The Diabetes Self-Management Program at South County Hospital was recently recognized by the American Diabetes Association for helping educate diabetics to manage their health.
Led by April Silvestro, a certified diabetes educator and registered nurse, the center offers one-on-one educational sessions with a diabetes nurse educator, a diabetes nutritionist educator and an exercise physiologist; classes, and support groups for adults, children and their families.
Silvestro answered questions about the program and what makes it successful..
PBN: How many patients do you see every year, and how do they come to you?
SILVESTRO: The numbers are growing. Last year we saw 526 patients. They come to us by primary-care provider or specialist referral. Some patients have attended one of our community lectures. … Some have been newly diagnosed by their doctor, some have had a crisis – it’s a mix.
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PBN: What is your typical patient’s experience with the center?
SILVESTRO: They make an appointment with our schedulers for the diabetes nurse educator and the diabetes educator nutritionist. They have the option of also meeting with our diabetes educator exercise physiologist for a custom exercise plan.
Many stay with us for a long time. Due to the chronic nature of diabetes, management and knowledge is ever changing. New advances in treatment offer better and easier ways to manage diabetes. We tailor a person’s management to what they want to do. Some patients see us once for a meal plan and perhaps insulin training and return as they see is necessary. Others see us once per month after their basic diabetes education training is completed for lifestyle change and just to “stay on track.” Others attend all our support sessions and every community lecture we give to gain all the latest knowledge on diabetes management.
PBN: What are your primary goals with these patients, and how do you measure success?
SILVESTRO: Our primary goal is to empower persons with diabetes to make healthy lifestyle choices to lead a long, healthy life. We know that with good blood glucose control, the risk for diabetes complications is reduced. We measure success with patient satisfaction surveys and the hemoglobin A1C [a blood test that shows a three-month average of blood glucose control].
But I know I’ve helped a person when we see them making healthy changes in their life. … Often people come to us angry and scared. I always ask, “Just give us some time.” … We always strive to look at the whole person and not just their blood sugars. Family support is something we always emphasize. We try to meet people where they are and focus on the issues with their diabetes that are most important to them. The joke around the center is that “nothing happens quick.” Diabetes is a complex, difficult disease requiring time and patience.
PBN: What does it mean for the program to get recognized by the American Diabetes Association?
SILVESTRO: The ADA recognizes diabetes education programs of excellence. Our program was originally recognized in 2003 and applies for recertification every three years. The ADA checks the credentials of the staff, curriculum, goals and outcome measurements. The process is stringent and it has taken more than one year to prepare for this recertification.
We not only follow the guidelines of the ADA, but we also are certified by the R.I. Department of Health. These entities set the gold standard for diabetes education programs by giving the programs direction in terms of staff credentials, curriculum and goal setting.
PBN: What led you personally to go into this field?
SILVESTRO: I graduated from Newport Hospital School of Nursing in 1985 and Salve Regina University in 1988. I began my career as a diabetes nurse educator in 1990 in Virginia. Since then I have designed and implemented programs in Connecticut, Chicago and the Washington, D.C., area. I was away from Rhode Island for 13 years, and nothing gave me greater pleasure then to return to my home state in 2005 to assist South County Hospital in revitalizing this program. I choose South County Hospital because of its deep commitment to the community. When I came on board, everyone was so supportive and eager to embrace the new diabetes center. And the most rewarding aspect of my job is helping people to make healthy lifestyle changes that really impact their lives and well-being.
