Examining the impact of Diabetes Inpatient Specialist Nursing in acute trusts in London

Journal article


Leary, A., Cook, R., Lawler, J., Trevatt, P. and Ravinder, D. (2021). Examining the impact of Diabetes Inpatient Specialist Nursing in acute trusts in London. Journal of Advanced Nursing.
AuthorsLeary, A., Cook, R., Lawler, J., Trevatt, P. and Ravinder, D.
Abstract

Abstract
Aims To examine if the introduction of Diabetes Inpatient Specialist Nurses impacted on length of stay and rates of readmission.
Design Knowledge discovery through data mining as part of a larger realist evaluation of the role.
Methods Data from January 2017 to January 2019 was extracted and examined. A subset of performance data from July 2017 -November 2018 was analysed. This consisted of 7320 records for Hospital Episode Statistics and 272 incident reports (Datix). The data were analysed via Generalised Linear Model regression routines in R. Analysis of readmission rates utilised binary logistic regression, while for the Length of Stay a count regression method was employed.
Results
Four trusts were found to have complete and rich data sets. All Trusts that returned complete data were found to have varying decreased length of stay and reduced readmission rates. In two trusts there were significant decreases in patient readmissions and length of stay after the introduction of the Diabetes Inpatient Specialist Nurses. A marked decrease (approximately half) in patient length of stay was found in one London trust after the introduction of the post. Issues with data quality were noted.
Conclusion
Reduced patient length of stay and rate of readmission were found since introduction of Diabetes Specialist Nurses. Patient safety data was incomplete and varied significantly between trusts.
Impact
The project sought to understand the impact of employing Diabetes Inpatient Specialist Nurses in hospitals in London. Overall, the specialist nurses helped reduce length of stay and the rate of readmissions. The research will have an impact on the workforce in diabetes and also people with diabetes who need hospital care.

Year2021
JournalJournal of Advanced Nursing
PublisherWiley
ISSN0309-2402
Publication process dates
Accepted20 Apr 2021
Deposited27 May 2021
Accepted author manuscript
License
File Access Level
Open
Additional information

This is the peer reviewed version of the following article: Leary, A. et al Examining the impact of Diabetes Inpatient Specialist Nursing in acute trusts in London, Journal of Advanced Nursing, which will published in final form at https://onlinelibrary.wiley.com/journal/13652648 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.

Permalink -

https://openresearch.lsbu.ac.uk/item/8ww86

Restricted files

Accepted author manuscript

  • 7
    total views
  • 2
    total downloads
  • 7
    views this month
  • 0
    downloads this month

Export as

Related outputs

A thematic analysis of the prevention of future deaths reports in healthcare from HM coroners in England and Wales 2016–2019
Leary, A., Bushe, D., Oldman, C., Lawler, J. and Punshon, G. (2021). A thematic analysis of the prevention of future deaths reports in healthcare from HM coroners in England and Wales 2016–2019. Journal of Patient Safety and Risk Management. 26 (1), pp. 14-21. https://doi.org/10.1177/2516043521992651
Implementation of advanced practice nursing for minor orthopedic injuries in the emergency care context – a non-inferiority study
Boman, E., Duvaland, E., Gaarde, K., Leary, A., Rauhala, A. and Fagerstrom, L. (2021). Implementation of advanced practice nursing for minor orthopedic injuries in the emergency care context – a non-inferiority study. International Journal of Nursing Studies. https://doi.org/10.1016/j.ijnurstu.2021.103910
Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evaluation
Lawler, J, Maclaine, K and Leary, A (2020). Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evaluation. Human Resources for Health. 18 (1), pp. 96-. https://doi.org/10.1186/s12960-020-00539-y
Why won’t workforce policy makers tackle gender inequality in healthcare?
Leary, Alison (2020). Why won’t workforce policy makers tackle gender inequality in healthcare? BMJ: British Medical Journal.
Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evaluation
Lawler, J., MacLaine, K. and Leary, A. (2020). Workforce experience of the implementation of an advanced clinical practice framework in England: a mixed methods evaluation. Human Resources for Health. 18, p. 96. https://doi.org/10.21203/rs.3.rs-55503/v2
Guest editorial
Leary, A. (2020). Guest editorial. International Journal of Urological Nursing. 14 (3), pp. 104-105. https://doi.org/10.1111/ijun.12254
Do working practices of cancer nurse specialists improve clinical outcomes? Retrospective cohort analysis from the English National Lung Cancer Audit
Stewart, I., Leary, A., Khakwani, A., Borthwick, D., Tod, A., Hubbard, R., Beckett, P. and Tata, L.J. (2020). Do working practices of cancer nurse specialists improve clinical outcomes? Retrospective cohort analysis from the English National Lung Cancer Audit. International Journal of Nursing Studies. p. 103718. https://doi.org/10.1016/j.ijnurstu.2020.103718
In praise of professional judgement
Maxwell, E and Leary, A (2020). In praise of professional judgement. BMJ: British Medical Journal.
Perceptions of the cancer care left undone in primary and community services: A mixed methods evaluation
Lawler, J., Leary, A., Lofton, L. and Bushe, D. (2020). Perceptions of the cancer care left undone in primary and community services: A mixed methods evaluation. Health & Social Care in the Community. 28 (6), pp. 2117-2124. https://doi.org/10.1111/hsc.13022
What does the future hold for the nursing associate role?
Hickman, S. and Leary, A. (2020). What does the future hold for the nursing associate role? Nursing Times.
The workload of the diabetes specialist nurse workforce in the UK
Lawler, J., Punshon, G., Leary, A., Walden, E. and Stainisstreet, D. (2020). The workload of the diabetes specialist nurse workforce in the UK. Journal of Diabetes Nursing. 24 (1).
Using knowledge discovery through data mining to gain intelligence from routinely collected incident reporting in an acute English hospital
Leary, A., Cook, R., Jones, S.J., Radford, M., Smith, J., Gough, M. and Punshon, G. (2020). Using knowledge discovery through data mining to gain intelligence from routinely collected incident reporting in an acute English hospital. International Journal of Health Care Quality Assurance. 33 (2), pp. 221-234. https://doi.org/10.1108/IJHCQA-08-2018-0209
Understanding the demand and unmet need of providing psychological cancer care in the community
Lawler, J., Lofton, L. and Leary, A. (2020). Understanding the demand and unmet need of providing psychological cancer care in the community. Cancer Nursing Practice. 19 (3). https://doi.org/10.7748/cnp.2020.e1680
Uncovering the hidden workload involved in providing cancer care in the community
Lawler, J., Leary, A., Lofton, L. and Bushe, D. (2020). Uncovering the hidden workload involved in providing cancer care in the community. Primary Health Care. 30 (2). https://doi.org/10.7748/phc.2020.e1610
Staffing the NHS: Why we need to invest in the community workforce
Leary, A (2019). Staffing the NHS: Why we need to invest in the community workforce. in: Martinez, C (ed.) The NHS Winter Crisis Reform. pp. 6
Implementation of advanced practice nursing for orthopaedic patients in the emergency care context – astudy protocol for outcome studies
Boman, E., Duvaland, E., Gaarde, K., Leary, A. and Fagerstrom, L. (2019). Implementation of advanced practice nursing for orthopaedic patients in the emergency care context – astudy protocol for outcome studies. Journal of Advanced Nursing. 76 (4), pp. 1069-1076. https://doi.org/10.1111/jan.14299
Modelling the Multiple Sclerosis Specialist Nurse Workforce by determination of optimum caseloads in the United Kingdom
Punshon, G., Sopala, J., Hannan, G., Roberts, M., Vernon, K., Pearce, A. and Leary, A. (2019). Modelling the Multiple Sclerosis Specialist Nurse Workforce by determination of optimum caseloads in the United Kingdom. International Journal of MS Care. https://doi.org/10.7224/1537-2073.2019-058
An observational study on the rate of reporting of adverse event on healthcare staff in a mental health setting: An application of Poisson expectation maximisation analysis on nurse staffing data
Cook, R., Jones, S., Williams, G., Worsley, D., Walker, Ray, Radford, Mark and Leary, A. (2019). An observational study on the rate of reporting of adverse event on healthcare staff in a mental health setting: An application of Poisson expectation maximisation analysis on nurse staffing data. Health informatics journal. 26 (2), pp. 1333-1346. https://doi.org/10.1177/1460458219874637
Does the Diabetes Specialist Nursing workforce impact the experiences and outcomes of people with diabetes? A hermeneutic review of the evidence
Lawler, J., Trevatt, P., Elliot, C. and Leary, A. (2019). Does the Diabetes Specialist Nursing workforce impact the experiences and outcomes of people with diabetes? A hermeneutic review of the evidence. Human Resources for Health. 17 (65). https://doi.org/10.1186/s12960-019-0401-5
Nursing pay by gender distribution in the UK- does the Glass Escalator still exist?
Leary, A, Punshon, G, MacLaine, K, Radford, M, Trevatt, P and Shanley, O (2019). Nursing pay by gender distribution in the UK- does the Glass Escalator still exist? International Journal of Nursing Studies. https://doi.org/10.1016/j.ijnurstu.2019.02.008
Determining acute nurse staffing, a hermeneutic review of an evolving science.
Leary, A and Punshon, G (2019). Determining acute nurse staffing, a hermeneutic review of an evolving science. BMJ Open. 9 (3). https://doi.org/10.1136/bmjopen-2018-025654
The healthcare workforce should be shaped by outcomes, rather than outputs
Leary, A (2019). The healthcare workforce should be shaped by outcomes, rather than outputs. BMJ Opinion.
Turning data into useful knowledge to improve patient care
Leary, A (2018). Turning data into useful knowledge to improve patient care. Journal of Nursing Management.
Do lung cancer nurses relieve the burden of lung cancer? An outcomes study
Leary, A (2018). Do lung cancer nurses relieve the burden of lung cancer? An outcomes study. Cancer Services, Data and Outcomes Conference 2018. Manchester 20 - 21 Jun 2018
Are working practices of lung cancer nurse specialists associated with variation in peoples’ receipt of anti cancer therapy
Stewart, I, Khakwani, A, Hubbard, R, Beckett, P, Borthwick, D, Tod, A, Leary, A and Tata, LJ (2018). Are working practices of lung cancer nurse specialists associated with variation in peoples’ receipt of anti cancer therapy. Lung Cancer. 123, pp. 160-165. https://doi.org/10.1016/j.lungcan.2018.07.022
Modelling the Inflammatory Bowel Disease Specialist Nurse Workforce standards by determination of optimum caseloads in the United Kingdom.
Leary, A, Punshon, G and Mason, I (2018). Modelling the Inflammatory Bowel Disease Specialist Nurse Workforce standards by determination of optimum caseloads in the United Kingdom. Journal of Crohn's and Colitis. 12 (11), pp. 1295-1301. https://doi.org/10.1093/ecco-jcc/jjy106
Barriers to delivering advanced cancer nursing: A workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit
Stewart, I, Leary, A, Tod, A, Borthwick, D, Khakwani, A, Hubbard, R, Beckett, P and Tata, LJ (2018). Barriers to delivering advanced cancer nursing: A workload analysis of specialist nurse practice linked to the English National Lung Cancer Audit. European Journal of Oncology Nursing. 36, pp. 103-111. https://doi.org/10.1016/j.ejon.2018.07.006
Nurse staffing levels and outcomes - mining the UK national datasets for insight.
Leary, A, Tomai, B, Swift, A, Woodward, A and Hurst, K (2017). Nurse staffing levels and outcomes - mining the UK national datasets for insight. International Journal of Health Care Quality Assurance. 30 (3), pp. 235-247. https://doi.org/10.1108/IJHCQA-08-2016-0118
Advancing Nursing Practice: The Emergence of the Role of Advanced Practice Nurse in Saudi Arabia
Hibbert, D, Aboshaiqah, A, Senko, K, Forestall, D, Harb, A, Yousuf, S, Kelley, P, Brennan, P, Serrant, L and Leary, A (2017). Advancing Nursing Practice: The Emergence of the Role of Advanced Practice Nurse in Saudi Arabia. Annals of Saudi Medicine. 37 (1), pp. 522-528. https://doi.org/10.5144/0256-4947.2017.522
Safety and service. Reframing the purpose of nursing to decision makers
Leary, A (2017). Safety and service. Reframing the purpose of nursing to decision makers. Journal of Clinical Nursing. 26 (23-24), pp. 3761-3763. https://doi.org/10.1111/jocn.13885
The experiences of specialist nurses working within the uro-oncology multidisciplinary team in the UK
Punshon, G, Endacott, R, Aslett, P, Brocksom, J, Fluere, L, Howdle, F, Masterson, M, O'Connor, A, Swift, A, Trevatt, P and Leary, A (2017). The experiences of specialist nurses working within the uro-oncology multidisciplinary team in the UK. Clinical Nurse Specialist: The Journal for Advanced Nursing Practice.
Emergency care patient driven solutions for severe asthma
Newell, K, Corrigan, C, Punshon, G and Leary, A (2017). Emergency care patient driven solutions for severe asthma. International Journal of Health Care Quality Assurance. 30 (7), pp. 628-637. https://doi.org/10.1108/ijhcqa-09-2016-0127
Variation in job titles within the nursing workforce.
Leary, A, Maclaine, K, Trevatt, P, Radford, M and Punshon, G (2017). Variation in job titles within the nursing workforce. Journal of Clinical Nursing. 26 (23-24), pp. 4945-4950. https://doi.org/10.1111/jocn.13985
Developing the next generation of specialist cancer nurses.
Leary, A, Whittaker, AJ and Hill, A (2017). Developing the next generation of specialist cancer nurses. Cancer Nursing Practice. 16 (9), pp. 25-30. https://doi.org/10.7748/cnp.2017.e1453
Crowd medical services in the English Football League: remodelling the team for the 21st century using a realist approach
Leary, A, Kemp, A, Greenwood, P, Hart, N, Agnew, J, Barrett, J and Punshon, G (2017). Crowd medical services in the English Football League: remodelling the team for the 21st century using a realist approach. BMJ Open. https://doi.org/10.1136/bmjopen-2017-018619
Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across england
Khakwani, A, Hubbard, R, Beckett, P, Borthwick, D, Tod, A, Leary, A, White, J and Tata, LJ (2016). Which patients are assessed by lung cancer nurse specialists? A national lung cancer audit study of over 128,000 patients across england. Lung Cancer. 96, pp. 33-40. https://doi.org/10.1016/j.lungcan.2016.03.011
Mining routinely collected acute data to reveal non-linear relationships between nurse staffing levels and outcomes
Leary, A, Cook, R, Jones, S, Smith, S, Maxwell, E, Punshon, G and Radford, M (2016). Mining routinely collected acute data to reveal non-linear relationships between nurse staffing levels and outcomes. BMJ Open. 6 (12). https://doi.org/10.1136/bmjopen-2016-011177
A systematic literature review comparing the psychological care needs of patients with mesothelioma and advanced lung cancer
Ball, H, Moore, S and Leary, A (2016). A systematic literature review comparing the psychological care needs of patients with mesothelioma and advanced lung cancer. European Journal of Oncology Nursing. 25, pp. 62-67. https://doi.org/10.1016/j.ejon.2016.09.007
Impact of proactive case management by multiple sclerosis specialist nurses on use of unscheduled care and emergency presentation in multiple sclerosis
Leary, A, Quinn, D and Bowen, A (2015). Impact of proactive case management by multiple sclerosis specialist nurses on use of unscheduled care and emergency presentation in multiple sclerosis. International Journal of MS Care. 17 (4), pp. 159-163. https://doi.org/10.7224/1537-2073.2014-011
The specialist nursing workforce caring for men with prostate cancer in the UK
Leary, A, Brocksom, J, Endacott, R, Fleure, L, Howdle, F, Masterton, M, O'Connor, A, Swift, A, Trevatt, P and Aslett, P (2015). The specialist nursing workforce caring for men with prostate cancer in the UK. International Journal of Urological Nursing. 10 (1), pp. 5-13. https://doi.org/10.1111/ijun.12104