In an On Medicine blog post for International Nurses Day 2023, Andrea K Lake discusses her route into research and the PREP-D feasibility study of the effect of proactive diabetes specialist nurse reviews of patients with diabetes in hospital.
Blue Planet Studio / stock.adobe.comThere are a few centers that will proactively see patients with diabetes in high-risk areas when admitted to the hospital, however, by far the most common practice is for patients to only be seen by a specialist team, including for diabetes, on receipt of a referral. In diabetes, referrals are often triggered by glycemic-related events, such as hypo/hyperglycemia and ketosis or for patient education.
We also know that glycemic events are associated with potentially worse outcomes, such as increased length of stay. Therefore, specialist teams receiving the referral after the event has already occurred seems counterintuitive, because the harm and potential impact on outcomes have already happened. I undertook a service evaluation exploring this in 2018 , which showed potential for reduced length of stay and hypoglycemia rates, however, the cost was a 30% increase in workload. Throughout my career, it has struck me that the assessments and procedures we undertake as nurses and the medicines and therapies we deliver are all evidence-based, but the way we deliver our services often are not.
Integrating research into clinical care is increasing, especially among specialist services. Though this is not often nurse-led research activity, and such integration often leads to complex funding streams. This results in nurses being all or in part on short-term, dual contracts, which is not appealing.
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