Diabetes Specialist Nursing in Edinburgh

Community Diabetes Specialist Nurses for Edinburgh Adele Dawson 07813546883 07770830622 07970622702 Lynn Keane Jill Armstrong communitydiabetesteam@nhslothian.scot.nhs.uk

Content Green book Insulin errors Blood glucose monitoring Ketone monitoring Promoting independence Hospital discharges Training Questions

Green diabetes book Green Book is for use only for patients being seen and having their insulin administered by a district nurse, otherwise just use a diary Prescription is written in the front of the green book, can be written by GP or V300 nurse prescriber with insulin on their formulary Prescription should be scored through if changes made so there is no confusion If a patient is on titration, the titration sheet should be pinned in the front of the green book over the prescription page Current green book New green book

Insulin Errors Right insulin Right dose Right time Right way Datix Reporting

Blood Glucose Monitoring Why do we check? When do we check? How often do we check? How to perform blood glucose monitoring at home What meter to use Quality control Monitoring patients on oral meds?

Blood Glucose Monitoring Always check BGL if patient is on insulin, don t give insulin without first checking. GLP1 weekly administration no sense in DN checking, check HBa1c instead, if patient can check daily then they should Patient on Gliclazide, should really check own BGL Metformin/SGLT2/DPP4s no BGM required

Ketone Monitoring For type 1 patients only Ketone testing instructions should be on the patient care plan Follow the guidelines for escalation to DSN or Diabetes registrar Use the ketone flow chart in the sick day rules document. Stopping other meds if patient is sick

Promoting independence Encourage independence/Self management Discourage dependency Use of pens from the very start (some insulins only come in pens) Retractable needles De -medicalise the process Teaching others Nursing home staff /care home and care at home staff

Hospital discharges Check the patient can manage independently Check dosage and insulin type Check if OD, BD or more often Check there is a nursing need Ensure a DN pack is sent with the patient Find out who is at home with the patient Contact us if there is any concerns about multiple insulin injections and team capacity

Training Must attend one day diabetes course Feel confident and be competent in administration of insulin Must attend titration and meter training Contact your local diabetes link nurse or diabetes nurse specialist Must complete competences 2 yearly Learnpro module - CPR Diabetic Feet

Contacts If you are not sure ALWAYS ask your Diabetes Link Nurse or Diabetes Specialist Nurse Adele Dawson 07813546883 Lynn Keane 07770830622 537 1746 WGH DSN 536 1470 RIE DSN 01506 523856 St Johns DSN 07713087403 East Lothian DSN

Questions Contact us via email on with any questions communitydiabetesteam@nhslothian.scot.nhs.uk Lynn Keane Adele Dawson Jill Armstrong