Lack of proper education on patient with type 2 diabetes

Lack of proper education on patient with type 2
diabetes

Quality Measures

How does lack of knowledge in
management of diabetes Type 2 impact;

equitable and efficient care

appropriate and Timely

Patient safety

Patient centered care

Purpose

The purpose is to explore lack of proper
education in patients with Type II diabetes to;

Understand socio-economic impact for

To identify barriers to patient education

To eliminate barriers using proper algorithm

Problem

The main problem is lack of knowledge
about diabetes in the community- especially
in young generation

Most people are not aware on ways to
manage or cope the disease

These makes the people to be confused,
disoriented, and unsure about the disease

Proposed Evidence Based Change

Apply of teach back method to

advocate for effective behavioural interventions

identifying strategies that could fail if specific regimen is not understood

Identify the environmental or even psychological barriers

screening these potential problems,

offers comprehensive training on the appropriate therapies and medications

Project Goal

To understand the impact of proper
education of patients with Type II diabetes
in promoting quality care management
regimen.

Review of the Literature and Body of Evidence Supporting the
Proposed Change

Effective management of the glycosylated haemoglobin (HbA1c) involves,

attaining stable blood sugar control

understanding the food intake and physical activity balance.

Anticipatory patient education using teach back will facilitate lifestyle modification as
a routine care especially during the developmental transitions(Reinehr, 2013).

successful management of diabetes type 2 need heterogeneous interventions including
(Stranieri, Yatsko, Jelinek & Venkatraman, 2015);

cognitive behavioural therapy, general diabetes education and skills training.
This is associated with significant improvements on emotional, physical and
developmental outcomes

Body of Evidence Supporting the Proposed Change

The evidence found supports the main reason for increased complications among
diabetes type 2 patients is reduced knowledge on coping strategies.

There is no treatment for diabetes Type 2; patient should be supported through
patient education. (Steinsbekk, et al., 2012).

Patient education empower the patient with capabilities that help them overcome
any shortcomings that would prevail (Kayshap et al., 2013).

Feasibility, Benefits, Risks

Benefits

Enable the patients to
understanding disease
pathophysiology,

establishment necessary
coping strategies

make appropriate decision,
ultimately reducing the
readmission rates, length of
hospitalization and slows the
disease progression

Risks

Increased confusion

Communication barriers

Ethical legal issues or
concerns

Feasibility

Cost effective

Timely care

Improve patient
knowledge

Improve patient quality
of life

Step 4: Design Practice Change

Process Variables

These includes outcome measures that can be expressed as a numerical figure.

In this case, designing of change practice model will focus on length of
hospital, departmental performance, emergency department performance etc.

Step 4: Design Practice Change

Key Attributes that influence the designing of practice change includes;

Creativity: to ensure that the team have dependent and independent solutions

Commitment: to ensure that the patients remain

Patience: Notably, change is invisible and slow, it needs time

Resilience; there are setbacks expected, but with commitment they will be
overcome.

Step 4: Design Practice Change

Change implementation

Step 4: Design Practice Change

Resources for Design Practice Change

Social: human resources such as nurses,
general physician, patient, and key
management representatives

Economic: fiscal resources to manage the
change implementation process

Environment: organization culture and
establishment of an environment that
promotes change

Step 5: Evaluating Change

the evaluation will be done on
quarterly bases using these
questions

Outcome Variables & Measurement Tools

Outcome variables that will be used to
assess change includes

lower clinical visits,

Morbidity

mortality

limp amputation rates

or disability for health issues associated with
diabetes

Cont’d

Measurement tools used to evaluate
change

Focus groups

One on one in-depth interviews

Online forums

Online communities/focus groups

Step 6: Maintain Change in Practice

Identify that change is a continuous process

Maintain review plans until one is sire that they are not needed

If the change lapse one should not start from the drawing board but instead
from the recognized process they should implement new plan based to the
mistakes

Always research on new ways to help others and the organization to make
positive changes at large

Final Discussion

Patient education – most cost effective intervention for patients with diabetes type 2 include

pharmacological -insulin action, the various modes of

administrations, and the processes of

blood glucose monitoring.

Nutrition therapy education – appropriate diet in

terms of quality and quantity.

physical activeness training -effective duration

of exercise, what should

be done before and after the exercise.

Cont’d

address underlying barriers including

Socioeconomic needs

cultural issues,

Psychological needs eg body shape
insecurities and substance use.

The proposed plan is anticipated to
support and maintain patient health safety
simultaneously and strengthen the
healthcare expertise, productivity and
quality management of care.

Source: http://www.acc.org/membership/member-benefits-and-resources/acc-member-publications/cardiosurve

Reflection

management of diabetes type 2 is a complex process.

Promotion of patient education is important

Patient education empower patients on

pharmacological therapy,

balanced nutrition

exercises to maintain.

manage effective glycemic control

prevent disease progression or associated complications.

Questions?

What are the Risk factors for type 2 diabetes?

Untreated diabetes may result in ?

Is diabetics patients at increased risk of heart disease?

References

Ahmad Ali, S. (2014). The role of educational level in glycemic control among patients with type II diabetes mellitus. Int J Health Sci (Qassim).;
8(2): 177–187. PMCID: PMC4166990

Akour N A., Khader YS., Alaoui AM. (2011). Glycemic control and its determinants among patients with type 2 diabetes mellitus attending a
teaching hospital. J Diabetes Metab;2:4.

American Diabetes Association. (2013). Standards of medical care in diabetes. Diabetes care. 2013 Jan;3(supplements 1)

Chapman, A. (2013). Change management: organizational and personal change management,
process, plans, change management and business
development tips.

Fain, J. (2012). National standards for diabetes self-management education and support: updated and revised 2012. The Diabetes Educator, 38(5),
595-595.

Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., … & Matthews, D. R. (2012). Management of
hyperglycemia in type 2 diabetes: a patient-centered approach position statement of the American Diabetes Association (ADA) and the European
Association for the Study of Diabetes (EASD). Diabetes care, 35(6), 1364-1379.

Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., … & Matthews, D. R. (2015). Management of
hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the
European Association for the Study of Diabetes. Diabetes Care, 38(1), 140-149.

Kashyap, S. R., Bhatt, D. L., Wolski, K., Watanabe, R. M., Abdul-Ghani, M., Abood, B., … & Kirwan, J. P. (2013). Metabolic effects of bariatric
surgery in patients with moderate obesity and type 2 diabetes analysis of a randomized control trial comparing surgery with intensive medical
treatment. Diabetes care, 36(8), 2175-2182.

Kotter, J. P. (2012). The Eight step process of leading change. Kotter International.

Kotter, J. P., & Cohen, D. S. (2012). The heart of change: Real-life stories of how people change
their organizations. Harvard Business Press.

Kirk JK., Davis Stephen W, Hildebrandt, C A., Strachan EN., Peechara M L., Lord, R. (2011). Characteristics associated with glycemic control
among family medicine patients with type 2 diabetes. NCMJ. 11;72(5)

LeClair, E. (2013). Type 1 diabetes and physical activity in children and adolescents. Journal of Diabetes & Metabolism, 01(S10).

Steinsbekk, A., Rygg, L., Lisulo, M., Rise, M. B., & Fretheim, A. (2012). Group based diabetes self-management education compared to routine
treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis. BMC health services research, 12(1), 213.

Stranieri, A., Yatsko, A., Jelinek, H., & Venkatraman, S. (2015). Data-analytically derived flexible HbA1c thresholds for type 2 diabetes mellitus
diagnostic. Artificial Intelligence Research, 5(1). D. (2016). Detection of diabetes mellitus using HbA1C as diagnostic criteria. Journal of Medical Science and Clinical Research 4(3),

Reinehr, T. (2013). Type 2 diabetes mellitus in children and adolescents. World Journal of Diabetes, 4(6), 270.

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