A Collaborative Approach to Diabetes Management The Choice Made for Colorado Schools

Students with diabetes deserve a school nurse who can effectively manage the disease. Tensions between the school and families sometimes emerge when a child with diabetes goes to school. To resolve these tensions in Colorado, stakeholders collaborated to implement a statewide program to meet the needs of students with diabetes. Colorado school nursing leadership partnered with the National Association of School Nurses to adapt components of the Managing and Preventing Diabetes and Weight Gain Program (MAP), funded by the Centers for Disease Control and Prevention. The Healthy Learner Model for Chronic Condition Management, integral to MAP, provided guidance for the Colorado Collaborative to design the Diabetes Resource Nurse Program. The program supports the practicing school nurse, and facilitates collaboration between the family, school, and health care provider. This article describes how stakeholders in Colorado chose to collaborate when faced with rising tensions over how to best manage students with diabetes. Keywords chronic diseases, diabetes, best practices/practice guidelines, case management, mentoring, program development/evaluation, evidence-based practice, role promotion/development Currently there are an estimated 25.6 million people 20 years or older, approximately 11.3 % of the population, with diabetes in the United States (Centers for Disease Control and Preven-tion [CDC], 2011). For children and youth younger than 20 years, diabetes is on the rise with an estimated 215,000 having the disease (Type 1 or Type 2) or about 0.26 % of this age group (CDC, 2011). In Colorado, the prevalence for adults is estimated at 5.9 % of the population (Colorado Diabetes Pre-vention and Control Program [DPCP], 2009). Vehik et al. (2007) reported that Type 1 diabetes is increasing in Colorado youth aged 0–17 years at an average rate of 2.3 % per year. The overall incidence of Type 1 diabetes in Colorado youth has increased from 14.8/100,000 to 23.9/100,000 over the past 27 years (DPCP, 2009; Vehik et al., 2007) Diabetes management in schools is resource intensive