diabetes education and care should be regarded as a specialty in the healthcare profession



Slide 29 of 30

Summary (ii)

• As more and more people develop diabetes new ways to provide diabetes education and care will have to be identified

• Team members have a responsibility to provide high-quality education to people with diabetes, care givers, team members and external agencies



Slide 30 of 30

References

1. Greenfield S, Kaplan SH, Ware JE Jr, Yano EM, Frank HJ. Patients’ participation in medical care: effects on blood sugar control and quality of life in diabetes. J Gen Intern Med 1988; 3(5): 448-57.

2. Ruggerio LA, Prochaska JO. Application of the Transtheoretical Model to diabetes. Diabetes Spectrum 1993; 6(1): 22-58.

3. Anderson BJ, Rubin RR. Eds. Practical Psychology for Diabetes Clinicians. Alexandria: American Diabetes Association, 1996.

4. Page P, Verstraete DG, Robb JR, Etzwiler DD. Patient recall of self-care recommendations in diabetes. Diabetes Care 1981; 4(1): 96-8.

5. Cotugna N, Vickery CE. Diabetic diet compliance: student dietitians reverse roles. Diabetes Educ 1990; 16(2): 123-6.

6. Schlundt DG, Pichert JW, Grgory B, Davis D. Eating and Diabetes: A Patient-entered Approach. In Anderson BJ, Rubin RR, eds. Practical Psychology for Diabetes Clinicians. Alexandria: American Diabetes Association, 1996; 63-72.

7. Australian Department of Health and Ageing. National Strategy for Quality Use of Medicines, Canberra 2002. www.health.gov.au/haf/nmp/advisory/pharma.htm

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