Competency level assessment of healthcare practitioners in managing diabetes and diabetic eye disease in the district health system of Limpopo province, South Africa

Abstract

Background: There are many gaps in the management of diabetes mellitus (DM) and diabetic eye disease in the district health system (DHS) of South Africa (SA). National guidelines recommend annual eye examinations for patients with DM. Aim: The purpose of this study was to describe the self-reported skill levels of healthcare practitioners (HCPs) to conduct eye examination procedures required for a proposed diabetic retinopathy (DR) screening model. Setting: The study was conducted in public health institutions of Waterberg district and Mankweng Hospital complex (Capricorn district) in Limpopo province, SA. Methods: A cross-sectional design using purposive sampling was conducted, and questionnaires were distributed to a total of 74 HCPs. The questionnaires distributed included questions relating to the competency levels of primary healthcare nurses (PHC nurses), optometrists, ophthalmic nurses and medical officers (MOs) regarding examination procedures in the management of patients with DM and whether they agreed with the developed DR screening model. Results: All the PHC nurses had knowledge about all the examination procedures required in the proposed DR screening model, whilst 94.1% of MOs exhibited knowledge regarding the procedures required from them. Optometrists lacked knowledge of grading DR, and ophthalmic nurses were least knowledgeable about conducting internal and external eye examinations and in detecting and grading DR. Conclusion: The proposed DR screening model did not need modification. The involvement of dieticians and more ophthalmic nurses could be beneficial to the DR screening model.

Keywords

• healthcare practitioners
• diabetes mellitus
• diabetic eye disease
• diabetic retinopathy
• district health system