Diab GA2 Assess and investigate individuals with suspected diabetes

Overview

This standard is about assessing individuals with suspected diabetes and deciding whether further investigations should be requested. The individual, or their companions, may suspect they have diabetes, and request an assessment, or they may have been advised to seek an examination by another healthcare practitioner. The setting in which the assessment takes place might include the individual’s home, community settings, day centres, surgeries, mobile assessment centres and hospitals. Users of this standard will need to ensure that practice reflects up to date information and policies. Version No 1

Knowledge and Understanding

You will need to know and understand:

1. the NSF for diabetes
2. the NICE guidelines on diabetes monitoring, management and education
3. causes of diabetes
4. signs and symptoms of diabetes
5. normal and abnormal blood glucose and HbA1c values
6. how to monitor glucose levels, HbA1c, blood pressure
7. typical progressive patterns of diabetes
8. the importance and effects of patient education and self management
9. the psychological impact of diabetes, at diagnosis and in the long term
10. how to gather information from patients about their health
11. how to work in partnership with patients and carers
12. the social, cultural and economic background of the patient/carer group
13. the impact of nutrition and physical exercise
14. the effects of smoking, alcohol and illicit drugs
15. the effects of, and how to manage, intercurrent illness
16. how to manage hypoglycaemia
17. the medications used to manage diabetes
18. the long term complications of diabetes and when they are likely to occur
19. how to examine feet and assess risk status
20. how to monitor cardiovascular risk
21. how to monitor for renal disease
22. how to monitor for diabetic retinopathy
23. the law and good practice guidelines on consent
24. the staff member’s role in the healthcare team and the role of others
25. local guidelines on diabetes healthcare
26. local referral pathways
27. local systems for recording patient information
28. quality assurance systems
29. the process of notification for legal and insurance purposes
30. sources of practitioner and patient information on diabetes
31. contact details of local and national support groups
32. how individuals can access facilities for exercise and physical activity, education and community activities

Performance Criteria

You must be able to do the following:

1. explain clearly to the individual
1. your own role and its scope, your responsibilities and accountability
2. the information that will be obtained and stored in records and with whom this information might be shared
3. what is involved in the assessment
2. respect the individual’s privacy, dignity, wishes and beliefs
3. minimise any unnecessary discomfort and encourage the individual’s full participation in the assessment
4. obtain the individual’s informed consent to the assessment process
5. communicate with the individual in an appropriate manner, recognising the stressful nature of a potential diagnosis of diabetes.
6. ask the individual to explain their condition in their own words, if possible, or obtain the story from any person accompanying the individual
7. ask appropriate questions that will enable you to assess whether the individual may be experiencing diabetes
8. obtain/confirm the individual’s and their family’s relevant medical history
9. obtain/confirm the individual’s recent and past medications
10. carry out baseline observations and tests relevant to confirming the presence of diabetes
11. make a justifiable assessment, based on the individual’s responses, baseline observations and tests and other medical conditions, whether to refer them for further investigations
12. request further investigations, if required, following national, local and organisational guidelines and protocols
13. explain to the individual why you are requesting further investigations, if any, what can be expected to happen and the expected timescales and possible implications of normal and abnormal results
14. provide opportunities for the individual to ask questions and increase their understanding of diabetes
15. assess how the individual is feeling and provide reassurance where appropriate
16. agree a date to review the results of further investigations
17. make a full, accurate and clear record of the information obtained, results of baseline observations and tests, further investigations requested, and agreed follow-up action

Additional Information

This National Occupational Standard was developed by Skills for Health. This standard links with the following dimension within the NHS Knowledge and Skills Framework (October 2004) Dimension: HWB7 Interventions and treatments