Proposal:A New Nurse-led program for Type II diabetes patients under General Outpatient Clinic (GOPC), Yan Chai Hospital

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Abstract Description
Abstract ID :
HAC439
Submission Type
Authors (including presenting author) :
Yeung K C
Affiliation :
General Outpatient Clinic, Yan Chai Hospital
Introduction :
Based on the declaration of Alma Ata, health is human right and the government has the responsibility to command actions from political, social, economic and health sectors to ensure the health of a population in order to have sustainable development of a country. Primary health care provide population with comprehensive, accessible and community-based care which meet the health need of individual and foster public health. Health care system with stronger primary health care can contribute to better universal health coverage and ultimately achieve health equity. However, disproportionate focus on tertiary care(hospital-centrism), multiplication of program and projects (fragmentation) and the pervasive commercialization of health care gravitate the public health system away from primary health care value . Currently, under hospital authority, many nurse-led programs are being conducted at primary health care setting, including Yan Chai Hospital, yet the service is fragmentated which increase the burden of both patients and hospital authority. The aim of my project is to propose a new nurse-led program on Type II diabetes management by assessing i) the health needs of Type II DM and ii) current Type II diabetes program, in order to streamline the work flow of Type II diabetes management under Yan Chai Hospital currently to prevent fragmentation and reduce hospitalization of Type II DM patient.
Objectives :
To identify and assess the population profiling, social determinants and risk factors of type II diabetes for determining an effective and acceptable program. To review the workflow of Type II DM management under Hospital Authority in Hong Kong currently Design a new nurse led program, which is feasible to be conducted under Yan Chai Hospital, for diseases prevention and promotion systematically in accordance to the health needs assessment
Methodology :
Literature review
- This project begins with a health needs assessment via i) analyzing the burden of Type II diabetes in Hong Kong, ii) analyzing the social determinant on diabetes of which affecting the prevention and control of it in Hong Kong and globally& iii) a systematic review on the nurse-led program globally on diabetes management. - A new nurse-led program is designed in accordance to the health needs assessment by i) Reviewing the workflow of Type II DM management under Hospital Authority in Hong Kong currently and ii) Analyzing the data collected for the need assessment report and to amend the current workflow in order to achieve the goal of the project.
Result & Outcome :
Results of literature review:
- The level of self-management of Type II diabetes can be influenced by different social determinants including education, social support, working environment and access to health/medical care and patients' carers contribute to the diabetes management of patient. - Risk stratification is being adopted with the risk factors of Type II diabetes were well identified and intervention was given to patient in accordance to their risk level under Hospital Authority currently, however, it doesn’t result in the behavior change to lower the risk since there is a variety of environmental and community force that constrain the behaviors and identification and intervention on those force should be done at the first place - The empowerment program provided by the Non-Governmental Organization (NGO) via the funding from Hospital Authority could contribute to the clinical outcome of Diabetic patients but could also cause duplicated community resources, and the participants who are more educated may be more motivated to join the program as a result of health disparities. Outcome
A new nurse-led program on Type II diabetes management is proposed and “Chronic care model” was utilized as conceptual and organizing framework for both patients and their carer.

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