1. THE ROLE OF NURSES IN DIABETES CARE AND EDUCATION By Prof. Morsi Arab IDF Chair EMME Region University of Alexandria

2. The Diabetes Care Team The Nurse is a member of the Diabetes Health Care Team which requires: - complementation - integration - no contradictions - strict job description ( without overdoing)

3. A special Member The nurse is a privileged member of the team. Why ? 1. Has more time ( to listen and to educate) 2. can replace the doctors orders by instructions and guidance : a psychol. value ? 3. Female nurses understand and communicate better with ( a female pt. or mother of a diab. child ) Sympathy and Care is a feminine specialty……

4. Positive and Negative Aspects of Historical Significance in the ME 1. Islamic history supported the role of woman nurses.** 2. Cultural factors delayed womens development. In the region X 3. Poor reputation about the standard of nursing in Arab hospitals X 4.Establishment of Higher schools of Nursing (Alexandria early 1960 ) ** 5. First recognition & a parallel international course (Alexandria 1991) **

5. Cont.(Historical …) 6. Developing National Diab. Nurse Training Programs ** 7. A generation of high-standard specialized educators with a nursing background **

6. The Diabetes Nurse gets international recognition

7. Notional Programme for Nurses Training

8. Nurse Training Workshops

9. Requirements to Perfect The General Requirements for a nurse to perfect her role in diabetes care and education : I. Knowledge -in diabetes and related sciences. -in basic principles in education II. Skills -clinical : history taking, examination,etc. -educational :skills of teaching knowledge and skills, and changing attitudes of pts. III. Special talents (Attitude) : interest, team working, respecting limitations,etc

10. Specific Considerations Specific role in Acute complications 1. Knowledge of causes, symptoms and signs, diagnosis, prevention and principles of management. 2. Clinical Skills :e.g. history, exam. (P & BP, urine test, bld sugar, acetone breath, etc) follow-up observations…………. 3. Educational Skills e.g. instructing prevention, diagnosing and immediate management. 4. Taking appropriate decisions

11. The Diabetes Nurse in Foot Care Knowledge : foot anatomy, vulnerability, types of injuries (mechanical, thermal, chem.) weight bearing walking dynamics,etc. Clinical examination Skills : pulses, sensation, dryness, colour changes, points of stress, etc ), Management skills according to her training. Level I : e.g. dressings, nail cut, etc. Level II : e.g. ulcer debridement, etc Education Skills for patients on : self inspection, shoes, stockings,, preventing mech., thermal and chemical injuries, etc

12. In the Absence of the Physician The Diabetes Nurse : - At School - As Health Visitor to Homes - At Far Rural Centres

13. The Diabetes Nurse at School - Keeps records of children with diabetes - checks times for insulin intake and snacks - manages acute episodes e.g. hypoglycemia - educates school staff to:- - consider the needs of the diab child - manage emergencies - avoid discrimination

14. The Diabetes Nurse at Homes - Encourages pt. compliance to: - regular check of glycem. Control - periodic checks e.g.,ophthalmoscopy, e.c.g.,etc - Monitors early develop. of complications - Guidance (Education) about special needs of : the Elderly,the Isolated, and the Handicapped diabetic.

15. The Diabetes Nurse at Far Rural Centres - Keeps sound balance between active management of diab care or referral ( to physicians and specialists) in due time. - Manages immediate care in emergencies - Checks sufficient stores of medications and equipment for emergencies. - Checks readiness of fast means for transportation in emergencies