AI Article Synopsis
- A lot of people with type 2 diabetes need to switch from taking pills to using insulin shots, but this change usually happens in hospitals instead of regular doctor offices.
- The study asked practice nurses in the UK about their opinions on this insulin switch and what help they might need to do it.
- Most nurses believe that switching to insulin would help patients, but they worry about not having enough time, training, and support to do it safely and effectively.
Article Abstract
Background: In order to optimize glycaemic control, substantial numbers of people with type 2 diabetes may require transfer from oral medication to insulin therapy. Although insulin conversion is traditionally a specialist secondary care function, as nursing roles change and expand there is growing pressure for this to be performed within primary care. However, little is known about the potential barriers to such a change, particularly from the standpoint of the frontline staff involved.
Aims: The study aimed to explore the views of practice nurses in the United Kingdom (UK) about converting diabetic patients from oral hyperglycaemic agents to injected insulin within primary care, and to investigate what structures and resources might be useful in supporting such a change.
Methods: Semi-structured interviews were conducted with 25 practice nurses, and interpreted using content analysis to extract key conceptual themes from the transcribed interview texts.
Findings: Most of the nurses felt that converting to insulin in primary care had considerable benefits for patients. However, issues of time, training, confidence about performing the change, and the adequacy of support systems, both for patient and nurse, emerged as the main perceived barriers to performing insulin conversions in primary care. Worries about legal and accountability issues surrounding the nurse prescribing elements were also raised.
Conclusions: Where insulin conversion within primary care is being considered, it is suggested that specific training is provided for practice nurses and general practitioners, protected time is made available, and a team-working approach is fostered to prevent isolation and boost patient support. Formal mentoring or supervision support for practice nurses may also help them to adapt to this new approach.
Limitations: These findings are based on the views of nurses from a single UK locality, and so widespread consultation is recommended before applying them in other settings.
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| http://dx.doi.org/10.1046/j.1365-2648.2003.02648.x | DOI Listing |
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