Taylor Rachael M, Acharya Shamasunder H, Parsons Martha E, Ranasinghe Ushank P, Kuzulugil Deniz O, Fleming Kerry C, Harris Melissa L, Byles Julie E, Philcox Annalise N, Tavener Meredith A, Attia John R, Kuehn Johanna, Ross-Evans Sharon N, Hure Alexis J
School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, University Dr, Callaghan, NSW 2308, Australia.
Hunter Medical Research Institute, Lot 1 Kookaburra Cct, New Lambton Heights, NSW 2305, Australia.
Fam Pract. 2025 Apr 12;42(3). doi: 10.1093/fampra/cmaf020.
In 2015, the Australian Diabetes Alliance Program (DAP) was implemented in the Hunter New England Local Health District, New South Wales as a collaboration with the Hunter Medicare Local. DAP integrates specialist teams within primary care practices, delivering case conferencing, practice performance reviews, and education sessions.
To report on practice nurses (PNs) perspectives on the impact of the DAP on their skills, knowledge, and approach in delivering care for adults with type 2 diabetes.
Three primary care practices with high rates of monitoring haemoglobin A1c (HbA1c) levels (> 90% of patients annually) and three practices with lower rates of monitoring HbA1c levels (< 80% of patients annually) from DAP provided the sampling frame. Interviews were conducted with six PNs, which were transcribed and analysed using codebook thematic analysis.
Overall, DAP was viewed favourably by PNs. Significant improvements in knowledge and skills were reported relating to administering antihyperglycemic agents, insulin, and other injectable therapy, as well as dietary modifications for diabetes management. PNs transferred this knowledge and skills to other patients not participating in DAP. An improvement in the delivery of diabetes care, rather than a change in approach, was also reported by PNs. However, the amount of preparation required for case conferencing in the program was identified as a burden to PNs.
PNs were supportive of DAP and identified knowledge gains that were transferable to other patients. The administrative burdens on PNs need to be considered for scalability of the program.
2015年，澳大利亚糖尿病联盟项目（DAP）在新南威尔士州亨特新英格兰地方卫生区与亨特医疗保险地方机构合作实施。DAP将专科团队整合到初级保健机构中，开展病例讨论会、机构绩效评估和教育课程。
报告执业护士（PN）对DAP对其为2型糖尿病成人患者提供护理的技能、知识和方法的影响的看法。
从DAP中选取三家血红蛋白A1c（HbA1c）水平监测率高（每年>90%的患者）的初级保健机构和三家HbA1c水平监测率低（每年<80%的患者）的机构作为抽样框架。对六名PN进行了访谈，并使用编码本主题分析法对访谈内容进行转录和分析。
总体而言，PN对DAP评价良好。据报告，在使用降糖药、胰岛素和其他注射疗法以及糖尿病管理的饮食调整方面，知识和技能有显著提高。PN将这些知识和技能传授给了其他未参与DAP的患者。PN还报告说，糖尿病护理的提供有所改善，而不是方法有所改变。然而，该项目病例讨论会所需的准备工作量被认为给PN带来了负担。
PN支持DAP，并认识到可传授给其他患者的知识收获。该项目的可扩展性需要考虑PN的行政负担。
