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18.11.2013.
 

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Z danych uzyskanych od prof. dr hab. n. med. Krzysztofa Strojka, Konsultanta Krajowego w dziedzinie diabetologii (z 5 czerwca br.) wynika, że Narodowy Fundusz Zdrowia kontraktuje świadczenia ambulatoryjne w diabetologii w ponad 700 podmiotach i w każdej placówce powinien być zatrudniony edukator.

Obecnie tytuł specjalisty w dziedzinie pielęgniarstwa diabetologicznego ma 246 pielęgniarek.

W ramach Narodowego Programu Walki z Cukrzycą na konferencji metodycznej Komisji ds. Edukacji tego Programu w 1998 r. w Łodzi opracowano zasady kształcenia edukatorów cukrzycy i przekazano do Ministerstwa Zdrowia.

24 stycznia 2009 r. odbyło się spotkanie przedstawicieli Polskiego Stowarzyszenia Diabetyków, którzy powołali Komitet Inicjatywy Ustawodawczej, z zamiarem opracowania i złożenia do laski marszałkowskiej projektu ustawy o cukrzycy. Według PSD, w projekcie Ustawy powinny znaleźć się rozwiązania dotyczące finansowania m.in. systemu szeroko pojętej edukacji z wprowadzeniem zawodu "edukator".

Departament Pielęgniarek i Położnych Ministerstwa Zdrowia zatwierdził w lutym 2011 r. ramowy program kursu specjalistycznego dla edukatorów diabetologicznych. Jego celem było przygotowanie pielęgniarek i położnych do prowadzenia i koordynacji działań związanych z edukacją terapeutyczną. Program został opracowany w porozumieniu z Naczelną Radą Pielęgniarek i Położnych.

Co w programie kursu Edukator w cukrzycy?

Łączna liczna godzin przeznaczonych na realizację programu kształcenia kursu specjalistycznego Edukator w cukrzycy wynosi 120 godzin dydaktycznych, z czego zajęcia teoretyczne – 84 godzin (w tym 40 godzin zajęć warsztatowych/ćwiczeniowych), a zajęcia praktyczne – 36 godzin (po 12 godzin w oddziale diabetologii dla dorosłych, dla dzieci oraz w poradnii ginekologicznej lub oddziale patologii ciąży).

Zgodnie z programem ramowym, w wyniku realizacji programu kształcenia kursu pielęgniarka/położna powinna:
- scharakteryzować cukrzycę jako chorobę cywilizacyjną,
- omówić zasady opieki diabetologicznej,
- prowadzić działania edukacyjne u osób z cukrzycą zgodnie z zasadami dydaktyki,
- różnicować metody działań edukacyjnych u osoby z cukrzycą w zależności od uwarunkowań: biologicznych, psychologicznych, ekonomicznych, społeczno- kulturowych,
- dobierać i wykorzystywać metody, formy i środki dydaktyczne stosowane w edukacji osób z cukrzycą,
- realizować aktualne programy edukacji pacjenta z cukrzycą typu 1 i z cukrzycą typu 2,
- rozpoznawać, planować, realizować, oceniać i dokumentować działania edukacyjne nad osobą z cukrzycą i jej rodziną,
- planować i prowadzić edukację kobiety ciężarnej z cukrzycą przedciążową oraz z cukrzycą ciążową,
- określać i wykorzystywać czynniki motywujące pacjenta do świadomego udziału w terapii oraz pomagać w akceptowaniu choroby,
- edukować pacjenta w zakresie zapobiegania powikłaniom w przebiegu cukrzycy i chorób współistniejących,
- wdrażać standardy i procedury edukacji terapeutycznej nad osobą z cukrzycą i jej rodziną,
- przygotować pacjenta z cukrzycą i jego rodzinę do samokontroli i samoopieki,
- współpracować z samorządami lokalnymi, organizacjami społecznymi, grupami wsparcia i samopomocy,
- organizować własne stanowisko pracy,
- uczestniczyć w procesie kształcenia i doskonalenia zawodowego oraz w pracach organizacji naukowych i stowarzyszeń zawodowych.

W 2011 r. i 2012 r. na terenie całego kraju kurs specjalistyczny "Edukator w cukrzycy" ukończyło 674 pielęgniarek i położnych. Jak wynika z planów kształcenia podyplomowego pielęgniarek i położnych, przedkładanych przez organizatorów do Centrum Kształcenia Podyplomowego Pielęgniarek i Położnych, 17 organizatorów zaplanowało realizację 46 edycji ww. kursu na I i II półrocze 2013 r. Z Ewidencji Organizatorów wynika, że uprawnienia do realizacji ww. kursu posiada 34 organizatorów (stan na 26 września 2013 r.).

Nowe stanowisko w szpitalach


Rozporządzenie Ministra Zdrowia z 20 lipca 2011 r. w sprawie kwalifikacji pracowników na poszczególnych stanowiskach pracy w publicznych zakładach opieki zdrowotnej (Dz. U. Nr 151, poz. 896) wprowadziło stanowisko edukatora do spraw diabetologii. Kwalifikacje wymagane odpracowników na stanowisku edukatora ds. diabetologii wymienione są w załączniku do rozporządzenia.

Zgodnie z tym załącznikiem na stanowisku edukatora do spraw diabetologii może być zatrudniona osoba, która posiada:
- magisterskie wykształcenie pielęgniarskie i specjalizację w dziedzinie pielęgniarstwa diabetologicznego oraz 2-letnie doświadczenie zawodowe
- licencjat pielęgniarstwa i specjalizację w dziedzinie pielęgniarstwa diabetologicznego oraz 2-letnie doświadczenie zawodowe
- co najmniej średnie pielęgniarskie i specjalizację w dziedzinie pielęgniarstwa diabetologicznego oraz 2-letnie doświadczenie zawodowe
- inne magisterskie wykształcenie pielęgniarskie i kurs specjalistyczny w dziedzinie edukator w cukrzycy oraz roczne doświadczenie zawodowe w ośrodku o profilu diabetologicznym
- licencjat pielęgniarstwa i kurs specjalistyczny w dziedzinie edukator w cukrzycy oraz 5-letnie doświadczenie zawodowe w ośrodku o profilu diabetologicznym
- co najmniej średnie wykształcenie pielęgniarskie i kurs specjalistyczny w dziedzinie edukator w cukrzycy.

W okresie przejściowym (do 2020 r.) rozporządzenie dopuszcza, że pracownik na stanowisku edukator ds. diabetologii nie będzie się legitymować specjalistycznym wykształceniem podyplomowym, ale musi mieć określony staż w ośrodku o profilu diabetologicznym.

Z kolei rozporządzenie Ministra Zdrowia z dnia 15 września 2011 r. zmieniające rozporządzenie w sprawie świadczeń gwarantowanych z zakresu leczenia szpitalnego wśród warunków szczegółowcyh, jakie powinni spełnić świadczeniodawcy przy udzielaniu świadczeń gwarantowanych w trybie hospitalizacji i hospitalizacji planowej wymienia, w diabetologii / diabetologii dla dzieci, pozostały personel - pielęgniarkę posiadającą doświadczenie w diabetologii lub specjalistę w dziedzinie pielęgniarstwa diabetologicznego, lub po kursie specjalistycznym w dziedzinie edukator w cukrzycy – równoważnik co najmniej 0,5 etatu.

Przełożenie na kontrakty szpitalne przepisy ministerialne znalazły w postaci zarządzenia Nr 72/2011/DSOZ Prezesa Narodowego Funduszu Zdrowia z dnia 20 października 2011 r. w sprawie określenia warunków zawierania i realizacji umów w rodzaju: leczenie szpitalne.

Zgodnie z Rejestrem Zakładów Opieki Zdrowotnej, prowadzonym przez Centrum Systemów Informacyjnych Ochrony Zdrowia, w Polsce są 174 placówki oferujące stacjonarne leczenie diabetologiczne.

Z danych uzyskanych od prof. dr hab. n. med. Krzysztofa Strojka, Konsultanta Krajowego w dziedzinie diabetologii (z dnia 05.06.2013 r.) wynika, że Narodowy Fundusz Zdrowia kontraktuje świadczenia ambulatoryjne w diabetologii w ponad 700 podmiotach i w każdej placówce powinien być zatrudniony edukator.

Oprócz edukatorów są też specjalistki ds. pielęgniarstwa diabetologicznego


Obecnie tytuł specjalisty w dziedzinie pielęgniarstwa diabetologicznego ma 246 pielęgniarek. 3 października do egzaminu państwowego po ukończonej specjalizacji w dziedzinie pielęgniarstwa diabetologicznego planowało przystąpić 99 osób. Ostatecznie egzamin zdawało 98 osób i tylko jedna go "oblała".

- Bardzo cieszy nas fakt, że trudu organizacji kształcenia podyplomowego w dziedzinie pielęgniarstwa diabetologicznego podejmuje się coraz więcej ośrodków, które uzyskują pozytywną decyzję z Centrum Kształcenia Podyplomowego Pielęgniarek i Położnych. Organizatorzy podyplomowego kształcenia specjalizacyjnego, którzy przygotowali obecnie zdających, to: Polska Federacja Edukacji w Diabetologii (PFED), Ośrodek Konsultingowo-Szkoleniowy z Wrocławia i Stowarzyszenie Pielęgniarek i Położnych na rzecz Promocji Zawodu i Praw Kobiet OAZA w Ostrołęce - komentuje Alicja Szewczyk, przewodnicząca PFED.

Postulaty Polskiej Federacji Edukacji w Diabetologii

Deklarację w sprawie miejsca i roli edukatora w opiece nad pacjentem z cukrzycą podpisali uczestnicy VI Konferencji Naukowo-Szkoleniowej Polskiej Federacji Edukacji w Diabetologii (Warszawa, 9-10 grudnia 2011 r.). Deklaracja jest zobowiązaniem do podjęcia kompleksowych działań prowadzących do poprawy stanu zdrowia i jakości życia osób chorych z cukrzycą w Polsce. Zdaniem sygnatariuszy Deklaracji kluczowy element tych działań stanowi implementacja do systemu ochrony zdrowia stanowiska edukatora ds. diabetologii. PFED przekazała Deklarację wszystkim instytucjom, organizacjom i strukturom, których pracownicy i działacze są zaangażowani w walkę z cukrzycą.

"Edukacja terapeutyczna w cukrzycy już 40 lat temu została uznana za równoprawny składnik całościowego leczenia tej choroby i element podstawowego schematu terapii. Uważamy zatem, że wprowadzenie do polskiego systemu ochrony zdrowia stanowiska edukatora ds. diabetologii da pacjentom szeroki dostęp do edukacji niezbędnej w terapii cukrzycy – a w rezultacie przyczyni się do poprawy zdrowia i jakości życia pacjentów diabetologicznych oraz redukcji powikłań cukrzycy, a także przyniesie duże oszczędności dla systemu ochrony zdrowia. Aby tak się stało, edukacja terapeutyczna w cukrzycy powinna być odrębnym świadczeniem kontraktowanym przez Narodowy Fundusz Zdrowia, zaś edukator ds. diabetologii – profesjonalistą zatrudnianym obligatoryjnie w placówkach medycznych określonego typu" - głosi stanowisko PFED z grudnia 2012 r.

PFED postuluje nie tylko zatrudnianie w placówkach medycznych (zarówno lecznictwa szpitalnego, jak i w opiece środowiskowej) pielęgniarek/położnych na stanowisku edukator do spraw diabetologii, zgodnie z rozporządzeniem Ministra Zdrowia z 20 lipca 2011 r., ale też finansowanie usługi edukacyjnej jako odrębnego świadczenia kontraktowanego przez NFZ.

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