Prevalence in diabetes

Designing a Practice Change
Introduction

Trends have indicated an increase in prevalence in diabetes with 42% of the patients with
diabetes aged over 65 years (Chen et al., 2012). Projections have been conducted and proved that
this ratio will increase to over 60% by 2050. This increase in diabetes prevalence has also
impacted related health care costs. For instance, the average acute hospital cost for managing
diabetic patient with a diabetic foot was estimated to be $9,900 in the USA (Dabelea et al, 2014).
According to Wong et al, this rise in the prevalence of diabetes has made it imperious to offer
training and practice care for clinicians to manage diabetes (Wong et al., 2015). This paper is
going to focus on the design of Evidence Based Practice training program that will be aimed at

PRACTICE CHANGE 2
training healthcare practitioners on diabetes and improving the outcomes of patients with
diabetes.
Timeline
The training module will involve one basic 50-minute presentation which will be
conducted by a well-trained diabetes educator and a physician. The presentation will be
conducted on Monday, Wednesday and from 0800hrs to 0850hrs for a period of two months. The
presentation will be divided into two parts. The first part will concentrate on enlightening the
trainees on diabetes, that is, the causes, risk factors, onset, types, signs and symptoms, treatment,
and management of this disease. This part will also highlight the complications associated with
diabetes. The second part of the presentation will concentrate more on patient education which is
an integral component of comprehensive patient care. Several long term care facilities will be
contacted as potential recruitment sites. Comprehensive training modules and assessment
measures will also be developed to aid in the evaluation of immediate and long term impact of
the training project.
Key Personnel
To achieve the educational needs of the clinicians the program will focus on training
licensed practical nurses (LPNs), registered nurses (RNs), and physical therapists. The module
will conduct a follow-up of learning outcomes in one group (RNs). The training will be designed
for a small group of between 20-30 trainees in each session. This will ensure that close
interaction is maintained between the participants and the instructors, with time set aside for
participant comments and questions.
Supplies Needed

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Some of the material that will be required include; PowerPoint presentation, videos, and
handouts.

  • PowerPoint Presentation: Will consist of 40 slides. These slides will entail
    a brief overview of diabetes, and the associated complications such as foot problems, risk
    of amputation, blurred vision, and kidney problems. It will also offer information on
    appropriate history taking, keeping of records, conducting physical examination, and
    appropriate specialist referral.
  • Video: This will demonstrate the proper techniques of carrying out patient
    examination such as conducting a monofilament examination with the aid of a tuning
    fork.
  • Handout: Will be issued to the participants for daily patient explaining and
    for explaining how to conduct physical examination on a patient with diabetes.
  • An official website that will contain all that will have been taught during
    this period.
    Cost
    For successful completion of this module, funds will be used in paying two diabetes
    instructors, paying the IT technicians who will compile the PowerPoint presentation, the video,
    creation of website and typing of the handout. Funds will also be used in buying enough training
    materials such as tuning forks for the monofilament examination and glucometers. All this will
    be allocated a total of $ 2,000.
    How do these items tie up to project goals?
    These items will help in achieving the set goal of 10-15% increase in diabetes practice
    change two month post training. Such training promotes clinical judgment and advance patient

PRACTICE CHANGE 4
care quality. The clinicians will understand how to acquire, interpret, and incorporate the best
available research evidence with clinical observations and patient data which are important
aspects in clinical practice (Wong et al., 2015).

References

Chen, L., Magliano, D. J., & Zimmet, P. Z. (2012). The worldwide epidemiology of type 2
diabetes mellitus—present and future perspectives. Nature Reviews Endocrinology, 8(4),
228-236.
Dabelea, D., Mayer-Davis, E. J., Saydah, S., Imperatore, G., Linder, B., Divers, J., … & Liese, A.
D. (2014). Prevalence of type 1 and type 2 diabetes among children and adolescents from
2001 to 2009. Jama, 311(17), 1778-1786.

PRACTICE CHANGE 5
Wong, C. K. H., Wong, W. C. W., Wan, Y. F., Chan, A. K. C., Chan, F. W. K., & Lam, C. L. K.
(2015). Effect of a Structured Diabetes Education Programme in Primary Care on
Hospitalizations and Emergency Department visits among people with type 2 diabetes
mellitus: results from the Patient Empowerment Programme. Diabetic Medicine.
Wong, C. K., Wong, W. C., Wan, Y. F., Chan, A. K., Chan, F. W., & Lam, C. L. (2015). Patient
Empowerment Programme (PEP) and Risk of Microvascular Diseases Among Patients
With Type 2 Diabetes in Primary Care: A Population-Based Propensity-Matched Cohort
Study. Diabetes care, 38(8), e116-e117.

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