An evaluation of diabetic care in registered nursing homes

Abstract

This study examines current clinical practice in relationship to the care of diabetic patients in Registered Nursing Homes in Argyll and Clyde NHS Board and training needs of staff. The prevalence of diabetes was found to be 6.5% (95% CI 4.7 - 8.3) with 12 having type 1 and 82 having type 2 diabetes. This comprised 58 women and 42 men with a mean age of 79 years. The mean number of patients per home was 2.6 (95% CI 1.9-3.4) with a range of 0-22. Eighty-one patients were medically cared for solely by general practice. Seventeen homes screened new patients on admission for diabetes using a variety of methods; only six homes tested blood glucose levels as part of their screening programme. Ninety-one per cent of the sample were receiving regular blood glucose monitoring; of the patients treated with insulin 50% were having blood glucose monitoring a minimum of once per day. Forty-seven per cent had annual retinopathy screening, with 62% being undertaken by an accredited optometrist. Nine-one per cent of patients had been treated by a chiropodist in the previous 12 months. A dietician had assessed 13% of patients in the previous 12 months. There was a positive response to further education on diabetes, with particular needs expressed for staff training, including blood monitoring and screening. This study has formed the basis for the development of nursing guidelines for diabetes in nursing homes and the development of an educational programme. Copyright © 2002 John Wiley & Sons, Ltd.