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Pictured Above: Cathy Page, Registered Nurse and Certified Diabetes Educator at St. Joseph's Healthcare Hamilton's King Campus demonstrates how to integrate exercise into one's daily routine. Cathy acts as instructor in the group classes within the Adult Diabetes Program

By implementing a Nursing Best Practice Guideline (BPG) developed by the Registered Nurses’ Association of Ontario (RNAO), registered nurses at St. Joseph’s Healthcare Hamilton are helping patients with diabetes self-manage their care with a client centred approach for patient  learning in the classroom.

Almost 2.4 million Canadians (6.8%) are living with diabetes according to a Public Health Canada statistic and the causes of type 2 diabetes in particular are complex. Risk factors include advancing age, obesity, physical inactivity, certain ethnicities, and a family history of diabetes.[1] For the approximately 200,000 newly diagnosed patients in Canada,  learning about how to self-manage their symptoms in order to live a healthy life can feel overwhelming.

“When I first learned I was diagnosed one of the first things we did was visit St. Joseph’s Healthcare Hamilton’s Adult Diabetes Program,” says Jim Belcoski, Stoney Creek resident who has taken the entire curriculum of group classes at the King Campus Adult Diabetes Program. “It was upsetting at first when we heard the diagnosis. It’s something you think happens to other people,” adds his wife Doreen Belcoski, who accompanied Jim the sessions.

St. Joseph’s Healthcare Hamilton’s Adult Diabetes Program at the King Campus in Stoney Creek offers one-on-one sessions with registered nurses and group classes where patients learn important diabetes related information such as  how to test and read their blood sugar levels, how to carefully read food labels and how to incorporate exercise into daily life.

Paula Eyles, Clinical Nurse Specialist in Patient Education examined the effectiveness of St. Joseph’s Healthcare Hamilton’s Adult Diabetes Program classroom curriculum and instruction techniques – by going back to school and attending every class. “I spent time in each of the classes and spoke to patients about the best way to create a safe, shame and blame free environment where the learning agenda is set by our patients,” explains Paula.

The program’s registered nurses incorporate the evidenced-based Best Practice Guideline of Facilitating Client Centred Learning into the introductory group classes  by inspiring group discussion and posing questions that ask each participating client to consider their unique needs. Other new techniques the registered nurses have incorporated include using props for physical demonstrations – like using a can of kidney beans to consider nutrition label reading and then showing how the same can of beans could be used as a weight for resistance training exercise.

“As practitioners, we often work with timelines and templates, but implementing this Best Practice Guideline has taught me that it is not about my agenda, it’s about what the patient thinks is important to learn about in the class and it’s my job to inspire them all, “ says Cathy Page, Registered Nurse and Certified Diabetes Educator. “The reason client centred learning works is because the patients become our partner in care. When diagnosed with diabetes, patients who come to  class are often surprised that  they can manage diabetes symptoms quite easily in some cases.”

“Thanks to nurses like Cathy, my husband and I have learned so many ways to manage Jim’s diagnosis,” says Doreen. “I know the time in the classroom is sticking with him because today for the first time he came with me to an exercise class!”

During The RNAO’s Nursing Week 2014 (May 12th to 18th) St. Joseph’s Healthcare Hamilton is celebrating patient-focused care provided by dedicated, innovative and compassionate registered nurses across the organization by sharing their stories.

 “The client centred learning initiative in our Adult Diabetes Program is just one of the ways our registered nurses are collaborating to implement a Best Practice Guideline set out by the Registered Nurses’ Association of Ontario (RNAO) with positive outcomes,” explains Sandra Ireland, Director of Nursing Practice, St. Joseph’s Healthcare Hamilton. “St. Joseph’s Healthcare Hamilton is proud to be a Best Practices Spotlight Organization.”



[1] Diabetes in Canada: Facts and figures from a public health perspective, Public Health Canada, Website Link


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