Best Practice Case Study
DAFNE type 1 diabetes training course for healthcare professionals is award nominated after moving online.
DAFNE – Dose Adjustment For Normal Eating – is a training course to help people with type 1 diabetes lead as normal life as possible while maintaining blood glucose levels within healthy targets, to reduce the risk of long-term diabetes complications.
The aim is to give people the skills to take the guesswork out of insulin adjustment, enabling them to optimise their blood glucose while reducing the risks of having a severe hypo and improving their quality of life.
By focusing on their insulin requirements on a meal-by-meal basis and taking into account things like exercise, alcohol or eating out, unrestricted food choices can be made. DAFNE teaches the importance of taking the right amount of quick acting insulin for a person’s individual needs and provides guidance on how to adjust quick acting insulin for illness and exercise.
DAFNE provides training for people with type 1 diabetes aged over 17 years and also for healthcare professionals to allow them to provide this life-changing training for groups of six to eight participants.
Responding to COVID-19
The advent of COVID-19 resulted in all DAFNE courses being cancelled. When lockdown ended, social distancing requirements, especially for a clinically vulnerable group, meant that very few courses could be delivered. In response to these challenges, the national DAFNE programme developed an online learning and remote group DAFNE course, ensuring that the same high-quality education could be provided, maintaining the group interaction without the need for face-to-face contact. The team also developed training for healthcare professionals on how to deliver this new course, with the HCP training following a similar online and virtual group format.
The training for people with type 1 diabetes was first to go online in July 2020. The Remote DAFNE course is a blend of online learning, workbook activities and remote group sessions facilitated by DAFNE educators. Since July 2020, over 1,200 people with type 1 diabetes have completed a Remote DAFNE course, and 95 per cent of participants would recommend the Remote course to other people living with type 1 diabetes. The Remote DAFNE course won the 2021 Diabetes UK Education and Management award.
Training for existing DAFNE HCPs on how to deliver the Remote DAFNE course was developed in parallel to the patient course; this was then followed by the remote training programmes for new educators (RDEP) and doctors (RDDP). These were launched in the final quarter of 2020 and led to DAFNE being shortlisted in the category ‘Best Diabetes Education Programme for Healthcare Professionals’ at this year’s Quality in Care (QiC) Diabetes Awards.
There are currently five remote healthcare professional training programmes available:
- Remote DAFNE Doctor Programme – RDDP (for new doctors)
- Remote DAFNE Educator Programme – RDEP (for new educators)
- Remote Pump conversion training (for existing educators)
- Remote Educator conversion training (for current educators)
- 5×1 DAFNE training (for existing educators)
To date more than 569 diabetes nurses, dietitians and diabetologists from 92 diabetes services across the UK and Republic of Ireland have completed one of the DAFNE healthcare professionals training courses and have delivered more than 355 Remote DAFNE courses to over 1,260 people living with type 1 diabetes.
As of August 2021, there have been more than 53,800 graduates from the DAFNE programme and more than 8,000 courses have been delivered.
Research and ongoing audit have shown the DAFNE course improves blood glucose control, with 40 per cent of participants achieving a target HbA1c of 58mmol/mol. DAFNE also reduces severe hypoglycaemia by 75 per cent and diabetic ketoacidosis by 80 per cent while improving diabetes-related quality of life.
“I’m so proud of the DAFNE team for all they have achieved over the past year and a half,” said Gillian Thompson, National Director of the DAFNE Programme. “It has certainly not been an easy time and they have done a fantastic job in adapting our services so that people could continue to access them safely during the pandemic. This is definitely a format we will be keeping going into the future and keep them as engaging and interactive as possible.”
Feedback from people with type 1 diabetes and healthcare professionals:
“The remote course is a lot more manageable for people who have jobs.”
“Learning from other people with diabetes is the best part of the course.”
“Going on DAFNE was like a light going back on in my life after 13 years of living in the gloom.”
“Don’t underestimate the impact that DAFNE has had on our lives. Not just us, but those around us too. My wife and my girls have got a husband and dad who is much more relaxed about his type 1 than before 2007.”
“What does DAFNE mean to me…time to spend with and learn about the lives of people living with Type 1 diabetes and to help them with extra tools for the job.” - Stella Rushton, Diabetes specialist nurse, University Hospitals of Derby and Burton NHS Foundation Trust.
“The RDEP workshops have prepared me and I feel I can deliver the course confidently.”
“I wasn’t confident with giving advice about type 1 diabetes and exercise before the Remote DAFNE Doctor Programme.”