Australian College of Nursing
Recommendations from the Australian College of Nursing on peripheral IV catheters, blood glucose self-monitoring, antipyretics, urinary catheters & x-rays for ankle trauma. The Australian College of Nursing (ACN) is the national professional organisation for nurses in health and aged care settings. ACN provides nursing expertise to government and key stakeholders, and seeks to enhance the expertise of nurses when providing leadership and contribution to policy, practice and delivery of health care.
2.
Don’t restrict the ability of people with diabetes to self-manage blood glucose monitoring unless there is a clinical indication to do so.
Imposing unnecessary blood glucose monitoring regimes that needlessly change a person’s routine, and are random, low frequency or do not provide patients or health care professionals with information that is of value in managing diabetes, will not enhance therapeutic goals.
Glycaemic control is pertinent to the management of Diabetes Mellitus (DM), with self-management a valuable tool in reducing the incidence of complications, improving HbA1c levels*, enhancing quality of life and reducing related health care costs.
The ability to self-care also empowers people and helps to engage them in developing and maintaining behaviours and lifestyle choices that result in improved long-term health outcomes. Blood glucose monitoring should provide feedback relevant to a person’s management plan, including frequency of timing and testing. In addition, unclear or inconsistent monitoring interventions can be needlessly traumatic, may confuse patients and even discourage them from the self-management process.
*The glycosylated haemoglobin (HbA1c) test shows an average blood glucose level over 10–12 weeks.
Supporting evidence
- Pulvirenti M, McMillan J, Lawn S. Empowerment, patient centred care and self-management. Health Expectations 2014;17(3):303-310.
- Funnell M, Anderson RM. Empowerment and self-management of diabetes. Clinical Diabetes 2004;22(3):123-127.
- Ahola AJ, Groop PH. Barriers to self-management of diabetes. Diabetic Medicine 2013;30(4):413-20.
- *National Diabetes Services Scheme 2015, Blood Glucose Monitoring, viewed 4 March 2016, https://www.ndss.com.au/blood-glucose-monitoring-information-sheet
How this list was made
The Australian College of Nursing (ACN) as nursing lead, established a collaborative working party incorporating a diverse range of nursing expertise. Professional nursing bodies involved in initial collaboration included: Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM); CRANAplus; Australian Primary Health Care Nurses Association (APNA); Australian College of Mental Health Nurses (ACMHN).
ACN’s membership was consulted via publications, web site and ACN’s National Nursing Forum. This consultation provided a broad view from our members regarding planning and delivery of nursing care across Australia. An interactive session invited delegates to actively participate in identifying those nursing practices, interventions, or tests that evidence shows provide no benefit or may even lead to harm. This informative stimulating session examined a range of nursing practices and their effects on healthcare consumers.
At this point specialist nursing groups were approached for comment on our recommendations. This group included: Australasian College for Infection Prevention and Control (ACIPC); Australian Diabetes Educators Association (ADEA); Continence Nurses Society Australia (CNSA); Australian and New Zealand Urological Nurses Society (ANZUNS); Medical Imaging Nurses Association (MINA); and the Australian and New Zealand Orthopaedic Nurses Association (ANZONA). Final consultation with ACN Members and Fellows prior to submission ensured a collaborative result.
- 1 Don’t replace peripheral intravenous catheter unless clinically indicated.
- 2 Don’t restrict the ability of people with diabetes to self-manage blood glucose monitoring unless there is a clinical indication to do so.
- 3 Don’t routinely administer antipyretics with the sole aim of reducing body temperature in un-distressed children.
- 4 Don’t use urinary catheters to manage urinary incontinence unless all other appropriate options have proved to be ineffective or to prevent wound infection or skin breakdown.
- 5 Don’t initiate plain X-ray for foot and ankle trauma unless criteria of the Ottawa Ankle Rules are met.