Diabetes Resource Nurse

A Diabetes Resource Nurse position was established in January 2003 and is employed by Manaia Health PHO. The purpose of this role is to initiate and facilitate an integrated, patient-centred and culturally appropriate approach to the management of a defined group of high-need patients with Type 2 diabetes enrolled with Manaia Health PHO general practices. The primary focus is working with Maori/PI patients and those living in NZ Dep 9-10 who have complex needs in relation to their diabetes management.
 
Key Activities undertaken by Diabetes Resource Nurse
Clinical assessment, short-term case management and providing recommendations for clinical management through clinics held in general practice settings.
Provision of focussed education, support and mentorship for general practice staff and other primary health care providers in relation to clinical management, referral pathways, services and resources available for patients with Type 2 diabetes. Examples include support with CME sessions and involvement in Careplus nurses education and support groups.
Enhancement of collaboration between primary and secondary care services to ensure a more integrated approach is undertaken for patient management. Examples include discussion with The Diabetes Centre, Northland Health regarding processes for insulin initiation in primary care and a collaborative approach undertaken for providing Diabetes Group Self Management courses.
Management of a contract with the Diabetes Northland Society to provide free diabetes supermarket tours.
Support for general practice teams in ensuring eligible patients access the annual free diabetes ‘get-checked’ programme. Assistance is provided to Practice Nurses where required, and patients whose clinical data indicates results which fall outside the accepted range are discussed further with the GP and seen by the Diabetes Resource Nurse for more intensive follow up. The annual free check contract is now held by the six Northland PHO’s (which includes Manaia) and is administered on their behalf by Kaipara PHO. Kaipara PHO collates the data at a regional level for Northland and provides both statistical and clinical data to individual PHO’s and practices.