tions—including indications, contraindications, warnings,
and adverse effects—before administering pharmacologic
therapy to patients.
1. Zahn D, Langelieer M, Moore J, Legendre Y, Edwards T. The New York State Health
Foundation’s Diabetes Policy Center and The Center for Health Workforce
Studies. Certified diabetes educators in New York: Findings from a state-wide
market analysis and recommendations for improving access to diabetes self-management education services. March 2010. http://nyshealthfoundation
-march-2010.pdf. Accessed January 15, 2013.
PACT RNs Describe Value, Impact of SCAN-ECHO DSME on Patient Care
Nurses are a vitally important part of the health care team; a nurse is often the first person that the patient sees
when attending an appointment. Patients confide in and look to their nurses for many things, particularly education and advice. The SCAN-ECHO Diabetes Self-Management Educator program (SCAN-ECHO DSME) is
designed to enhance the skills of these important patient advocates. Three such advocates discuss their experiences with the SCAN-ECHO program:
Jeannette Richardson, MS, RN, Clinical Nurse
Specialist (Primary Care)
A small group of our PACT RN care managers were invited to attend the SCAN-ECHO DSME course and our
division leaders decided to offer this set of 14 weekly
classes to our telehealth RNs. Because we do not have a
local diabetes class for nurses and many of our staff are
interested in becoming CDEs, the group was very enthusiastic about starting. Like many other VA facilities, we
care for a lot of diabetic patients.
The classes were an immediate hit! The staff appreciate
the interactive nature of the sessions. Participants bring
real-life scenarios to the group of content experts to re-
ceive helpful explanations, as well as guidance, on future
patient care efforts. Despite some initial reluctance to
present a case study to a national group, the nurses were
excited to receive ideas for handling challenging patient
scenarios from the content experts. Presentation of a
case study was an additional professional growth experi-
ence, as it has helped the RNs frame a patient problem
and collaborate in how to problem-solve. After the ses-
sions, we often discuss what we have learned.
The attendees have learned much from each session
and I have received requests from many other RNs who
are interested in this program. I hope that this interactive
strategy with case studies presented alongside didactic
content will continue to be available on an ongoing basis.
Thanks for all your hard work on behalf of our staff and,
of course, our veterans.
Anne Clark, RN (Primary Care)
I have been very grateful for the SCAN-ECHO DSME pro-
gram. I have been able to manage patients with diabetes
with more confidence and independence, thus opening
up access for primary care physicians (PCPs). I have
been able to teach patients self-management skills using
the various tools we were provided. I have learned how
to teach patients a more reasonable and realistic food
plan using compromise, rather than exact weights and
measures. I have seen patients’ self-confidence rise as
they learn to make better food choices and manage their
own insulin titration. I have seen patients “buy in” to their
own treatment plans, including increased attention to foot
care, compliance with blood glucose monitoring, being
prepared for case manager visits (phone or face-to-face),
and improved adherence to their insulin regimens.
All of this has generated better outcomes, with fewer
unscheduled walk-in visits and urgent visits. My own job
satisfaction has increased tremendously, as I am able to
immediately apply the information learned in the SCAN-ECHO classes. I hope you plan to continue this program.
It is an asset for PCPs and veterans.
Frances Bell Banks, RN (Endocrine Clinic)
I think that the SCAN-ECHO DSME program is excellent. It gave me a lot of common-sense information to
use with patients. The information on [blood glucose]
meters was just what I needed. Being new to the VA,
I was not very familiar with the [blood glucose] meter
that we use. The meter class taught me helpful information that needed to be passed on to patients and that
patients may not know. Patients tend to use the meter
without reading the manual. Many of my patients don’t
even know that the meter will not automatically update
the date and time. Not being a CDE, this class has given
me a lot of information on motivational interviewing skills.
Also, an excellent review of medications was presented.
When I could not attend the teleconference, I really appreciated being able to listen on the phone line. Thank
you for the opportunity to attend.
2. Butcher MK, Gilman J, Meszaros JF, et al. Improving access to quality diabetes education in a rural state: The Montana quality diabetes education initiative. Diabetes
3. American Academy of Family Physicians, American Academy of Pediatrics, American College of Physicians, American Osteopathic Association. Joint principles
of the patient-centered medical home. February 2007. http://www.aafp.org/dam
/AAFP/documents/practice_management/pcmh/initiatives/PCMHJoint.pdf. Accessed January 15, 2013.
4. Siminerio LM, Piatt G, Zgibor JC. Implementing the chronic care model for
improvements in diabetes care and education in a rural primary care practice.
Diabetes Educ. 2005;31(2):225-234.
5. Tricco AC, Ivers NM, Grimshaw JM, et al. Effectiveness of quality improvement strategies on the management of diabetes: A systematic review and meta-analysis. Lancet. 2012;279(9833):2252-2261.