We have a protocol for lab order for DM. A1c every 3-6 months depending on previous result (if above 8 then 3 months, if below 8 then 6 months), Micro albumin yearly, BMP/CMP and Lipid screening every 6 months.
We can also refer for DM eye exam yearly.
We can refer to Podiatry for a yearly DM foot exam as well, however most of our PCPs will do the foot exam in office at the follow-up.
We do not have protocol for initiating any medications as that requires prescriptive authority and evaluation by a provider. Keep in mind there are many different statins and there are risks with any medication. Our providers use the AVSCD risk score to determine statin appropriateness.
For nursing to order, the patient must be an established patient at our clinic, brand new patients must be seen by PCP prior to labs. The patient must have been seen within the past 6 months or have an upcoming follow-up appointment scheduled with our clinic. We require our patients with DM to be seen every 3-6 months so it is usually not an issue.