Trends in diabetes care and education by primary health care nurses in Auckland, New Zealand

Abstract

AimsTo examine trends in the management of patients with diabetes by primary health care nurses, its association with diabetes education and how valued and supported nurses feel in Auckland, New Zealand. MethodsTwo representative cross-sectional surveys of all nurses providing community-based care, and patients with diabetes they consult, were conducted in 2006–8 and 2016. All participants completed a self-administered questionnaire on biographical details and a telephone interview on their provision of diabetes care. ResultsSignificantly more nurses discussed serum glucose and medications with patients, planned follow-up and scheduled practice nurse appointments in 2016 compared with 2006–8, and fewer specialist diabetologist appointments were made (12% versus 2%). Fewer nurses in 2016 than in 2006–8 felt valued (62% versus 75%) and supported (78% versus 89%) when managing patients (p-values = 0.0004). Nurses diabetes education was associated with recommended practice and feeling valued. Significantly more patients were prescribed metformin (81%) and insulin (46%) in 2016 compared with 58% and 30% in 2006–8. Despite this, HbA1c levels remained unchanged. ConclusionsPrescribed glycaemic-related medications increased, and more nurses engaged with patients about glycaemic control and medications in 2016 compared with 2006–8. Nurses undertaking diabetes education was strongly associated with best management practices and nurses feeling valued.