Diabetes Care in an Acute Psychiatric Inpatient Setting: a logic model
for service delivery
Abstract
Aims and Objectives To develop a logic model that illustrates the steps
needed to develop an effective intervention for diabetes management in a
psychiatric inpatient setting, as the point of admission to a
psychiatric inpatient unit may present as an opportune time for
improving diabetes care. Methods We undertook (i) a survey of diabetes
care among inpatients in a Mental Health Trust in England, comparing
care to the National Health Service (NHS) Core National Diabetes
Standards (ii) interviews with key clinical staff to understand
challenges in delivering good diabetes care (iii) a review of current UK
guidance on standards for diabetes care. On the basis of the findings we
developed an initial logic model for service delivery. Results Among 163
inpatients reviewed, 44 (27%) had a diagnosis of diabetes, and only
three (7%) had all three National Institute for Health and Care
Excellence (NICE) treatment targets within range. Staff identified needs
for regular training, better understanding of roles in shared care, and
good quality IT support. We developed a logic model that illustrates the
steps needed to develop an effective intervention for diabetes
management in a psychiatric inpatient setting. Clinical Implications
Admission to a psychiatric inpatient setting provides an opportunity in
which diabetes care may be optimised. The quality and understanding of
diabetes care will need to be enhanced if this opportunity is to be
exploited.