Cesem Cycling Tour For Children And Charity 2010 Sponsoring Final
A cycling tour of diabetes
-
Upload
australian-primary-health-care-nurses-association -
Category
Health & Medicine
-
view
74 -
download
0
Transcript of A cycling tour of diabetes
A Cycling Tour of Diabetes
Karen Booth RN
Leichhardt General Practice
Be Prepared! Are We in the Zone?
How Will We Get There? The Strategic Plan!
• What do you want to achieve? Target audience
• Marketing (letter, phone, opportunistic, dr refer)
• Space & Time / Appt schedule e.g. nurse then doctor
• Budget e.g. cost of staff & room
• Equipment, documents/templates
• Division of labor/ teamwork/roles
• PIP & SIP incentives
• How do you bill??
• Recalls & flow on services (referrals, HMR, care plan)
• ***Establish a Model/Process that could be Easily Replicated***
Equipment Tune-Up
Components of check up:-
• HT, Wt, BMI,
• Diet & exercise, education
• Feet
• Blood results
• Medication review
• ECG
You’re not Cycling on Your Own!!
Help Them Keep Their Balance• Annual cycle of care• 6 month review• 10997 for CDM monitoring visits with the
nurse• GPMP & TCA• Referral pathways for support (allied, Type II
programs etc)
• Build in the expectation of the return visits
Remove the Training Wheels!Get Out on the Velodrome!
• Give them information
• Feel empowered to take control of their own health
• Respond well to recalls, most pts are attending scheduled visits
• Monitoring own BSL & weight
• Regular exercise program
Puncture Repair
• Regular review for maintenance & treatment adjustments
• May need new referrals
• Endocrinologist, Clinic review
• Diabetes educator, exercise phys referrals
• Motivation
THE LEICHHARDT GENERAL PRACTICE DIABETES MANAGMENT CHECKLIST
Activity Target Values
Frequency Date Date
Date
Date Date
Hb A1c < 7.0% 6mths
u/a Microalb < 20mg/L spot catch
12mths
Cholesterol < 4.0 12mths
Triglycerides < 1.5 12mths
HDL > 1.0 12 mths
LDL < 2.5 12 mths
Weight 6 mths
Height 12mths
BMI 25 6 mths
BP <130/80 6 mths
Examine feet 6 mths
Eye check 2 yr min
Selfcare 3-6 mths
Diet review 6 mths
Physical activity 6 mths
Smoking status 6 mths
Medication review
6 mths
ECG 12 mths
Cycling is a Team Sport
• Coach – GP
• P/T, Mx - Practice Nurse
• Support Crew – Clerical staff
• Specialist support – Endocrinologist, Diab Educ, Dietitian, Exercise Phys.
New Patient: Joan
• A 66 year old female type II diabetic, Joan, has recently moved to your area to be nearer to her family. She would like to renew her prescriptions.
• The receptionist books her 1st visit as a long consult
• Triage by nurse: records BP, Wt, past medical history, medications & supplements?, vaccination status etc.
• She has her current tablet packets with her.• She states she has been very happy with her
current medication & would just like some repeats please!
• Pt has been diabetic for past 9 Yrs
• Has been taking tablets past 2 years
• Discovered high BSL when having routine cholesterol check (which was also “a bit high” but pt has switched to low fat milk)
• Moderately obese, BMI 30, BP 140/85, P 90 reg• (Hx diabetes & High cholesterol past 9 yrs) Mild
hypertension not previously noted
• Patient does not take own BSL
• Joan likes to get her prescriptions with all her repeats “filled” at the same time. This saves her having to go back to the doctor or the chemist unless she feels unwell.
• Patient does not have set exercise regime because she does enough running around when she visits the grandchildren & doing the housework.