Endocrine Abstracts

Introduction: According to think glucose traffic light referral, Diabetic patients with persisting hyperglycaemia or recurrent hypoglycaemia should be referred to diabetes specialist team, which include diabetic specialist nurses (DSN). In our trust, the point of care alerts the system when BM is <4 mmol/l and > 20 mmol/l.

Aims and Methods: We conducted a retrospective analysis of all patients within a 2 week period at our hospital with blood sugar levels < 4 mmol/l or >15 mmol/l. We looked at 397 patients in total, and evaluated the adequacy of referral to the DSN. We also looked at the current work load for DSN’s, calculating the number of hours needed to see all of the referred patients. We assumed that each referral would take 30 minutes to assess. We further extrapolated the data, assuming all patients requiring referral were referred, to estimate the total number of hours needed for DSN’s to see all the necessary patients.

Results: A total of 220 patients were recorded to have a BM < 4.0. Of these 202 were referred to DSN’s (92%). 65 Patients were recorded to have a BM >15, and only 25 of these were referred to DSN’s (38%). 112 patients were recorded to have BM >20, and only 40 of these were referred to DSN’s (36%). It was calculated that an average of 12.8 h each day was needed to assess patients with abnormal BMs, with the number of hours being as high as 15 on some days.

Conclusion: Currently there are an inadequate number of referrals made to DSN’s in our hospital. This may be due to poor education amongst healthcare professionals, with lack of guidance regarding when to refer. In addition, despite the inadequate referral, we have highlighted the large demand for DSN’s, with referrals taking a significant number of hours each day to assess. With an increasing incidence of diabetes, perhaps this is an area that needs further investment in our health-board.