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diabetes coalface

Volume 1. Edition 1. April 2017.
Fifty percent of Australians with diabetes don't reach their glycaemic target. In anyone's language that isn't good, but considering high glucose levels affect a person's small blood vessels, especially the eyes and kidneys, it also affects the quality of life of people with diabetes and the Australian health budget's bottom line.

It's time for change ...  time to do things differently!

diabetes coalface is a monthly newsletter for health professionals who see people with diabetes in their clinical work. In this inaugural edition I explore the true meaning of team care and the role we all play in a person's primary care diabetes team. Look out for the link to a blog published a few weeks ago exploring the potential to improve primary healthcare by strengthening the business planning skills of small businesses delivering these services in Australia. We look at the strange phenomenon of themes that develop in clinical sessions and direct from my own clinical practice is a tip on communicating with people with significant communication challenges. Test your knowledge of the latest Australian insulin usage statistics and click on the link to get a fact sheet on the topic. There are also links to some of the latest blogs and resources on the DE@Connect site.  
Love to hear what you think of the newsletter - you can leave a comment on my website or email jayne@edhealth.com.au.  Until next time be kind to yourself!    
Jayne Lehmann, Editor.
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Primary Diabetes Care – There’s a role for us all!

Responsibility for the management of the rising number of people with type 2 diabetes sits pretty much in the lap of primary health care. In this inaugural article, Jayne Lehmann explores the role all primary care health professionals have in increasing the number of people with type 2 diabetes achieving their glycaemic targets.

The Chronic Disease Management system, put in place via Medicare in 2004, provides GPs with the ability to refer to allied health professionals in their local community. Increasing access to the additional skills of these allied health professionals was meant to significantly improve health outcomes in people with chronic conditions like diabetes. It would seem we have a way to go with 50% of people with diabetes currently NOT achieving their glycaemic targets.

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When you see someone with diabetes ask yourself three questions:

1. How is diabetes affected by their health issue?

2. Is this health issue affected by their diabetes?

3. What can I suggest to improve their diabetes? 

Then incorporate your answers into your care to play your part in their diabetes care team.

Is it just me or do your clinics evolve their own theme?

I've noticed that when I see a number of patients in a sessions a theme will be revealed over the course of appointments. I thought it might just be me, but when I asked the bloke who is a GP he agreed that he found the same thing. Do you find the same thing?

Sometimes the theme will be something I don't see very often but more than one patient will have the same thing. I might see similar clinical presentations. Equally sometimes the clinic will go eerily smoothly ... everyone's issues are addressed without a hitch, on time and under control. Other times it feels like I'm a lunatic trying to manage various surprises, challenges and longer appointments to make me run late all day. 

Read on for some recent examples ...
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Working in the health sector can be stressful. We look out for the welfare of others all day so try to give yourself a break outside every now and again. Make an effort to look around and appreciate things that make you happy.

In the mean time here's one I prepared earlier!

Communication Tip


Challenge brings communication innovation
There are moments in our work that crystallise why we do what we do as health professionals.

An older man with an intellectual disability, who I have seen for some years, walked in and sat down in the chair of the consulting room recently, just like he has every other time he has come to my clinic. There is no talking and no eye contact. He is accompanied by a carer and the man, a tall man stooped with age, walks in and sits down to patiently wait while the carer and I discuss his diabetes management. Once we have finished, the carer tells him it’s time to go, he stands up and off they go.

At his last appointment, I decided to try and make a connection with him so he too got something positive out of the appointment. From my bag of resources for people with intellectual disability I brought out Lennie the Lion (pictured), a company soft toy. Lenny was introduced to the man and gently I rubbed Lennie's mane against his arm. The man responded, looking right into my eyes with the most joyous smile from our interaction. I flicked Lenny towards the ground so his mane of hair stood on end and again showed him the toy, touching his arm with the soft fur. Again his eyes locked on mine, he smiled and a little laugh slipped from his lips.

I don’t know what he was thinking in that moment but I do know he was happy with our interaction. We may not be able to talk to each other about his diabetes but if our interaction leads him to associate happiness with coming to see me about his diabetes then what a great outcome.

We often forget to engage with people who can't speak siply talking to the carer. Next time - try and connect with the person. More than likely you will have your own moment of clarity about the work you do.

I love my job.
Jayne Lehmann RN CDE
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BLOG by Jayne.

Primary health care is constructed predominantly by a web of small businesses. Could it be that quality business planning is the answer to improving the cohesiveness and effectiveness of primary health care?
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Enjoying the newsletter?
If you have a question you want answered about diabetes care, send it to Jayne Lehmann and she will answer it in a future edition of diabetes coalface.

Enjoyed the newsletter? Don't keep it to yourself .. share it with your friends and colleagues!
The Australian Institute of Health and Welfare (AIHW) have released a new fact sheet, Incidence of insulin-treated diabetes in Australia, 2015. This handy resource provides a quick snapshot on the statistics and features of people using insulin to treated their diabetes in Australia.
 
Use it for:
  • A quick update on the statistics on insulin-treated diabetes
  • PowerPoint presentations
  • Background information in handouts and articles.
QUICK QUIZ
How well do you know the current insulin treated diabetes data?
  1. Are there more men or women with type 1 diabetes in Australia?
  2. If you come from a lower socioeconomic group how much more likely are you to require insulin to treat your diabetes?
  3. Aboriginal and Torres Strait Islander people are how many times more likely to require insulin to treat their diabetes?
  4. What percentage of women with Gestational Diabetes aged between 40-44 years of age require insulin treatment?
Click Answers to find out and get a copy of the fact sheet.
Click here to find a link to your local PHN and see how you can get involved. Don't forget to check out their website for resources available in your local area.

 

Jayne explores You Tube!

I've taken multi-skilling as a CDE to a new level this time...

For anyone who has seen the costumes I've worn at previous ADS/ADEA Annual Scientific Meeting dinners it was only a matter if time before I'd see how You Tube could be used as an education tool!  I've even got my own You Tube channel!

Click on the link to see my foray into the world of making You Tube videos that are available 24 hours a day, free of charge to anyone who goes to the channel. It amazes me how many people have already looked at the videos as I "fake it 'till I make it" with my rudimentary video production skills.

My initial foray has shown me there's a lot of potential for us to use You Tube to produce great education resources that are cheap to make and are available 24 hours a day for free!  Mind you there is a lot of learning on my part if I am to make them much shorter and better lit!Subscribe to receive notification of the new videos to be posted to the channel in the near future. You can add a link to a video on your own website or simply see it for your own education and enjoyment! 

If there are any videos you would like to see added to the channel drop me a line! jayne@edhealth.com.au
 
diabetes coalface links primary care health professionals with information and clinical vignettes from the coalface to inspire better support for people with diabetes. Also included are links to new information, resources, and blogs by Jayne Lehmann on DE@Connect, an online site supporting grassroots health professionals to provide quality diabetes care and education to people with diabetes. Evidence based practice made easy. 
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