Diabetes care for the most vulnerable in society – the views of professionals working in care homes and domiciliary care using focus group methodology

Fox, Charles; Cr, Gillespie; Kilvert, Anne; Sinclair, AJ

doi:10.1177/1474651413506021

Cited by 9 publications

(6 citation statements)

References 10 publications

(11 reference statements)

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“…6 The same focus groups also identified lack of staff training as a major concern and this has been confirmed by the present audit, in which a third of the care homes did not have access to diabetes education and training for their staff.…”

Section: Poor Communication and Staff Trainingsupporting

confidence: 71%

The neglected elderly with diabetes – raising the standards in care homes

Fox

Kilvert

2014

Br J Diabetes

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Section: Poor Communication and Staff Trainingsupporting

confidence: 71%

The neglected elderly with diabetes – raising the standards in care homes

Fox

Kilvert

2014

Br J Diabetes

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“…Educational needs for care home staff are being recognized and supported [41-44,47] by using technological interventions such as VC alongside educational workshops, pilot programs, electronic learning (e-learning), and websites [41,45,48,49,52] including Web-based learning and information communication toolkits [44,45]. The significance of design and support is recognized within studies rating the suitability of blended learning as an approach to education, including a combination of hands-on skills-based training from experts to enhance evidence-based practice skills in addition to using Web-based or e-learning facilities.…”

Section: Discussionmentioning

confidence: 99%

Diabetes, Care Homes, and the Influence of Technology on Practice and Care Delivery in Care Homes: Systematic Review and Qualitative Synthesis

Mathews¹,

O’Malley²,

Hall³

et al. 2019

JMIR Diabetes

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Background Diabetes is increasing in prevalence and complexity in the care home setting, affecting up to a quarter of care home residents. Health outcomes for these residents are impacted by management of the disease, health care professionals (HCPs)’ decision-making skills within the care home setting, and access to specialist services. The use of technology has the potential to recognize opportunities for early intervention that enables efficient responsive care, taking a fundamental role in linking the care home community to wider multidisciplinary teams for support. Objective The aim of this paper was to identify evidence that explores factors relevant to the use of technology in and around the care home setting to aid in the management of diabetes. Methods Databases searched using a structured prespecified approach included: PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), OVID Nursing database, Scopus, MEDLINE, the Cochrane Library, and the King’s Fund from 2012 to 2017: handsearching was undertaken additionally for any gray literature. Preferred Reporting Items for Systematic review and Meta-Analysis Protocol was used as protocol with Risk of Bias in Systematic reviews a tool to assess the risk of bias across studies. Studies had to include interventions that combined technology to or from the care home setting to support residents living with diabetes. Results The combined search strategy identified a total of 493 electronic records. Of these, 171 papers were screened for eligibility, 66 full papers were accessed, and 13 have been included in this study. Qualitative synthesis has identified different strands of research evidence in what and how technology is currently being used in and around care homes to enhance diabetes management. New initiatives and implementations of technology and emerging models of care that included the use of technology have also been included. Conclusions By triangulating the perspectives of HCPs, practitioners, specialists, and members of the care home community, the authors anticipate that this review will represent an up-to-date, evidence-based overview of the potential for using technology within the care home setting for diabetes management as well as stimulate research in this area.

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“…In a focus group study from the UK addressing healthcare professionals’ concerns about diabetes care in care homes and domiciliary care, the participants stated that, even though regular CBGM and detailed communication between shifts are helpful, knowing your patients well is the key to preventing hypoglycaemia [ 29 ]. And, as the physicians in our study pointed out, even though the range of values where residents experience hypoglycaemia can be extremely wide, the registered nurses managed acute situations well.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have observed inappropriate care to be a consequence of deficiencies in guidelines [ 15 , 19 , 30 ] or formal training in diabetes care for healthcare professionals working in long-term care [ 25 , 29 ]. Accordingly, a need for training in diabetes care has also been pointed out [ 10 , 24 , 25 , 29 , 31 ], highlighting areas such as which signs and symptoms to look for, recognising when to perform a CBGM and managing hypoglycaemia. Others have emphasised how continued education in diabetes care could enhance the nursing staff’s knowledge, confidence and professional competence, and lead to improved patient outcomes [ 11 , 31 – 33 ].…”

Section: Discussionmentioning

confidence: 99%

‘I try not to bother the residents too much’ – the use of capillary blood glucose measurements in nursing homes

et al. 2016

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BackgroundCapillary blood glucose measurements are regularly used for nursing home residents with diabetes. The usefulness of these measurements relies on clear indications for use, correct measurement techniques, proper documentation and clinical use of the resulting blood glucose values. The use of a regular, invasive procedure may also entail additional challenges in a population of older, multimorbid patients who often suffer from cognitive impairment or dementia. The aim of this study was to explore the perspectives of physicians, registered nurses and auxiliary nurses on the use, usefulness and potential challenges of using capillary blood glucose measurements in nursing homes, and the procedures for doing so.MethodsThis was a qualitative study that used three profession-specific focus group interviews. Interviews were transcribed in modified verbatim form and analysed in accordance with Malterud’s principles of systematic text condensation. Five physicians, four registered nurses and three auxiliary nurses participated in the focus groups.ResultsAll professional groups regarded capillary blood glucose measurements as a necessity in the management of diabetes, the physicians to ensure that the treatment is appropriate, and the nurses to be certain and assured about their caring decisions. Strict glycaemic control and excessive measurements were avoided in order to promote the well-being and safety of the residents. Sufficient knowledge of diabetes symptoms, equivalent practices for glucose measurement, and unambiguous documentation and communication of results were determined to be most helpful. However, all professional groups seldom involved the residents in managing their own measurements and stated that guidelines and training had been inconsistent or lacking.ConclusionInadequate procedures and training in diabetes care may compromise the rationale for capillary blood glucose measurements in nursing homes, and hence the residents’ safety. These concerns should be addressed together with the possibility of involving and empowering residents by exploring their ability and wish to manage their own disease.

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Diabetes care for the most vulnerable in society – the views of professionals working in care homes and domiciliary care using focus group methodology

Cited by 9 publications

References 10 publications

The neglected elderly with diabetes – raising the standards in care homes

The neglected elderly with diabetes – raising the standards in care homes

Diabetes, Care Homes, and the Influence of Technology on Practice and Care Delivery in Care Homes: Systematic Review and Qualitative Synthesis

‘I try not to bother the residents too much’ – the use of capillary blood glucose measurements in nursing homes

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