blood glucose monitoring protocol · 2 sh cp 158 blood glucose monitoring protocol version: 3 april...

1 SH CP 158 Blood Glucose Monitoring Protocol Version: 3 April 2018

SH CP 158

Blood Glucose Monitoring Protocol

Version: 3

Summary:

This protocol provides direction and guidance for blood glucose monitoring.

Keywords (minimum of 5): (To assist policy search engine)

Diabetes, Blood, Glucose, Monitoring, Protocol, Competencies, competence

Target Audience:

All staff carrying out blood glucose monitoring employed by Southern Health NHS Foundation Trust.

Next Review Date: April 2021

Approved & Ratified by:

Medicines Management Committee

Date 21/3/18

Date issued:

April 2018

Author:

Steve Coopey, Head of Clinical Development

Sponsor:

Medical Director


Version Control

Change Record

Date Author Version Page Reason for Change

16/7/15 Steve Coopey 2 Review of existing protocol

Jan 18 Steve Coopey 3 12

Review of existing protocol / change of meters Section 10.3 eVerification for MH inpatient nurses

Jan 18 Mel Clemetson 3 11 9 8

Performa meter ranges added (section 9) Advise if meter dropped added (section 8.4) Wait for blood drop time 10-20 secs 6.10 clarification of procedure for new meter steps 2,7,9,12, Section 6 meter limitation and quality control for new meter See 6.3.1, 6.4, 6.4.1, 6.6, 6.6.1

Jan 18 Maggie McDonald

3 12 NICE reference updates (section 12)

Reviewers/contributors

Name Position Version Reviewed & Date

Marie Corner Medical Device Advisor 21/5/13

Steve Coopey Practice Development Specialist Nurse 26/6/13

Caroline Atkinson Maggie McDonald

Lead Diabetes Specialist Nurse Diabetes Specialist Nurse

11/3/15

Theresa Lewis Lead Infection and Prevention Control 25/6/13

Marie Corner Medical Devices Lead Feb 2015

Jacky Hunt Infection Control Nurse Feb 2015

Caroline Atkinson/ Maggie McDonald Diabetes Specialist Nurses 11/3/15

Kate Fayers Consultant Diabetologist 15/7/15

Mel Clemetson Training Specialist Roche Diagnostics Ltd 4/1/18

Maggie McDonald Diabetes Nurse Specialist Jan 2018


Contents

Page 1. Introduction 4 2. Status 4 3. Scope 4 4. Definitions 4 5. Responsibilities 5 6. Blood Glucose Monitoring 5 6.1 Rationale for procedure 5

6.2 Meter Limitations 5

6.9 Equipment required for blood glucose monitoring procedure 6

6.10 Procedure 7 7. Decontamination 8 8. Advice and Guidance 8 9. Blood Glucose Monitoring Protocols 9 10. Training strategy 12 11. Monitoring compliance 12 12. Associated documents/ References 12 Appendices A Blood glucose monitoring clinical competency 13 B Annual Self-Assessment Competency Statement 16 C LEaD (Leadership, Education & Development) Training Needs Analysis 18


Blood Glucose Monitoring Protocol 1. Introduction 1.1 This protocol has been developed to provide direction and guidance through which

services are expected to manage the risks associated with the process of clinical testing in response to the changing nature of health care provision for people with diabetes mellitus.

2. Status 2.1 This is a clinical protocol and defines the boundaries for what course of action is (or

is not) permitted when completing a task 3. Scope 3.1 The contents of this document apply to all staff (including permanent or bank staff)

employed by Southern Health foundation Trust carrying out blood glucose monitoring.

3.2 Blood Glucose monitoring should only be performed by staff that are trained and

assessed as competent. 4. Definitions 4.1 Registered nurse - The registered nurse is professionally accountable for the

delegation of the task 4.2 Carer - A carer is defined as any paid carer receiving a wage i.e. from social

services, care agencies or under the Local Authority’s Direct Payment Scheme, and who has a NVQ Level 2 or equivalent. This protocol does not apply to self-employed carers.

4.3 Non-registered practitioner - A non-registered practitioner is defined as a Band 3

health care assistant or health care support worker with NVQ level 3 or equivalent, or Band 4 Associate Practitioner working in the community and is employed by Southern Health NHS Foundation Trust.

4.4 Support Worker – non registered staff that work within the trust. 4.5 Health Care Assistant - The Health Care Assistant or other non-registered

member of clinical staff. 4.6 Safer Sharps – all products listed under the Trust safer sharps product list and

designed to minimise the risk of injury to the healthcare worker e.g. single use totally disposable blood lancet with concealed needle.


5. Responsibilities 5.1 The Non Registered Practitioner, Support worker, Health Care Assistant

Are responsible for their actions

It is the responsibility of the individual to work within their scope of practice and job description

It is the responsibility of the individual to ensure that their knowledge and skills are maintained in the area of blood glucose monitoring

Must receive approved training prior to using blood glucose meters, demonstrate competence (Appendix A) and attend 3 yearly update sessions and an annual reassessment of competence by a registered practitioner.

5.2 The Registered Nurse

The registered nurse must receive approved training prior to using a blood glucose meter, demonstrate competence (Appendix A) and must complete an annual self-assessment competency statement (Appendix B)

The registered nurse is accountable for the delegation of all aspects of the blood glucose monitoring and ensuring that anyone delegated to, is competent to carry out the task (NMC 2008). This includes on-going assessment and supervision of practice.

6. Blood Glucose Monitoring 6.1 Rationale for procedure To ensure that all staff using this equipment are aware of its correct and safe use. 6.2 Meter Limitations 6.3 Meter results are not as accurate as laboratory results. Staff must also ensure the

relevant calibration of the meter (if required) has been completed and the record book completed. If the meter result does not seem appropriate to the patients / service user’s clinical condition, always send a venous blood sample to the laboratory for verification.

6.3.1 Roche Performa specific meter limitations

Blood concentrations of galactose >0.83 mmol/L

Triglycerides > 20.3 mmol/L

Intravenous administration of ascorbic acid which results in blood concentrations > 0.17mmol/L will cause over estimation in blood glucose result.

6.4 Quality control solutions obtained in date from the manufacturer must be used to

check meters. Frequency of testing should follow manufacturer’s instructions and all results should be recorded in the quality control book, which is a legal document and must meet record keeping standards. The life of control solution and test strips are limited once opened and so date of first use must be completed on the relevant area of the containers to allow staff to check the products are in date for use. Roche QC solutions expire 3 months from opening. Strips expire from strip box expiry date.

6.4.1 How to quality control the Performa Roche meter

Turn meter on. Insert Inform II test strip into meter in direction of arrows.

Check code number on screen matches test strip pot.


Select level of Accu-Chek Performa Glucose Control Solution. Date with 3 month expiry date (NB ensure the 3 month expiry date after opening is also within overall expiry date). Place meter on a flat surface.

Mix QC, remove lid and wipe tip with tissue. Squeeze bottle to form a drop and touch the front edge of the test strip – do not put solution on top of test strip.

Flashing egg timer displayed when sufficient sample added and test is processing.

Glucose result is displayed in mmol/L – the result appears on the display, along with the control bottle symbol and flashing “L.” Do not remove the test strip yet.

Press once to mark the result as a Level 1. Press twice to mark the result as a Level 2. Then press the on/off button at top of meter to check the result is in the desired range.

“OK” will be displayed if the result is within range. (The range is also printed on the test strip container label). “Err” may be displayed if the result is out of range – repeat QC until result is within range.

Record results in the log book which is a legal document and needs to be kept for 10 years once completed. (25 years if testing babies and children).

Repeat for other level of QC. 6.5 Meters should be stored in a cool place as per manufacturer’s instructions between

4°C-30°C. Meters should not be stored in cars overnight due to the variation in

temperature

6.6 Blood glucose meters used incorrectly could result in erroneous prescribing and

administering of insulin with potentially fatal results. Error codes and troubleshooting advice can be found in the back of the Log book

and in the Roche Performa manual 6.6.1 Contraindications to testing

Impaired peripheral circulation – including poor circulation, shock, hypotension and shut down patients

Severe dehydration

DKA

Decompensated heart failure NYHA class 1V

Oedematous fingers 6.7 The patient / service user’s own blood glucose monitoring equipment and capillary

sampling device must only be used by the patient / service user as these may differ from meters used by the Trust and are not part of the trust quality control process.

6.8 The meter is for monitoring purposes only. IT MUST NOT BE USED FOR

DIAGNOSTIC PURPOSES. Follow manufacturer’s instructions. 6.9 Equipment required for blood glucose monitoring procedure:

Blood glucose meter

Sharps bin

Glucose test strips

Paper towel & tissue

Non-sterile gloves

Single use sampling device


6.10 Procedure

Action Rationale 1. Explain procedure to the patient / service user and ask for and record verbal consent.

1. To inform the patient / service user and obtain evidence of informed consent.

2. Ensure machine is calibrated using corresponding code chip to match strip lot number

2. To ensure meter is correctly calibrated.

3. Ensure meter has quality control (QC) performed. This should be done as a minimum weekly or daily if using for more than one patient such as in a clinic, or before each single use, and when new box of strips started. If opening a new QC solution, record the date on the pot(s) and expiry. Record the QC result in the meter Quality control record book.

3. To ensure the meter is working accurately. QC solution expires after 3 months (12 weeks). QC test records must include serial number of meter and follow record keeping standards.

4. Ask patient / service user to wash their hands with soap and warm water, and dry thoroughly.

4 To ensure there are no traces of sugar, cosmetics or other contaminants on the finger to be pricked, which may give a false reading. To obtain blood sample easily.

5. Staff to decontaminate their hands and put on gloves.

5. To prevent cross infection and contamination by following Trust Infection Prevention and Control Policy: i.e. use soap and water or alcohol gel.

6. Protect work surface with paper towel.

6. To protect patient / service user’s property.

7. Where the meter requires coding, ensure that the code number on the meter display matches that on the test strip.

7. To ensure meter is correctly calibrated. To ensure test strip is in date. Step 7 & 8 could be removed as calibration is covered in step 2

8. Check expiry dates of test strips.

Correct code chip ensures that the strips are in date

9. Remove strip from container and insert into the meter.

8. To start the meter.

11. Use single use safer sharp lancet sampling device.

10. To prevent cross infection and contamination and reduce pain from a blunt lancet and to meet EU Directive 2010/32/EU. To help prevent needle stick injuries

13. Discard single use sampling device in recognised sharps bin.

11. To prevent cross infection, contamination and sharps injury by following Trust infection control and safe disposal of sharps Policy.


12 Prick side of finger (avoid finger pad, thumb and index finger where possible) wait 10-20 seconds and, if drop of blood has not appeared, gently `milk’ finger if necessary by massaging finger from base towards fingertip to help with blood circulation to fingertip ensuring hand is below heart level

12. To reduce discomfort and avoid finger pads where nerves are located for sensitivity. People with diabetes can develop neuropathy and finger pricking in this area will further reduce sensation. Ensuring hand is below heart level will aid blood flow to hand

14. Take the strip in the meter to the blood and ensuring meter and strip are above the drop of blood touch the strip tip into the blood.

13. Blood will be drawn up by capillary action.

15. Wait till meter displays blood glucose reading.

16. Wipe away any blood, with tissue, from the patient’s finger.

15. To avoid bleeding and contamination.

17. Remove and safely dispose of test strip from meter in patient’s waste bin (community) or orange clinical waste (inpatient), Remove gloves and wash hands.

16. To prevent cross infection and contamination by following Trust infection control policy.

18. Document result in patient’s notes and their record sheet or results diary.(QC results should be recorded in meter QC record book).

17. To maintain accurate records and follow Trust policy on record keeping, as these are legal documents.

19 If glucose result is outside target range take appropriate action and follow care plan

To ensure safety of service user

7. Decontamination 7.1 Regular cleaning – the device will need to be included into a regular cleaning

programme. A Clinell sanitising wipe can be used for regular cleaning. This device must be cleaned prior to use on another patient.

7.2 Visible contamination – the device will need to be decontaminated immediately after

use if there is visible contamination e.g. blood. For blood contamination apply 10,000ppm of av, chlorine solution for 3 minutes then wipe off with a Clinell wipe.

If staff have no access to chlorine e.g. mobile community staff, small blood specs

can be cleaned by double wiping with a Clinell wipe (wearing disposable gloves), allowing to air dry in between each wipe. For larger blood contamination, the glucometer must be cleaned with a chlorine solution e.g. actichlor (10,000ppm) on return to base.

8. Advice and Guidance 8.1 All staff undertaking blood glucose monitoring should only use equipment issued to

them individually, or to the team.


8.2 All staff undertaking blood glucose monitoring are responsible for following the

quality control guidelines or as instructed when attending updates locally. 8.3 All staff should only use single use lancet devices that meet EU2010/32 Safer

Healthcare Sharps Directive. For southern health staff these can be obtained from SBS supplies

8.4 If you drop the meter and you are worried that it may be damaged inside please

check the screen by switching the meter off and pressing and holding down on the on/off button. You should be able to see the display.

check that this is all intact 9. Blood Glucose Monitoring Protocols This table identifies the minimum information that is required for local protocols in

relations to blood glucose monitoring in accordance with the clinical diagnostic testing policy.

Diagnostic Test

Blood Glucose Monitoring

Requesting Clinical Tests

Profession/Grade/Role of requester

All clinical staff Band 5 and above and/ or Medical practitioner / care manager.

Competency requirements

Staff must receive approved training prior to requesting and using blood glucose meters and demonstrate competence (Appendix A) and attend update sessions.

Roles and Responsibilities

All staff requesting blood glucose monitoring must ensure patient / service user consent has been given and is undertaken in partnership with the designated medical practitioner. Current NICE guidelines should be followed for frequency of testing and who should be tested, and any local guidelines.

Method for requesting clinical test

Written or verbal message


Reporting Clinical Tests

Profession/Grade/Role of person reporting clinical test.

All clinical staff

Competency requirements

Staff must receive approved training prior to reporting blood glucose tests and demonstrate competence (Appendix A) and attend update sessions.

Roles and responsibilities

All staff reporting blood glucose tests must ensure patient / service user consent has been given and is undertaken in partnership with the designated medical practitioner.

Receiving Clinical test results

Profession/Grade/Role of person receiving clinical test (if different from the person interpreting them)

Registered Nurse Band 5 or above and / or Medical practitioner / care manager. Other staff must report any received results to the manager in charge.

Roles and responsibilities

To inform team of any changes in medication / care plan/ support plan. To report any missing or incomplete data as per trust policy.

Interpreting Clinical Tests

Profession/Grade/Role of person interpreting clinical test.

Registered Nurse Band 5 or above


Only the Registered Nurse is responsible for interpreting the result of the test. Other staff should report abnormal results to the manager in charge.

Normal parameters of glucose in someone without diabetes

Pre prandial 3.5 - 6.0mmol/l Post prandial up to 7.8mmol/l

Normal parameters of test results Type 2 Diabetes.

Pre –prandial (before food) 4-7mmol/l Post prandial (after food) <8.5mmol/l

Normal parameters of test results for Type 1 Diabetes.

Pre –prandial (before food) 4-7 mmol/l Post prandial (after food) <9 mmol/l


Alternative ranges for individual patients

An individualised target range may be agreed for a particular patient; / service user this can only be used if it is documented within the care plan / support plan.

Process if test results within normal parameters

Normal results are recorded in Patient / service use’s notes and reported during handover.

Process if test results outside normal parameters

Abnormal results are recorded in patient / service user’s record and reported immediately to manager in charge and / or medical practitioner. A repeat test may be indicated if clinical condition does not match glucose result Respond appropriately to signs of hypoglycaemia.

Roche Performa Meter ranges

is displayed on the meter when the patients result is > 33.3 mmol

is displayed on the meter when the patients result is < 0.6 mmol/L

Actioning Test Results

Profession/Grade/Role of person actioning clinical test.

All clinical staff


Only the Registered Nurse is responsible for actioning the result of the test. Other staff administering insulin will follow care plan / support plan.

Recording the actions taken

Profession/Grade/Role of person recording clinical test.

All clinical staff

Roles and Responsibilities.

All clinical staff undertaking blood glucose monitoring should record test results in log book and Patient Notes.


10. Training strategy 10.1 All clinical staff employed by Southern Health Trust who are required to undertake

blood glucose monitoring must complete approved training and be assessed by a designated practitioner, using the competencies in Appendix A.

10.2 Additionally Registered Nurses must complete an annual self-assessment

competency statement (Appendix B), unqualified staff must receive an annual reassessment of competence by a registered practitioner (Appendix A) see training needs analysis (Appendix C).

10.3 All registered nurses working in adult mental health inpatient settings must complete

an eVerification of competency every three years. 11. Monitoring compliance 11.1 Audit and compliance with the protocol will follow the principles as set out in the

clinical diagnostic testing policy. Line manager will review competency as part of annual appraisal process

12. Associated documents/ References

Consent to Examination and Treatment Policy

Hand Hygiene Procedure

Infection Prevention and Control Policy

Mental Capacity Act Policy and Guidance

Medicines Control, Administration and Prescribing Policy (MCAPP)

Policy for Managing Incidents

Sharps and Inoculation management

Standard Precautions Procedure

Supporting Service Users to Manage their Medication

Clinical Diagnostic Testing Policy Type 2 diabetes Management of type 2 diabetes NICE NG 28 Dec 2015

Partial update Dec 2017 https://www.nice.org.uk/guidance/ng28

Type 1 diabetes: diagnosis and management of type 1 diabetes NG 17 Aug 2015 https://www.nice.org.uk/guidance/ng17

https://www.nice.org.uk/guidance/ng28

https://www.nice.org.uk/guidance/ng17


Appendix A: Blood glucose monitoring clinical competency

Name:

Role:

Base:

Date initial training completed:

Competency Statement:

The participant demonstrates clinical knowledge and skill in blood glucose monitoring without assistance and/or direct supervision (level 3 - see level descriptors). Assessment in practice must be by a Registered Health Care Professional who can demonstrate competence at level 4 or above.

Performance criteria Assessment method

Level achieved

Date Assessor/self-assessed

1. The participant will be able to demonstrate the knowledge and skills to perform blood glucose monitoring.

a) The reason for the patient needing blood glucose monitoring.

Questioning

b) The limitations of using a blood glucose meter.

Questioning

c) The rationale for calibrating meter, ensuring test strips are in date, performing internal Quality Control (QC) and external Quality Assurance (QA)

Questioning

d) Correct method to obtain blood sample.

Questioning

e) Significance of test results and how to interpret.

Questioning

f) When it is necessary to refer to a GP or the diabetes nurse specialist.

Questioning

2. The participant will be able to demonstrate practical skills in blood glucose monitoring.

a) How to ensure accuracy of meter by demonstrating internal quality control (QC) check

Observation

b) Correct calibration procedure if needed for meter.

Observation

c) How to operate the meter.

Observation

d) Correct procedure for skin preparation.

Observation

e) Correct method to obtain blood sample.

Observation


f) Practices in accordance with Trust Infection Control Policy and Sharps Inoculation and Management Policy to avoid needle stick injury.

Observation

g) Practices in accordance with Trust Infection Prevention and Control Policy and Hand Hygiene Procedure and Standard Precautions Procedure to avoid contamination and cross infection.

Observation

h) Interprets and actions results in accordance with role and responsibilities.

Observation

i) Documents all care given in accordance with Trust policy & procedures.

Observation

Source: SHFT Blood Glucose Monitoring Protocol

Date all elements of competency tool completed to level 3: ……………………………… Name: …………………………………………… Signature: …………………………………….. Status: ………………………………………….. Date: …………………………………………... I confirm that I have assessed the above named individual and can verify that he/she demonstrates competency in blood glucose monitoring. Assessor: ……………………………………… Signature: ……………………………………… Status: …………………………………………. Date: ……………………………………………..

Review dates Competent (yes/no)

Healthcare Professional/ Assessor signature

Verifier signature

Comments


Levels of competency rating scale

Level of achievement Level

Novice Cannot perform this activity satisfactorily to the level required in order to participate in the clinical environment

0

Can perform this activity but not without constant supervision and assistance

1

Can perform this activity with a basic understanding of theory and practice principles, but requires some supervision and assistance

2

Competent Practitioner

Can perform this activity with understanding of theory and practice principles without assistance and/or direct supervision

3

Can perform this activity with understanding of theory and practice principles without assistance and/or direct supervision, at an appropriate pace and adhering to evidence based practice At this level competence will have been maintained for at least 6 months and/or is used frequently (2-3 times /week) The practitioner will demonstrate confidence and proficiency and show fluency and dexterity in practice This is the minimum level required to be able to assess practitioners as competent

4

Can perform this activity with understanding of theory and practice principles without assistance and/or direct supervision, at an appropriate pace and adhering to evidence based practice. At this level the practitioner will be able to adapt knowledge and skill to special/ novel situations where there maybe increased levels of complexity and/or risk

5

Expert Can perform this activity with understanding of theory and practice principles without assistance and/or direct supervision, at an appropriate pace and adhering to evidence based practice. Demonstrate initiative and adaptability to special problem situations, and can lead others in performing this activity At this level the practitioner is able to co-ordinate, lead and assess others who are assessing competence. Ideally they will have a teaching and /or mentor qualification

6

Adapted from: Herman GD, Kenyon RJ (1987) Competency-Based Vocational Education. A Case Study, Shaftsbury, FEU, Blackmore Press, cited in Fearon, M. (1998) Assessment and measurement of competence in practice, Nursing Standard 12(22), pp43-47.


Appendix B: Annual Self-Assessment Competency Statement Blood Glucose Monitoring

Surname: Forename(s): Dept & Ward/Unit: Job title/designation:

Self-verification of competence is undertaken by assessment against the statements below. These statements are designed to indicate competence to undertake this skill. If you are in any doubt regarding your competence, you should seek education (consider self-directed learning, coaching and formal training) to bring about improvement. Your statement of competence will provide evidence towards the national TREND-UK competence criteria in relation to blood glucose monitoring (section 5.6): For the safe use of blood glucose monitoring and associated equipment you should be able to: 1. Unregistered practitioners Perform the test according to manufacturers’ instructions and local guidelines. Perform the test unsupervised, at the request of a registered nurse. Document and report the result according to local guidelines. Recognise and follow local quality assurance procedures, including disposal of sharps. Recognise hypoglycaemia and be able to administer glucose. Understand the normal range of glycaemia and report readings outside this range to the appropriate person. 2. Competent nurse As above and: Actively seek and participate in peer review of one’s own practice. Interpret the results and report readings outside the acceptable range to the appropriate person. Teach the test procedure to a person with diabetes or their carer. Identify situations where testing for ketones is appropriate. Carry out an initial assessment. You must be able to answer ‘Yes’ to all the questions before considering yourself to be competent. If you are not competent, instigate learning and then repeat self-verification.

Ask yourself the following questions. Initial

assessment date:

Final assessment

date: Do I understand my accountability within the NMC Code (NMC 2015) and my responsibility within the law?( Registered Nurses only)

Yes/No Yes/No

Can I describe the Trust’s policy and procedure with regard to blood glucose monitoring?

Yes/No Yes/No

Can I describe the indications and frequency for blood glucose monitoring?

Yes/No Yes/No

Can I describe the infection control precautions to take when undertaking blood glucose monitoring?

Yes/No Yes/No

Can I describe the appropriate equipment to use in undertaking the procedure for blood glucose monitoring?

Yes/No Yes/No

Can I describe the contradictions and test interferences to be aware of when blood glucose monitoring?

Yes/No Yes/No


Do I know: How to obtain verbal consent? Yes/No Yes/No How to prepare the patient for blood glucose monitoring?

Yes/No Yes/No

When and where to seek help if required? Yes/No Yes/No How to interpret and act upon blood glucose results appropriately

Yes/No Yes/No

How to care for the blood glucose meter and how and when to perform internal quality control (QC) and external quality assurance (QA)

Yes/No Yes/No

How to report an error or clinical incident and what to do if your meter fails QC or QA testing?

Yes/No Yes/No

STATEMENT OF COMPETENCE

I certify that I am aware of my professional responsibility for continuing professional development and that I am accountable for my actions. With this in mind I make the following

statement:

I am competent to undertake Blood Glucose Monitoring without further training Signature: ……………………………………………………………… Date: ………………………

I require further training before I can undertake Blood Glucose Monitoring in a competent manner Signature: ……………………………………………………………… Date: ………………………

Keep this form in your personal portfolio or training record. Ensure your manager has

seen the form when completed.

A new self-assessment competency statement must be completed each year for Appraisal.

Indicate how you plan to meet your learning needs: By when:


Appendix C Training Needs Analysis

Approved for Statutory / Mandatory Training Status Yes / No

If there are any training implications in your policy, please complete the form below and make an appointment with the LEaD department (Louise Hartland, Quality,

Governance and Compliance Manager or Sharon Gomez, Essential Training Lead on 02380 874091) before the policy goes through the Trust policy approval process

Blood Glucose Monitoring

Every 3 years Up to 1 hour e-Video / e-Assessment N/A LEaD Strategic – Director of Nursing Operational – Head of Clinical Development

Directorate Service Target Audience

MH/LD/TQ21

Adult Mental Health

All health care professionals including non-registered practitioners and support workers who care for patients and service users with diabetes or who are required to perform blood glucose monitoring procedure.

Specialised Services


Learning Disabilities


TQtwentyone


ISD’s

Older Persons Mental Health


ISD’s

Adults


ISD’s

Childrens Services


Corporate

All
