Developing the 2020 Diabetes Care & Education Specialist Competencies: A Modified Delphi Study.

PURPOSE: The purpose of the study was to develop diabetes care and education specialty competencies that align with the Association of Diabetes Care & Education Specialists (ADCES). METHOD: A Delphi method of consensus development was used, comprising 5 survey rounds. Interprofessional diabetes specialty experts were asked to identify and rate trends and issues important to diabetes specialists on a global scale. Use of a 5-round Delphi process allowed diabetes care and education specialty experts to refine their views considering the progress of the group's work from round to round. RESULTS: A total of 457 diabetes care and education specialists across the United States in various professions participated in the Delphi rounds to identify a final set of 130 competencies across 6 domains. CONCLUSION: Use of the Delphi method as a consensus guideline helped to identify core competencies for diabetes care and education specialists, reflecting the knowledge and skills necessary to provide evidence-based, high-quality care.

Competencies for Diabetes Care and Education Specialists.

PURPOSE: Diabetes care and education specialists provide collaborative, comprehensive, and person-centered care and education to people with diabetes and cardiometabolic conditions. The implementation of the vision for the specialty has prompted the need to reexamine the knowledge, skills, and abilities necessary for diabetes care and education specialists in today's dynamic health care environment. The purpose of this article is to introduce an updated set of competencies reflective of the profession in this dynamic health care environment. Diabetes care and education specialists are health care professionals who have achieved a core body of knowledge and skills in the biological and social sciences, communication, counseling, and education and who have experience in the care of people with diabetes and related conditions. Members of this specialty encompass a diverse set of health disciplines, including nurses, dietitians, pharmacists, physicians, mental health professionals, podiatrists, optometrists, exercise physiologists, physicians, and others. The competencies are intended to guide practice regardless of discipline and encourage mastery through continuing education, individual study, and mentorship. CONCLUSION: This document articulates the competencies required for diabetes care and education specialists in today's dynamic health care environment as they pursue excellence in the specialty.

Local anesthesia before IV catheterization.

BACKGROUND: Intradermal buffered lidocaine is known to be effective in producing local anesthesia prior to IV catheterization. Recently, intradermal bacteriostatic normal saline has been suggested as a possible alternative. OBJECTIVE: To compare the efficacy of intradermal bacteriostatic normal saline with that of intradermal buffered lidocaine in providing local anesthesia to adult patients prior to IV catheterization. METHODS: In a randomized, double-blind, parallel-design, quasiexperimental study, we compared pain ratings of adult patients receiving either intradermal buffered lidocaine or intradermal bacteriostatic normal saline before IV catheterization. We measured pain at venipuncture through the use of a verbal numeric rating scale, used the test to compare group differences, and performed an analysis of covariance to test for outcome differences related to age, sex, and race or ethnicity. RESULTS: The final sample (N = 148) was 65% women and 82% white, with a mean age of 52 years (range, 19 to 80 years). Demographic characteristics between the two treatment groups were similar. Intradermal buffered lidocaine was demonstrated to be significantly superior to intradermal bacteriostatic normal saline in reducing the pain of IV catheterization (P = 0.007). Differences in pain ratings between the two groups were not associated with age, sex, race or ethnicity, catheter size, or location of the IV site. CONCLUSIONS: Intradermal buffered lidocaine was superior to intradermal bacteriostatic normal saline in providing local anesthesia prior to IV catheterization in this group of predominately white adults and should be the solution of choice for venipuncture pretreatment.