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Changing Diabetes® and the Apis bull logo are registered trademarks of Novo Nordisk A/S Clinic Organisation Echelon 1 - 2.

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Presentation on theme: "Changing Diabetes® and the Apis bull logo are registered trademarks of Novo Nordisk A/S Clinic Organisation Echelon 1 - 2."— Presentation transcript:

1 Changing Diabetes® and the Apis bull logo are registered trademarks of Novo Nordisk A/S Clinic Organisation Echelon 1 - 2

2 Programme Equipping a clinic External partners and donors Diabetes camps Patient safety Ordering insulin

3 Equipping a clinic

4 Echelons of care Echelon 1 Primary care facilities Hospitals where children with diabetes are rarely seen Goals: Diagnosis of diabetes Recognise the role of insulin Understand principles and priorities of treating children with diabetes Understand storage and use of insulin Assist with continuing care Local support of the child with diabetes

5 Echelon 1: Equipment (1) Blood glucose meter with test strips Urine strips for glucose, ketones & protein Benedicts solution, test tube and spirit lamp Blood pressure set (child and adult cuffs) Weigh scale Height measure Height and weight charts ELOUISE BARRET United Kingdom Elouise has type 1 diabetes

6 Echelon 1: Equipment (2) Regular insulin Intermediate or long-acting insulin 100 U/ml syringes with needles Drip setting equipment and IV fluids Chart for diagnosis of diabetes mellitus Chart with emergency treatment of DKA Chart with management of sick days

7 Echelon 1: Support Communication chain with access to an echelon 2-4 centre Access to transport A paper-based recording system LIAM & JORDAN CARSTENS South Africa Liam & Jordan have type 1 diabetes

8 Echelon 2 Echelon 1 Echelon 2 Have basic exposure to diagnosis and treatment of diabetes Have insulin and diabetes supplies on site Know how to start treatment with insulin Recognize and start basic measures for DKA Distribute insulin and diabetes supplies to patients Supervise care prescribed by an echelon 3 facility

9 Echelon 2: Staffing Project officer responsible Order supplies Collect and record data Distribute insulin, needles, syringes and diabetes supplies One or more clinic personnel would have attended a specialised workshop on the care of diabetes in childhood Healthcare worker for administering the data collection and management of stocks of medications

10 Echelon 2: Equipment (1) Glucose meters and strips Filter paper strip for HbA1c determination or HbA1c point of care analyzer Urine microalbumin strips Urine glucose and ketone strips Refrigerated storage and insulin supplies Stadiometer Weigh scale

11 Echelon 2: Equipment (2) Be able to send samples for laboratory testing A computer to enter demographic data as part of a central registry A computer programme to track attendees and defaulters Display diagnosis posters LIAM CARSTENS South Africa Liam has type 1 diabetes

12 Equipment for in-patient care Blood glucose meter Access to laboratory measurements IV fluids for DKA management IV infusion pump/3-way tap /Y connector Chart for DKA management Copies of the treatment plan (completed)

13 Teaching support Charts for: Routine diabetes clinic visit Sick days Managing DKA patient Teaching insulin injections Blood and urine testing Simple dietetic advice Information for schools Recording booklets (diaries) Diabetes support group

14 Ordering insulin

15 Maintaining supply of insulin Insulin is a life-saving drug Crucial to keep adequate supplies at the clinic Needs transportation and storage at 2-8 o C It has a limited shelf life – take note of expiry dates Excess stocks of insulin should be returned as soon as it is confirmed that they are not needed

16 Ordering insulin Should have at least double the amount needed by the hospital between resupply intervals 2 groups who require insulin Existing patients New type 1 diabetes patients Insulin requirements increase with growth Increased requirement for illness / DKA

17 Information needed How many vials or units of insulin did your centre use last year? Was it enough? When was there a shortage of insulin during the year? Do you know the cause? How many patients are in your clinic or centre now? How many new patients tend to come each year (on average)?

18 Patient safety

19 Children and adolescents with diabetes who are not well controlled (i.e. high Hb1C) are vulnerable to infection Infection can cause DKA Nosocomial infections possible during clinic visitS Safety programme (WHO)

20 Safety programme Wash hands before and after examinations Use standard precautions Clean and disinfect equipment Specimen transport to the laboratory Handling and disposing of sharp and contaminated items Ensure that the clinic is well ventilated Regular cleaning

21 Diabetes camps

22 Camps are a great source of learning and support for both children and professionals Can be organised just for children or just for adolescents Can also include other family members, parents, siblings Goal is to share knowledge about living with childhood diabetes Live with other children who have diabetes for a few days Teaching by healthcare professionals, children and parents

23 Goals of the camps Knowledge and confidence to: Give injections Test glucose levels Estimate food portions Deal with other illnesses Understand why diabetes in children is different from adult diabetes Learn how to live a normal life with diabetes with peer- to-peer teaching and role modelling Parents learn how to give emotional and practical support to the child

24 External partners and donors

25 External partners & donors Reinforce the development of your clinic with support from external partners and donors Knowledge Manpower Resources Skills Experience Process and considerations in manual

26 ISPAD ( International Diabetes Federation (IDF) ( World Diabetes Foundation (WDF) ( Life for a Child ( Children with Diabetes ( Rotary Club ( Lions Club ( Juvenile Diabetes Research Foundation (JDRF) ( Organizations

27 Questions

28 Changing Diabetes® and the Apis bull logo are registered trademarks of Novo Nordisk A/S

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