Improve the Standard of Care in Nurse Assessment of the Risk Assessment and Management Program for Diabetes (RAMP-DM) in General Outpatient Clinics

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Abstract Description
Abstract ID :
HAC661
Submission Type
Authors (including presenting author) :
Ma CL(1), Chu TK(1), Chan ML(1), Wong BC(1), Liang J(1)
Affiliation :
(1)Department of Family Medicine and Primary Health Care, NTWC
Introduction :
Periodic nurse assessment and intervention are part of the essential components of the Risk Assessment and Management Program for Diabetes (RAMP-DM), which has been shown to reduce diabetic-related complications and mortality. Regular audit of standard of care would be important for service evaluation and better patient care.
Objectives :
To evaluate and improve standard of care in nursing care provided in the Risk Assessment and Management Program for Diabetes (RAMP-DM) for diabetic patients followed up in 8 General Outpatient Clinics in the New Territories West Cluster.
Methodology :
Documentation of 9 essential components of comprehensive diabetes complication assessment (DCA) during nursing care in RAMP-DM (performed once every 2 years) were reviewed regularly, which included assessment of HbA1c, blood pressure, cholesterol, serum creatinine, urine albumin, diabetic foot surveillance, diabetic retinopathy screening (by retinal photography), body mass index and smoking status. A departmental taskforce on chronic disease management involving medical and nursing staff has been established to enhance service delivery for diabetic patients since 2014. Regular staff meetings and training sessions to nurses providing RAMP-DM service since 2015 followed by audits aiming to review and enhance the standards of care during the nursing assessment. A reminder system to nurses by using cue cards was implemented to improve documentation of nurse assessment in 2018.
Result & Outcome :
The proportion of diabetic patients followed up in New Territories West cluster with comprehensive diabetes complication assessment performed within 3 years has increased from 77% in 2014/15 to 90% in 2017/18. In conclusion, multi-faceted interventions can improve the standards of diabetes nursing care in complication assessment.

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