Objective: The number of elderly people with chronic diseases receiving amb
ulant nursing care in the German population is continually increasing. Howe
ver, little information is available on the quality of care of elderly diab
etic patients. The aim of this study was to investigate the pattern of care
provided for this group by such ambulatory nursing services.
Patients and methods: All ambulant nursing services in the county of Heinsb
erg, North-Rhine-Westphalia, were contacted and asked to answer a standardi
zed questionnaire. 23 of the 24 services participated in the study and prov
ided suitable answers. The study was conducted between October 1998 and Mar
ch 1999.
Results: All services together took care of 337 persons with known diabetes
mellitus, of whom 79.6% were female and 20.4% were male. The total diabete
s prevalence among all patients was 27.2%. 231 diabetic persons (68,5%) wer
e treated with insulin. Nurses administered insulin to 84.8% of the patient
s. As expected many diabetics had severe late complications (7.4% amputatio
n, 20.8% blindness, 4.2% renal failure). In the majority of patients, blood
glucose was monitored, but only occasionally, whereas urinary glucose was
checked in only a few cases. Foot inspection and care were provided regular
ly. 115 diabetics (34.1%) had at least one hospital stay during the previou
s 12-months period.
Conclusion: The results of this study indicate that ambulatory nursing serv
ices care mainly for insulin-treated diabetic patients in late stages of th
e disease. The current organisational structure not meet the requirements o
f modern diabetes management.