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Nurse-led shared care diabetes projects: lessons from the nurses' viewpoint.
Irmgard M J G Eijkelberg1, Cor Spreeuwenberg, Bruce H R Wolffenbuttel
1Faculty of Health Sciences, Department of Health Organisation, Policy and Economics, University of Maastricht, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. i.eijkelberg@beoz.unimaas.nl
Health Policy (Amsterdam, Netherlands)
|September 23, 2003
Summary
Shared care projects in diabetes management faced challenges, primarily due to how care was structured between nurses and doctors. Addressing these structural issues is key for improving patient care quality.
Area of Science:
- Nursing
- Healthcare Management
- Diabetes Care
Background:
- Shared care models aim to improve healthcare quality by distributing responsibilities.
- Nurse-led initiatives are increasingly important in managing chronic diseases like diabetes.
- Understanding implementation barriers is crucial for successful healthcare innovation.
Purpose of the Study:
- To explore nurse practitioners' experiences in developing and implementing nurse-led shared care projects for diabetes.
- To identify impeding factors in the development and implementation of these projects.
- To compare nurses' and physicians' perspectives on shared care barriers.
Main Methods:
- Qualitative research methods were employed.
- The study involved four specialized diabetes nurse practitioners.
- Experiences were compared with 38 participating physicians.
Main Results:
- Both nurses and physicians identified the structure of shared care delivery as the primary impediment.
- Downward substitution of care from doctor to nurse was a significant barrier.
- Discrepancies in perceived roles and responsibilities may hinder effective collaboration.
Conclusions:
- The structure of shared care delivery requires careful planning and clear role definition.
- Addressing physician-nurse role perceptions and care substitution is essential for successful implementation.
- Lessons learned can inform future nurse-led projects to improve diabetes care quality.