Context: The Diabetes Nurse Educators (DNE) and Dietitians at Royal Melbourne Hospital record daily activities that include: patient name, admitting unit, location of the activity, activity type and duration using Activity Bar Code (ABC) scanners. This data has been used to highlight areas of clinical need for DNEs and Dietitians and assist with a better understanding the role of a DNE and Dietitian in an acute tertiary hospital.
Method: Data collected during 2016 from ABC scanners was cross checked with hospital admissions to identify patients admitted with diabetes who were seen by a DNE and Dietitian. Patients admitted to an acute ward and outpatient clinics were included for analysis.
Results: In 2016, Dietitians saw 3,450 individual patients (30% of total pts admitted with diabetes) with over 14,000 interventions provided to these patients, the average time of these interventions was 45 minutes (SD+/- 32 min). The top 3 interventions provided by Dietitians were nutrition support, education and nutrition assessment. The DNEs saw 1,300 individual patients (12% of total pts admitted with diabetes) with over 4,000 interventions; the average time of these interventions was 56 minutes (SD +/- 52min). The top 3 interventions provided by a DNE were insulin stabilization, assessing injection technique and discharge planning.
Discussion: During acute admissions a DNE and Dietitian have a vital role in discharge planning and providing education and supporting patients to optimize glycemic control and manage dietary and lifestyle modifications. However, our data clearly shows that the vast majority of patients with diabetes admitted to hospital miss out on these services.