Abstract
Objective: To determine the model of nurse led diabetic clinic network, the effects of model on vascular risk factors in primary care units of health department, Bangkok metropolitan.
Study design: Prospective descriptive study, and action research
Materials and methods: Fours primary care units 251 diabetes were recruited, and the model was developed on the 2 stages as following: stage1 preparation, in this stage, we review the diabetic burden, nursing role and service pattern for diabetes patients these primary care units, before model set up. and in stage2, we developed The Nurse led diabetes program to help nurse manager in providing standardized care for diabetes as recommended in national guideline, and nurse educator development by educational motivation from multidiscipline conference, and clinical set up with periodic auditation and brain storm to re-evaluate, re-modeling the model.
Results:
• The risk burdens as in obesity, truncal obesity were high initially 78%, 62% in subsequently, and the patients having target LDL cholesterol, blood pressure, fasting sugar, HbA1c were 36%, 38%, 31%, 34% in subsequently, However These un-optimized risk factors had trended to lower after the model implementation.
• For the model had improved the nursing attitude as nurse manager, confident , quality service and standardized diabetes care, and the patients had improved coping skill in behavior modification, and most importantly the good relationship between the community and clinic which could motivated patients adherence and confidence in nurses.
• The Nurse led diabetes program could help nurse manager in risk factor development, sugar control, complication detection and improved standardized protocol as in national guideline recommendation.
Conclusion: The nurse led diabetic clinic network could provide more standardized care by The Nurse led diabetes program, multidiscipline approach, and community relationship.
