Community Nursing Team

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"Telemonitoring has helped provide quicker detection of problems developing and more timely intervention."

Background

The Diabetes Nurse Specialists have worked in partnership with the Telehealth coordinator for the Western Trust to develop a telemonitoring service which allows remote monitoring of blood glucose in patients under the care of the community diabetes nurses.

How it works?

Each Diabetes Specialist Nurse (DSN) refers patients to the telemonitoring service following explanation, assessment and agreement by the individual and if appropriate their carer. Their telemonitoring data is reviewed weekly by one of the DSN’s who is allocated to do this as a dedicated full day clinic session.

Reviewing of data on occasion may initiate either clinic visits or home visits to address identified problems or individuals are contacted by telephone and advised accordingly. The success of this project is dependant on the collaborative approach by the DSN’s in the team and shared responsibility for people with diabetes throughout the locality.

What benefits are you hoping to see from the project?

Clinical Benefits

  • Improved access to DSN service and also equity of access to the service particularly for those living in rural areas or who are housebound.
  • Reduced home visiting without reducing or negatively impacting on client contact and the provided service.
  • Reduce DSN clinic visits for clients whilst allowing an increase in contact to improve Glycaemic clinical outcomes.
  • Reduce hospital admissions and Implement changes where required more timely, enhancing clinical outcomes.

Patient Benefits

  • Telemonitoring to be used as an educational tool, to encourage self management with frequent DSN contact – this will enable a sustained improvement in lifestyle.
  • Build confidence in clients with the knowledge that their readings are reviewed regularly whilst also increased confidence in self management skills.
  • Support for carers.

Results/Outcomes so far

To date we have observed both clinical and patient benefits which have resulted in some improved level of care and service.

  • There has been improved and appropriate monitoring of patients with the ease of viewing their blood glucose levels at various venues including clinics.
  • There has been a reduction in DSN clinic visits for clients. -Telemonitoring also means the elderly and rurally isolated patients still have access to DSN service with appropriate information available to enable treatment decisions.
  • There has been improved team work with telemonitoring carried out by all DSN team members this has helped increase knowledge of all patients and build relationships.
  • Telemonitoring has helped provide quicker detection of problems developing and more timely intervention. For example- Unexplained hyperglycaemia in elderly patients may indicate infection and early treatment can prevent hospital admission.
  • Reduction in home visiting, allowing more efficient time management and enhancement of level of care.

The Future...

Hope to see telemonitoring supporting newly diagnosed Type 1 diabetes patients, coming from an acute setting, to encourage self management at home and to also enhance their knowledge whilst providing security and reassurance.

Hilary Caskey - Diabetes Nurse said. Telemonitoring has proven beneficial for us as professionals as it allows for more efficient use of our service. We can review more patients via telemonitoring in a given time period than if we were seeing them at clinic or on a home visit. This reduces travel time and costs for both the nurse and the patient. Telemonitoring will never replace face-to-face contact completely, but it can reduce the frequency of such encounters and provides a valuable support service for the on-going management of some patients with diabetes.

Michael and Marie Farren have telemonitoring in their home; Marie said The main benefit we gain from telemonitoring is that we are now more aware of what the readings are and have gained control; we know exactly what the readings should and shouldn’t be. The monitor also helps us keep on track. Before it was difficult to track everything on your own, now we have the monitoring were able to control his levels on a daily basis, Michael hasn’t had a hospital admission or infection since.