What role do nurses play in Type 2 diabetes care in the community: a Delphi study

Objectives. To identify the views of nurses on their current and future rol es in care in the community for people with Type 2 diabetes. Method. A two-round Delphi study was used to elicit, and assess consensus o n opinions from random samples of practice nurses, with a substantial role in the management of diabetes patients and diabetes specialist nurses. Both groups had defined levels of expertise in diabetes care and worked in Grea t Britain. The study instrument in round one comprised a questionnaire with 10 statement headings inviting opinions on the nursing role in the managem ent and care of people with Type 2 diabetes. In the second round levels of agreement were elicited from responders on collated opinions from round one . The initial questionnaire also included closed questions to obtain a prof ile of current care delivered. Results. Responders were 97 practice nurses and 69 diabetes specialist nurs es with second round response rates of 93% and 86%, respectively. The 47 th emes raised could he grouped under headings of clinical practice, responsib ility, communication, knowledge, education/experience, rewards, and patient s roles. Many were common to several statements and both nurse groups. The level of agreement on the themes fed back was high, 85% of the 165 items ac hieved greater than 80% agreement. Agreement occurred for factors relating to clinical effectiveness, audit, knowledge. education and experience. Diss ent occurred both within and between individual nurse groups on issues of r esponsibility, prescribing, service delivery, resources, and patient factor s. Conclusions. This Delphi study has identified key areas of consensus on the management of care for people with Type 2 diabetes in the community bur al so areas in which further work needs to be carried out to understand the di fferences found. Many of the discordant items relate to the separate roles and associated issues of the two nurse groups.