Specialist diabetes nurses helping to reduce length of hospital stays

Diabetes specialist team

A specialist team at the Royal Cornwall Hospital is leading the way in diabetes care which is helping to reduce the length of time people spend in the hospital.

Some 16 percent of people admitted to the hospital are also living with diabetes and, if not managed correctly, face longer and more complicated stays.

The diabetes clinical nurse specialist in-patient team (CNS), from Cornwall Partnership NHS Foundation Trust (CFT) are based at Treliske hospital and provide support to inpatients with diabetes.

Amanda Veall, lead diabetes CNS oversees the team, said: “Diabetes is among the most challenging of chronic conditions. People with diabetes are at risk of health problems including renal disease and cardiovascular disease and while these health problems are not always related to their diabetes, it can mean they are likely to need hospital admission.

“When our inpatient specialist diabetes team was launched more than 10 years ago we very quickly reduced the length of bed stay by six days. There has also been a reduction of prescribing errors, and in the improvement in the numbers of people who experienced a hypoglycaemic episode while in hospital, all of which improving patient safety.”

The team previously trialled a label scheme, which provides a reminder of the correct treatment for a patient whose blood sugar has fallen below the normal level, and it was such a success it has been rolled out across all wards at the hospital. As a result it led to less people suffering from hypoglycaemic episodes.

Another initiative that the team instigated was to work with the hospital pharmacy team to get a daily list of all patients who are on insulin and diabetes medication. It allows the team to focus on specific diabetes patients on the wards and focus on ensuring safe prescribing and administration of medicines, to avoid and reduce medication errors.

Amanda Davis, senior diabetes CNS who specialises in renal diabetes management, said: “When people with diabetes enter the hospital we want them to have a good experience, better management of their diabetes, and hopefully their stay will be shorter. It’s about positive patient care and a positive experience for staff.

“Our team works closely with the hospital’s pharmacists to make sure that that every day we know which patients are receiving insulin and diabetes medication which means we can provide one-to-one care to them and support the teams working on the wards with patients with these specific needs.

Alison Barber, diabetes CNS who recently joined the team, added: “It has been eye opening to see the unique way the team works and be able to be part of carrying out transformational work with educating staff on the new hypo label. Working within a role where I am able to review patients and give them specialist advice on their diabetes management is extremely rewarding and it’s been great to develop my knowledge and skills in such a valuable area."

Ashlie Birkett and Katie Bray were recruited to the team late last year, thanks to a successful bid by NHS Kernow Clinical Commissioning Group to NHS England for funding to support a quality improvement project which has led to a 59 percent reduction in prescribing errors.

Katie said: “Colleagues from all areas of the hospital have been keen for education in diabetes and we have covered topics such as hypoglycaemic awareness and treatment, diabetes medication management, including the management of insulin and also education on how patients can self-manage their own insulin whilst in hospital.”

The team hope to receive more funding to roll-out its work in the county’s community hospitals.

Phot caption left to right: The specialist diabetes team are Amanda Veall, Alison Barber, Amanda Davis and Katie Bray