- •This is the first study to document increases in nursing management of diabetes.
- •Practice nurses increasingly conduct diabetes reviews independently of doctors.
- •General practices continue to support designated diabetes nurse specialisation.
- •Most nurses now address cardiovascular risk factors in the diabetes annual review.
- •Community-based nurses conduct >310,000 annual diabetes consultations in Auckland.
Examine trends in nurse’s contribution to diabetes funded programmes,estimate total nurse consultations, and document the division of diabetes care between doctors and nurses in general practice.
All primary health care nurses in Auckland were identified in 2006-8 and 2016 and 26% and 24% were randomly surveyed, achieving response rates of 86%and 73%, respectively. Participants completed a self-administered and telephone questionnaire detailing their contribution to diabetes funded programmes.
In response to more people with diabetes, significantly more nurses in 2016 consulted patients, provided follow-up care, completed Diabetes Annual Reviews independently of doctors (48%), accessed more educational resources (including theinternet) and 63% felt supported, compared with 27% and 55% of nurses respectively,in 2006-8. The main reason nurses surveyed did not participate in diabetes reviews was because designated nurses conducted them, with more reporting this in 2016 (55%) compared to 32% in 2006-8. Most nurses in the 2016 survey addressed cardiovascular risk such as blood pressure, smoking cessation, physical activity and nutrition during the review.
Nurses conducted more diabetes consultations and reviews, addressed cardiovascular risk in 2016 and reported increased support for participating in diabetes reviews within general practice, compared with nurses in 2006-8.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Primary Care Diabetes
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Mortality rates, by selected causes of death.. Accessed 15 February 2021)
- Living well with diabetes.Ministry of Health, Wellington (New Zealand)2015
- Annual Update of Key Results 2019/20: New Zealand Health Survey.https://minhealthnz.shinyapps.io/nz-health-survey-2019-20-annual-data-explorer/_w_20e602b4/#!/explore-indicators(. (Accessed 6 October 2021))Date: 2020
- About primary health organisations.https://www.health.govt.nz/our-work/primary-health-care/about-primary-health-organisations(. (Accessed 8 October 2021))Date: 2021
- More Heart and Diabetes Checks Evaluation.Ministry of Health, Wellington (New Zealand)2016
- Quality Standards for Diabetes Care Toolkit 2014.(Wellington (New Zealand))2014
- Investing in Health: Whakatohutia Te Oranga Tangata: A Framework for Activating Primary Health Care Nursing in New Zealand.Ministry of Health, Wellington (New Zealand)2003
- The New Zealand Nursing Workforce 2018–2019.(Wellington (New Zealand))2020
- Trends in the primary health care nursing workforce providing diabetes care in Auckland, New Zealand: A cross-sectional survey.Prim Care Diab. 2018; 12: 491-500
- Population.www.stats.govt.nz(. (Accessed 8 October 2021))Date: 2020
- Virtual Diabetes Register (VDR).Ministry of Health, Wellington (New Zealand)2020
- Task shifting from physicians to nurses in primary care in 39 countries: a cross-country comparative study.Eur J Public Health. 2016; 26: 927-934
- Primary Health Care.. (Accessed 8 October 2021))
- Ethnic differences in type 2 diabetes care and outcomes in Auckland: a multiethnic community in New Zealand.N. Z. Med. J. 2006; 119: U1997
- Nurse perceptions of the Diabetes Get Checked programme.Nurs Prax N Z. 2013; 29: 18-30
- Diabetes workforce service review.Ministry of Health, Wellington (New Zealand)2011
- Clinical outcomes of an integrated primary-secondary model of care for individuals with complex type 2 diabetes: a non-inferiority randomised controlled trial.Diabetologia. 2019; 62: 41-52
- Are there disparities in care in people with diabetes? A review of care provided in general practice.J. Prim. Health Care. 2009; 1: 177-183
- Cohort Profile: The PREDICT Cardiovascular Disease Cohort in New Zealand Primary Care (PREDICT-CVD 19).Int J Epidemiol. 2017; 46: 22
- Does a diabetes annual review make a difference?.Diabet Med. 2012; 29: e217-222
- Patient outcomes from 10 years of annual diabetes reviews in New Zealand.Diabetes Res. Clin. Pract. 2013; 102: 129-137
- Health outcomes for diabetes patients returning for three annual general practice checks.N. Z. Med. J. 2007; 120: U2493
- Analysis of a primary care led diabetes annual review programme in a multi ethnic cohort in Wellington, New Zealand, Diabetes Res.Clin. Pract. 2011; 91: 164-170
- Trends in cardiovascular management of people with diabetes by primary healthcare nurses in Auckland, New Zealand.Diabet Med. 2019; 36: 734-741
- Improved foot management of people with diabetes by primary healthcare nurses in Auckland, New Zealand.N. Z. Med. J. 2020; 133: 39-50
- Trends in the management of risk of diabetes complications in different ethnic groups in New Zealand primary care.Prim Care Diabetes. 2008; 2: 181-186
- General practitioners’ views and experiences of counselling for physical activity through the New Zealand Green Prescription program.BMC Fam Pract. 2011; 12: 119
- Ethnicity and risk of lower limb amputation in people with Type 2 diabetes: a prospective cohort study.Diabet Med. 2016; 33: 55-61
- Development and validation of a predictive risk model for all-cause mortality in type 2 diabetes, Diabetes Res.Clin. Pract. 2015; 108: 482-488
- The impact of patient and practice characteristics on retention in the diabetes annual review programme.J. Prim. Health Care. 2013; 5: 99-104
- Why don’t patients with diagnosed diabetes attend a free’ Get Checked’ annual review?.J. Prim. Health Care. 2009; 1: 222-225
- Retention of patients in the Get Checked free annual diabetes review programme in New Zealand, N. Z.Med. J. 2008; 121: 35-44
- Cardiovascular Disease Risk Assessment and Management for Primary Care.Ministry of Health, Wellington (New Zealand)2018
- An association between ethnicity and cardiovascular outcomes for people with Type 2 diabetes in New Zealand.Diabet Med. 2008; 25: 1302-1308
- International Variations in Amputation Practice: A VASCUNET Report.Eur J Vasc Endovasc Surg. 2018; 56: 391-399
- Obesity and diabetes in Pacific Islanders: the current burden and the need for urgent action.Curr Diab Rep. 2015; 15: 29
- Incidence Rate of Prediabetes: An Analysis of New Zealand Primary Care Data.Stud Health Technol Inform. 2015; 214: 81-86
- Social disparities in the prevalence of diabetes in Australia and in the development of end stage renal disease due to diabetes for Aboriginal and Torres Strait Islanders in Australia and Maori and Pacific Islanders in New Zealand.BMC Public Health. 2017; 17: 802
- Collective Agreements.. (Accessed 24 September, 2021))
- Registered Nurse.https://www.careers.govt.nz/jobs-database/health-and-community/health/registered-nurse/about-the-job(. (Accessed 24 September 2021))Date: 2021
- The Primary Health Care Strategy.Ministry of Health, Wellington (New Zealand)2001
- Trends in diabetes care and education by primary health care nurses in Auckland, New Zealand.Diabetes Res. Clin. Pract. 2021; 177108903
- Experiences of registered nurse prescribers; a qualitative study.Contemp Nurse. 2020; 56: 388-399
Published online: January 19, 2022
Accepted: January 13, 2022
Received in revised form: November 15, 2021
Received: February 23, 2021
© 2022 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.