Oklahoma Area Model Diabetes Programs

Claremore Diabetes Program
Lawton Service Unit Model Diabetes Program


Claremore Diabetes Program
Claremore, Oklahoma

Melanie Sipe, RN, MSN, Coordinator
P H S Indian Hospital
101 South Moore Ave.
Claremore, Oklahoma 74017
Phone: (918) 342-6451
FAX: (918) 342-6585
melanie.sipe@ihs.gov

Program Description

Diabetes education program maintains the American Diabetes Association Diabetes Education Recognition since 1988. Program staff includes: family nurse practitioner/certified diabetes educator (C D E), registered dietitian/C D E, registered nurse, certified pedorthist, program sercretary, computer assistant, clinic clerk, pharmacist (P h D, C D E) and contract podiatrist. Consultation with Cherokee Nation Community Health public health nurses for diabetes screening and blood sugar monitoring.

Epidemiology

• Maintain diabetes registry for 3,591 participants. Current active registry--1,536 (people with diabetes and at two visits in 1999)
• Maintain diabetes risk staging: cardiac, kidney, eye, foot, and gums
• Yearly audit of I H S and A D A standards of care and biometric data
• Maintains registry for women with gestational diabetes, screening and follow-up lab
• Audits hospital registry for persons with a diagnosis of diabetes

Clinical

• Family Nurse Practitioner--physicals in yearly diabetes clinic & follow-up (FY 1999 Total 757)
• Screenings--eye: 631, dental:458, foot:593, pap smears: 279
• Nutrition visits: 466
• Physical activity counseling: 647
• Certified pedorthist--foot exams & screening: 637, shoe fitting & shoes, podiatry care: 996

Education Presentations & Consultation

• Professional Workshop: offered from 1986 to 1997: Total number of participants: 373
• C H R Conferences: Lawton 1995 & 1997; O S U 1994-96 with Cherokee Nation P H N 1994-96; Diabetes Management, O K C, 1994 and
• Diabetes Nutrition Conference, O K C, 1995
• Mid-level Providers in O K C 1986, 1988-1989 & Lawton Service Unit National Conference, 1997
• Area Diabetes Conferences, Tulsa, 1984-86, Native American Alaska Native, Tulsa, 1995
• Area Facility Conferences: Carl Albert Hospital, Pawnee, Holton/Haskell, Talihina 1984-86
• Diabetes Prevention and Management Conference, O K C, 1998
• Winnipeg, Canada, Diabetes in Indigenous Peoples International Conference, 1993
• Mesa, A Z, Diabetes in Native Americans and Alaska Natives, 1990
• Dallas Primary Care Conference, Dallas, 1996 and Weatherford, O K, Diabetes Conference, 1998
• O S U Annual Dietitians Conference, 1997 and Langston University School of Nursing 1997-99
• Washington, D. C., Managed Care Conference, 1997
• American Association of Diabetes Educators Annual Meeting 1994-1999
• Commissioned Officers Association Annual Conference, Tulsa, 1997
• Consultations/Preceptorships: Clinton, El Reno, Carl Albert, Miami, Eastern Shawnee, Tulsa and Dallas Urban Centers and Nutrition dietetic interns from O S U and O U Advanced Nurses
• I H S Diabetes Headquarters Program task forces on diabetes education and nutrition education
• Cherokee Nation Diabetes Work Group for Grant Program
• C D C Conference on Diabetes 2000-Poster presentation on New patient program
• Consultation: E P I Info-Support services for annual clinic audits: 14 clinics in O K and Kansas

Community

• Diabetes Family and Leadership Camps: 24 tribes participated, ten tribes continue
• Healthy Baby Picnic: 1992-1994 Women with history of gestational diabetes
• Cherokee Nation Youth Fitness Camps: 1990-1996 Nutrition and fitness
• Support Groups: Claremore, Pawhuska, Coweta, Okmulgee, Sapulpa, Rogers County 1997-1999
• Health Fairs: Ottawa, Pawnee, Salina, Miami, Quapaw, Senecca-Cayuga 1996-1998
• Muscogee National Holiday, Nutrition Booth, 1995-1997
• Walk a Mile Club 1993-1995
• " Choosing Well" a lifestyle change program for people with diabetes and high-risk groups 1988-95
• " Cold Turkey Day" annual smoking cessation event 1988-92
• " Year of the Indian" family fitness walk & run 1992-1994
• Rogers County American Diabetes Association Walk since 1997
• Tulsa Indian Health Care Resource Center board member 1988-90

Resource Development

• New patient program and teaching guide--available on disk, other programs can adapt/modify
• Feelings and diabetes booklet
• Choosing good foods--a self-assessment/educational tool
• Seven things to do when you have protein in your urine
• How to have a healthy baby--gestational diabetes booklet
• Indian women and diabetes brochure
• Risk staging for six major complications
• Log book for diabetes management, developed with Cherokee Nation.

Unique Contribution

• American Diabetes Education Program Recognition. Able to supply resources and lessons learned and curriculum materials to other programs (disks available upon request).

Lawton Service Unit Model Diabetes Program
Lawton, Oklahoma

Claire Turner, Coordinator
Lawton Service Unit
1515 Lawrie Tatum Road
Lawton, OK 73501
Phone: (580) 353-0350 Ext. 560
FAX: (580) 353-3039
E-mail: Claire.Turner@ihs.gov

Program Description (Established 1995)

The diabetes program functions to provide specialized education and services in the care of persons with diabetes and people at high risk for diabetes. Program staff includes: registered dietitian/certified diabetes educator (C D E), registered nurse/C D E, contract podiatrist, contract ophthalmologist, office automation clerk, nurse assistant, community nutritionist/registered dietitian, optometry resident, contract dentist.

Data & Epidemiology

• 1,661 patients with diabetes in the Lawton Service Unit covering a 10 county area.
• 37,667 service population (Lawton, Anadarko, & Carnegie)
• Registry started for gestational, amputations, dental, eye, heart, and kidney patients.

Clinical Accomplishments

• Training to healthcare providers, Diabetes Team and Tribal Leaders
• Monitors diabetes care according to Standards of Care through annual diabetes audit.

Primary Prevention

• Education to patients and family members who are at high risk for diabetes
• Resource center for educational materials and technical assistance.

Secondary Prevention

• Provides blood sugar meter supplies, medications, dentures, shoes & orthotics
• Education by Certified Diabetes Educators (Registered Dietitian and Registered Nurse).
  

Tertiary Prevention

• High-risk foot programs by contract podiatrist
• Laser treatments provided on site by contract ophthalmologist
• Optometry program by optometry resident.
  

Community Activities

• Development of screening guidelines for CHRs
• Screening for diabetes at community events
• Technical assistance to tribes for "Strong in Body & Spirit" programs
• Nutrition & fitness education by public health nutritionist for Head Start & Senior nutrition staff & clients
• Presentations and information dissemination at health fairs and other community events.
  

Unique Approach

• Modification of local recipies.
  

Education Programs

• In-service training for professionals & paraprofessionals (W I C, C H R's & other tribal health staff)
• Individual and family education program targeted for newly diagnosed, gestational, & patients at high risk for diabetes patients.

Resource & Product Development

• Health maintenance summary & overprinted P C C for patient charts
• Educational posters for health fairs, HeadStart & Senior Nutrition Centers
  " My Health Record" for people with diabetes.
  

Challenges

• Limited staff and budget to meet needs of population
  

Unique Contributions

• Resources shared to improve health of patients and their families
• Resources shared to improve knowledge of healthcare staff, tribal workers, and communities.