1. Sarah Gregory Diabetes Specialist Nurse Diabetes UK Clinical Champion
Use of workshops to improve diabetes management in Mental Health settings
Sarah Gregory
Diabetes Specialist Nurse
Diabetes UK Clinical Champion

2. Mental Health and Diabetes
A poorly written about area in diabetes
Psychological support for those with diabetes, but lack of physical support for those with poor mental health
Most mental health trusts are separate to Community and Acute Trust
Limited support from specialist services
There are only a handful of mental health trusts who employ physical health nurses specifically for diabetes
Patients ‘fall through the net’ between these services
Often a challenge to manage
Many mental health nurses are not dual trained
little knowledge of diabetes

3. Education Delivery – Primary and Secondary Care
In-Patient ‘Think Glucose’ programme
Three day course to cover all aspects of in-patient diabetes care
Two Modules for care homes – both based on TREND competencies and DUK guidelines
Module 1 – ‘Basic’ competencies – Different types of diabetes, symptoms, blood glucose monitoring, recognition and treatment of hypoglycaemia, Annual Review and footcare
Module 2 – Insulin Delegation – Safe use of insulin, hypoglycaemia, ‘Six Steps’

4. Kent, Surrey & Sussex Mental Health Project June – September 2017
Training needs discussed
Some funding from HEEKSS (Health Education England)
Remainder from Industry
High number of staff - not suitable for delivery in Modules
Self Assessment identified as baseline evaluation
Overview of Diabetes and Mental Health to ‘set the scene’ and four workshops in key risk areas:
Hypoglycaemia
Medication for Diabetes
Safe Administration of Insulin

5. Competencies Based on the TREND competencies
Self Assessment by delegates pre and post course with 11 key questions in the management of diabetes
Delegates assessed themselves as ‘Competent’ ‘Almost there’ or ‘Not Competent’

6. Self Assessment Questions Part One (Overview)
Know the difference between Type 1 and Type 2 diabetes
Identify individuals at risk of diabetes – those of antipsychotic medication and poor mental health
Outline the long term health consequences of diabetes

7. Self Assessment Questions (Medication Workshop)
Demonstrate a basic knowledge of the range of oral anti-hyperlycaemic agents and their mode of action
Be aware of agents that which carry a higher risk of hypoglycaemia
Demonstrate a basic knowledge of the main groups of insulin and GLP-1 receptors agonists and administration devices used locally

8. Self Assessment Questions (Insulin Safety workshops)
Have an understanding of the importance of timing of insulin – be aware of common insulin errors
Know the importance of maintaining injection sites and site rotation - identify the term lipohypertrophy
Be able to correctly administer insulin and dispose of sharps -know how to use insulin pen devices or needles/syringes

9. Self Assessment Questions (Hypoglycaemia workshop)
Be able to define and recognise hypoglycaemia - be aware of medications most likely to cause hypoglycaemia
Know the treatment for hypoglycaemia

10. Data and Outcomes A total of 134 staff attended the Workshops
Students Nurses to Consultants
A mixture of paper self assessments and electronic assessments
Electronic assessments easier to follow up and collect data
Evaluation of workshops and facilitators

11. Self Assessment – Pre and Post Surrey Mental Health Trust

12. Evaluation Data Average Score (1-5) Comments
Overview of Diabetes (Presentation)
4.3
Excellent overview, will encourage me to read more. Easy to understand
Workshop – Medication for Diabetes
Fantastic information and clear delivery. More understanding of different drugs to treat diabetes
Workshop - Hypoglycaemia
4.5
I would have overtreated before! Good use of examples – would like to have hypo boxes where I work
Workshop – Insulin Safety
4.4
Clearly explained, well presented with good examples relevent to practice
Workshop – Pen Demonstration and needles
4.6
Will benefit my practice and has given be the ability to educate patients and colleagues

13. Top Three things learned from the Workshops
More awareness of hypoglycaemia
95% of delegates felt competent post workshop
Insulin Timing & Safe Administration of insulin (‘Rock n Roll’ and Safety Needles
Only 20% felt competent prior to workshop, 100% felt competent after
Medication groups
Only 5% felt competent in this area prior to workshop, still work to be done as this increased to 45%

14. Summary Training and education programmes work but…..
They need to be relevent to practice and have key messages
They need to be sustainable (financially and human)
There should be Quality Assurance through self assessment and evaluation
They need to provide Continuing Professional Development (CPD)