Integrated care pathway for diabetes identified in pregnancy

Abstract

Summary

We developed an integrated care pathway for diabetes identified in pregnancy largely based on National Institute of Clinical Excellence (NICE) CG063 - Diabetes in Pregnancy (2008). As well as providing the integrated care pathway (ICP) for clinicians to consider using in their units, this article describes the process used, and the lessons learned, during the project. The ICP runs from the point of diagnosis to the early postnatal period. It covers glycaemic management, care of diabetic complications, obstetric care (antenatal and intrapartum), thromboprophylaxis and influenza vaccination. It is used by physicians, obstetricians, dieticians, specialist diabetes nurses and specialist midwives. An audit showed a high degree of compliance with a care bundle derived from NICE CG063 (2008). We felt that it systemized our clinical processes and reduced errors of omission. Alongside the production of the ICP, a patient information leaflet was written to support women in making choices during pregnancy and afterwards.