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Published in: Human Resources for Health 1/2019

Open Access 01-12-2019 | Care | Review

Does the Diabetes Specialist Nursing workforce impact the experiences and outcomes of people with diabetes? A hermeneutic review of the evidence

Authors: Jessica Lawler, Paul Trevatt, Clare Elliot, Alison Leary

Published in: Human Resources for Health | Issue 1/2019

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Abstract

Objectives

The aim of the hermeneutic review was to identify and clarify the mechanisms by which the Diabetes Specialist Nursing workforce affect the outcomes of diabetes patients, with a focus on those in the United Kingdom. A clarification of diabetes specialist nurses’ work is necessary in understanding and improving diabetes inpatient care.

Design

The design is a hermeneutic evidence review and was part of a wider evaluation of Diabetes Inpatient Specialist Nurses for which the evidence was sourced. The literature search was limited to specialist nursing workforce caring for adults with diabetes. In order to gain global understanding of the impact of specialist nursing in diabetes, worldwide literature was included.

Methods

A hermeneutic literature review of 45 publications was carried out, which included citation analysis. Relevant literature was identified from 1990 to 2018.

Results

Evidence suggests that Diabetes Specialist Nurses educate patients and other healthcare professionals as well as delivering direct care. The outcomes of these actions include a reduced patient length of stay in hospital, reduced inpatient harms and complications, and improved patient satisfaction. Additionally, they are cost-effective.

Conclusions

The Diabetes Specialist Nursing workforce is essential in diabetes care, particularly in hospital settings. They improve patient experience and outcomes.
Appendix
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Literature
6.
go back to reference Daultrey H, Gooday C, Dhatariya K. Increased length of inpatient stay and poor clinical coding: audit of patients with diabetes. RSM Short Rep. 2011;2(11):83. Daultrey H, Gooday C, Dhatariya K. Increased length of inpatient stay and poor clinical coding: audit of patients with diabetes. RSM Short Rep. 2011;2(11):83.
7.
go back to reference Macmillan Cancer Support. Specialist adult cancer nurses in England. A census of the specialist adult cancer nursing workforce in the UK. 2014 Available at: https://bit.ly/2Juu9XI [Accessed 11 June 2018] Macmillan Cancer Support. Specialist adult cancer nurses in England. A census of the specialist adult cancer nursing workforce in the UK. 2014 Available at: https://​bit.​ly/​2Juu9XI [Accessed 11 June 2018]
9.
go back to reference NICE. Quality Standards Programme Diabetes in Adults National Institute for Health and Clinical Excellence., Centre for Clinical Practice. 2011 Available at: https://bit.ly/2s7K56Z [Accessed 23 May 2018] NICE. Quality Standards Programme Diabetes in Adults National Institute for Health and Clinical Excellence., Centre for Clinical Practice. 2011 Available at: https://​bit.​ly/​2s7K56Z [Accessed 23 May 2018]
10.
go back to reference Diabetes UK. Diabetes specialist nursing 2016 workforce survey: a workforce in crisis. Diabetes UK, London. 2016 Available at: https://bit.ly/2vPbYBg [Accessed 10 May 2018] Diabetes UK. Diabetes specialist nursing 2016 workforce survey: a workforce in crisis. Diabetes UK, London. 2016 Available at: https://​bit.​ly/​2vPbYBg [Accessed 10 May 2018]
11.
12.
go back to reference Oliver S, Leary A. Return on investment: workload, complexity and value of the CNS. Br J Nur. 2013;21:1 Rheumatology. Oliver S, Leary A. Return on investment: workload, complexity and value of the CNS. Br J Nur. 2013;21:1 Rheumatology.
13.
go back to reference Buchan J, Dal Poz M. Skill mix in the health care workforce: reviewing the evidence 2002. Bull World Health Organ. 2002;80(7):575–80.PubMedPubMedCentral Buchan J, Dal Poz M. Skill mix in the health care workforce: reviewing the evidence 2002. Bull World Health Organ. 2002;80(7):575–80.PubMedPubMedCentral
15.
go back to reference Greenhalgh T. Cultural Contexts of Health: The use of narrative research in the health sector. Copenhagen: WHO Regional Office for Europe; 2016. (Health Evidence Network Synthesis Report, No. 49.) ANNEX 2. HERMENEUTIC REVIEW. Available at: https://bit.ly/2yrM7ll [Accessed 10 Oct 2018] Greenhalgh T. Cultural Contexts of Health: The use of narrative research in the health sector. Copenhagen: WHO Regional Office for Europe; 2016. (Health Evidence Network Synthesis Report, No. 49.) ANNEX 2. HERMENEUTIC REVIEW. Available at: https://​bit.​ly/​2yrM7ll [Accessed 10 Oct 2018]
16.
go back to reference Smythe E, Spence D. Re-viewing literature in hermeneutic research. Int J Qual Methods. 2012;11(1).CrossRef Smythe E, Spence D. Re-viewing literature in hermeneutic research. Int J Qual Methods. 2012;11(1).CrossRef
17.
go back to reference Smythe E, Ironside P, Sims S, Swenson M, Spence D. Doing Heideggerian hermeneutic research: a discussion paper. Int J Nurs Stud. 2008;45(9):1389–97.PubMedCrossRef Smythe E, Ironside P, Sims S, Swenson M, Spence D. Doing Heideggerian hermeneutic research: a discussion paper. Int J Nurs Stud. 2008;45(9):1389–97.PubMedCrossRef
18.
go back to reference James J, Gosden C, Winocour P, Walton C, Nagi D, Turner B, Williams R, Holt R. Diabetes specialist nurses and role evolvement: a survey by Diabetes UK and ABCD of specialist diabetes services 2007. Journal compilation 2009 Diabetes UK. Diabet Med. 26:560–5 Special Report.PubMedCrossRef James J, Gosden C, Winocour P, Walton C, Nagi D, Turner B, Williams R, Holt R. Diabetes specialist nurses and role evolvement: a survey by Diabetes UK and ABCD of specialist diabetes services 2007. Journal compilation 2009 Diabetes UK. Diabet Med. 26:560–5 Special Report.PubMedCrossRef
19.
go back to reference Gosden C, James J, Winocour P, Turner B, Walton C, Nagi D, Williams R, Holt R. Leading the way: the changing role of the diabetes specialist nurse. J Diabet Nur. 2009;13:9. Gosden C, James J, Winocour P, Turner B, Walton C, Nagi D, Williams R, Holt R. Leading the way: the changing role of the diabetes specialist nurse. J Diabet Nur. 2009;13:9.
21.
go back to reference Kousoulis AA, Patelarou E, Shea S, Foss C, Ruud Knutsen IA, Todorova E, Roukova P, Portillo MC, Pumar-Méndez MJ, Mujika A, Rogers A, Vassilev I, Serrano-Gil M, Lionis C1. Diabetes self-management arrangements in Europe: a realist review to facilitate a project implemented in six countries. BMC Health Serv Res. 2014;2(14):453. https://doi.org/10.1186/1472-6963-14-453.CrossRef Kousoulis AA, Patelarou E, Shea S, Foss C, Ruud Knutsen IA, Todorova E, Roukova P, Portillo MC, Pumar-Méndez MJ, Mujika A, Rogers A, Vassilev I, Serrano-Gil M, Lionis C1. Diabetes self-management arrangements in Europe: a realist review to facilitate a project implemented in six countries. BMC Health Serv Res. 2014;2(14):453. https://​doi.​org/​10.​1186/​1472-6963-14-453.CrossRef
22.
go back to reference Feddersen E, Lockwood DH. An inpatient diabetes educator’s impact on length of hospital stay. Diabet Educator. 1994;20(2):125–8.CrossRef Feddersen E, Lockwood DH. An inpatient diabetes educator’s impact on length of hospital stay. Diabet Educator. 1994;20(2):125–8.CrossRef
24.
go back to reference Davies M, Dixon S, Currie CJ, Davis RE, Peters JR. Evaluation of a hospital diabetes specialist nursing service: a randomized controlled trial. Diabet Med. 2001;18(4):301–7.PubMedCrossRef Davies M, Dixon S, Currie CJ, Davis RE, Peters JR. Evaluation of a hospital diabetes specialist nursing service: a randomized controlled trial. Diabet Med. 2001;18(4):301–7.PubMedCrossRef
25.
go back to reference Gardiner F, Nwosea E, Bwititic P, Crocketta J, Wang L. Does a hospital diabetes inpatient service reduce blood glucose and HbA1c levels? A prospective cohort study. Ann Med Surg. 2018;26:15–8.CrossRef Gardiner F, Nwosea E, Bwititic P, Crocketta J, Wang L. Does a hospital diabetes inpatient service reduce blood glucose and HbA1c levels? A prospective cohort study. Ann Med Surg. 2018;26:15–8.CrossRef
26.
go back to reference Alabraba V, Floyd E, Wallymahmed M. Delivering a diabetes inpatient specialist nursing service: the Aintree experience. J Diabet Nur. 2010;14:10. Alabraba V, Floyd E, Wallymahmed M. Delivering a diabetes inpatient specialist nursing service: the Aintree experience. J Diabet Nur. 2010;14:10.
27.
go back to reference Brown S. Effects of educational interventions in diabetes care: a meta-analysis of findings. Nurs Res. 1998;37(4):223–30. Brown S. Effects of educational interventions in diabetes care: a meta-analysis of findings. Nurs Res. 1998;37(4):223–30.
28.
go back to reference Davies M, Davis R. Role of the hospital diabetes specialist nurse: perception vs reality. J Diabet Nurs. 1998;2:4. Davies M, Davis R. Role of the hospital diabetes specialist nurse: perception vs reality. J Diabet Nurs. 1998;2:4.
30.
go back to reference NHS England, National Diabetes Treatment and Care Programme, Introduction to and supporting documentation for VALUE BASED TRANSFORMATION FUNDING SITE SELECTION Five Year Forward View, 2016 https://bit.ly/2ljkDcf [Accessed 23 May 2018] NHS England, National Diabetes Treatment and Care Programme, Introduction to and supporting documentation for VALUE BASED TRANSFORMATION FUNDING SITE SELECTION Five Year Forward View, 2016 https://​bit.​ly/​2ljkDcf [Accessed 23 May 2018]
32.
go back to reference Eaglesfield B. Think Glucose at an acute hospital – a “roller-coaster” project. J Diabet Nurs. 2012;16:9. Eaglesfield B. Think Glucose at an acute hospital – a “roller-coaster” project. J Diabet Nurs. 2012;16:9.
33.
go back to reference Ryder B, Burbridge W, Braycotton L, Ryder B, Cull M, Davies P, De P, Basu A, Lee B. Inpatient diabetes: do-it-yourself electronic referral system to support and enhance the Think Glucose project. Pract Diabet. 2014;31(5):194–6 3p. ISSN: 2047-2897.CrossRef Ryder B, Burbridge W, Braycotton L, Ryder B, Cull M, Davies P, De P, Basu A, Lee B. Inpatient diabetes: do-it-yourself electronic referral system to support and enhance the Think Glucose project. Pract Diabet. 2014;31(5):194–6 3p. ISSN: 2047-2897.CrossRef
34.
38.
go back to reference Vissarion B, Malliarou M, Theofilou P, Zyga S. Improvement of diabetic patients nursing care by the development of educational programs. Health Psychol Res. 2014;2(1):931 PMCID: PMC4768559 PMID: 26973922.PubMedPubMedCentralCrossRef Vissarion B, Malliarou M, Theofilou P, Zyga S. Improvement of diabetic patients nursing care by the development of educational programs. Health Psychol Res. 2014;2(1):931 PMCID: PMC4768559 PMID: 26973922.PubMedPubMedCentralCrossRef
39.
go back to reference NHS England. Patient safety alert stage three: directive Improving medication error incident reporting and learning. 2014. Available here: https://bit.ly/2GHxTPC [Accessed 21 May 2018] NHS England. Patient safety alert stage three: directive Improving medication error incident reporting and learning. 2014. Available here: https://​bit.​ly/​2GHxTPC [Accessed 21 May 2018]
40.
go back to reference Diabetes UK, Trend UK, Royal College of Nursing. Diabetes specialist nurses: improving patient outcomes and reducing costs, position statement. 2014 Available at: https://bit.ly/2kfKJM2 [Accessed 11 May 2018] Diabetes UK, Trend UK, Royal College of Nursing. Diabetes specialist nurses: improving patient outcomes and reducing costs, position statement. 2014 Available at: https://​bit.​ly/​2kfKJM2 [Accessed 11 May 2018]
41.
go back to reference Thompson DM, Kozak SE, Sheps S. Insulin adjustment by a diabetes nurse educator improves glucose control in insulin-requiring diabetic patients: a randomized trial. Can Med Assoc J. 1999;161(8):959–62. Thompson DM, Kozak SE, Sheps S. Insulin adjustment by a diabetes nurse educator improves glucose control in insulin-requiring diabetic patients: a randomized trial. Can Med Assoc J. 1999;161(8):959–62.
43.
go back to reference Cavan D, Hamilton P, Everett J, Kerr D. Reducing hospital inpatient length of stay for patients with diabetes. Diabet Med. 2001;18(2):162–4.PubMedCrossRef Cavan D, Hamilton P, Everett J, Kerr D. Reducing hospital inpatient length of stay for patients with diabetes. Diabet Med. 2001;18(2):162–4.PubMedCrossRef
44.
go back to reference Mahaffey K, Stanisstreet D, Ford M, Chapman L, Summerhayes B, Brown S, George S, Winocour P. Role of the diabetes inpatient specialist nurse in preventing hospital admission from A&E. J Diabet Nurs. 2012;16:2. Mahaffey K, Stanisstreet D, Ford M, Chapman L, Summerhayes B, Brown S, George S, Winocour P. Role of the diabetes inpatient specialist nurse in preventing hospital admission from A&E. J Diabet Nurs. 2012;16:2.
45.
go back to reference Davidson M, Ansari A, Karlan V. Effect of a nurse-directed diabetes disease management program on urgent care/emergency room visits and hospitalizations in a minority population. Diabet Care. 2007;30:2.CrossRef Davidson M, Ansari A, Karlan V. Effect of a nurse-directed diabetes disease management program on urgent care/emergency room visits and hospitalizations in a minority population. Diabet Care. 2007;30:2.CrossRef
46.
go back to reference Taylor CB, Miller NH, Reilly KR, Greenwald G, Cunning D, Deeter A, Abascal L. Evaluation of a nurse-care management system to improve outcomes in patients with complicated diabetes. Diabet Care. 2003;26(4):1058–63.CrossRef Taylor CB, Miller NH, Reilly KR, Greenwald G, Cunning D, Deeter A, Abascal L. Evaluation of a nurse-care management system to improve outcomes in patients with complicated diabetes. Diabet Care. 2003;26(4):1058–63.CrossRef
47.
go back to reference Bonney R and Crowe S. “Outcomes that matter” A summary report of outcomes that matter to people with type 1 and type 2 diabetes. London Diabetes Clinical Network, Professor Sir Muir Gray’s Oxford Centre for Triple Value and Diabetes UK. 2018 Bonney R and Crowe S. “Outcomes that matter” A summary report of outcomes that matter to people with type 1 and type 2 diabetes. London Diabetes Clinical Network, Professor Sir Muir Gray’s Oxford Centre for Triple Value and Diabetes UK. 2018
48.
go back to reference Hardy D, Stanisstreet D. Is it time for a review of the skill mix within the diabetes inpatient specialist nurse team? J Diabet Nurs. 2017;21(5):172–3 2p Publisher: SB Communications Group, A Schofield Media Company. Hardy D, Stanisstreet D. Is it time for a review of the skill mix within the diabetes inpatient specialist nurse team? J Diabet Nurs. 2017;21(5):172–3 2p Publisher: SB Communications Group, A Schofield Media Company.
49.
go back to reference Flanagan D, Moore E, Baker S, Wright D, Lynch P. Diabetes care in hospital—the impact of a dedicated inpatient care team. Diabetic Medicine. 2008;25(2):147–51.PubMedCrossRef Flanagan D, Moore E, Baker S, Wright D, Lynch P. Diabetes care in hospital—the impact of a dedicated inpatient care team. Diabetic Medicine. 2008;25(2):147–51.PubMedCrossRef
50.
go back to reference Kerr M. Inpatient care for people with diabetes: the economic case for change. Insight Health Econ. 2011. Kerr M. Inpatient care for people with diabetes: the economic case for change. Insight Health Econ. 2011.
Metadata
Title
Does the Diabetes Specialist Nursing workforce impact the experiences and outcomes of people with diabetes? A hermeneutic review of the evidence
Authors
Jessica Lawler
Paul Trevatt
Clare Elliot
Alison Leary
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
Human Resources for Health / Issue 1/2019
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-019-0401-5

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