Meuhedet, health-care provider, Israel
Bushra Yunis is a Clinical Nurse Practitioner (CNP) Diabetic Nurse. She has worked as Director of Basics in Diabetes for Nurses Program in Rambam Hospital. She has completed her Master’s degree in Nursing, with specialty in Emergency Medicine and Diabetes
Background & Aim: Diabetes is one of the most common chronic diseases. Recent surveys shows increase in the prevalence of diabetes in the Arab population in Israel. European studies show the contribution of the diabetic clinical nurse practitioner (CNP) in improving the glucose outcome measures. Recently, the nursing administration organization in Israel recognized the role of CNP. This gives the nurse authorization to treat diabetes, including diagnosis, regulation and balance of the disease, counseling for patients and teams, prescribing prescriptions and more. The primary target is to examine the effectiveness of intervention model of CNP in primary care physician’s treatment of diabetic patients in the Arab sector. The secondary targets are improving the glucose outcome measures of diabetic patients in the Arab sector by CNP consulting with the physician and the nurse in the clinic and to improve the patient’s adherence to treatment.
Methods: The methods are: 1) Selection of two clinics from the Arab sector at the northern district, 2) Focusing on unbalanced patients with HbA1c>9%, 3) Discussion of 5 cases at each advisory meeting between CNP and primary physician and 4) Involving the nurse in the treatment plan. Arranged meeting with the primary physician and a weekly meeting with the physician. The physician fully cooperated. Both clinics had about 100 unbalanced patients. During the year, 22 meetings were held with staff of the chosen clinics.
Results: Improvement in glucose outcome measures with HbA1c>9%. In one clinic: Improvement from 14.3% to 11.9%, decrease of 17% and in the second clinic: 23.5% to 18.5% decrease of 21% in HbA1c>9%. (One of the physicians have joined the class on "Treatment of diabetes").
Conclusion: To extended this program to additional areas in accordance with the worsening level of glucose outcome measures. Build a direct computerized consulting program between CNP and physicians.