Education Staff Nurses on Diabetes - Thesis Example

EDUCATING STAFF NURSES ON DIABETES: By (Insert both names) (Name of class) (Professor’s name) (Institution) (City, State) (Date) Nursing: Education staff Nurses on Diabetes: Abstract Education on diabetes self management to the increasing number of patients hospitalized with hyperglycemia and diabetes is a challenging responsibility. The inpatients are chronically ill and in a setting that is laden with constant interruptions and other issues concerned with issuing diagnosis. Due to such competing priorities, strained time and even ailing-conducive learning setting, the key attention for diabetes self management learning need to be such skills which are critical for the patients to enable them get back home safe. This paper explores the evidence based education of staff nurses regarding diabetes, comprising the evaluation, determination of barriers and processes, fundamental subjects of content, goal setting. Practical highlights are provided to assist incorporate management of diabetes education within the current medical process in the inpatient environment. Background Information According to (Center for Disease Control and Prevention 2008)), diabetes is the 4th leading cause of fatality in the whole world claiming the lives of 3.8 million people every year due to its related complications. The complications of diabetes account for about 20 per cent of all chronic admissions care or in other words one in every five patients manifest diabetes-linked condition (ADA 2011). Nurses and patients education in the aspects of healthy eating, lifestyle modification and effective medication administration in study supported to medically reduce the occurrence of chronic complications. Moreover, chronic care nurses lead the pack in patient learning delivery and they have the chance to establish the behavioral phases . More than 25% of hospitalized Americans have been diagnosed with diabetes resulting to about $40 billion expenditure of inpatient healthcare cost. In the USA, an estimated 23.6 million persons have diabetes according to CDC (Center for Disease Control and Prevention 2008). The rate of prevalence also continues to grow at alarming pace. In every hospital there are patients who are suffering from diabetes. Nurses and health care professionals in general need to be equipped adequately with knowledge of the present evidence based processes to deliver competent and effective care to the concerned patients. The studies contain outcomes of limited knowledge and understanding when taking care for diabetic patients. (Chan and Zang 2007) assessed nurse’s actual and perceived degree of knowledge concerning diabetes using “modified diabetes”, a 64-element tool measuring elementary diabetes knowledge, experience aspects and the perception of nurses regarding diabetes. Nurses were classified into three categories relying on the similarity of their answers. Table 1 Nurse groups Diabetes competence and knowledge Nurse characteristics One Very good to good Higher level of education, Majority classified as senior nurse More work experience Two Moderate Mainly work in surgical units Most are registered nurses A lot are baccalaureate prepared three low Less education Less years of work experience Majority work within medical ward departments The results hinted the significance of tailoring plans to mitigate for the educational needs of particular nursing professionals for instance the medical-surgical nurses. Morrison, Griffins and Beauvias (2007), performed need evaluation with sensitive care nurses to establish knowledge concerning diabetes care. The results showed that the biggest knowledge gaps happened in the fields of medications, diabetes therapies and therapeutic objectives. The findings could be applied to establish diabetic educational instruments meticulous to the learning requirements of the nurses who perform acute care. (Spollett 2006) reported findings of the earlier works that examined nurses’ comprehension of elementary diabetes knowledge. The assessment indicated that nurses had poor understanding of primary diabetes care, comprising hemoglobin AIC. Moreover, nurses had information shortfall in self-care management of diabetes, use of medication and its side effects. He proposed multiple models should be applied to educate the nurses regarding management of diabetes, including learning modules, lectures, and collaborative initiatives and mentoring. The most probable option of providing information to nurses concerning diabetes is through the application of computer based program. (Hart et al. 2008) established that computer based teaching was an effective approach to teach nurses on evidence-based processes, besides nurses appear to have positive mind-set with computers (Lulic, Kovic and Brumini 2005). (Manchester 2008) in addition suggested fundamental basics for successful education schedule for management of inpatient glycemic which comprised knowledge evaluation and a well structured educational framework. Jabbour, Rubin and Moshang (2007) evaluated 48 nurses competence on current diabetic care standards. The findings illustrated that participants did not have critical diabetic knowledge, concerning insulin pharmacokinetics, fasting glucose echelon, hypoglycemia treatment and diabetic perioperative management. The scores of the diabetic resource nurses were higher in comparison to the nurses who lacked training on diabetes. The authors proposed that extra diabetes education is linked to improved comprehension of diabetes care. (Jackson and Manning 2008) established that staff nurses were not examining glucose within the desirable time prior to issuing insulin to the diabetic patients. Staff education, process redesign and policy review were imperative to address barriers to determine timing of glucose examination and administration of insulin. The work demonstrated that nurses require education to deliver better care for patients suffering from diabetes. Studies have indicated that development is required in the care that patients with diabetes get in the hospitals (Cox et al. 2007). They found that nurses who are taking care of diabetic patients resulting form cardiac surgery has greater confidence in care of cardiac, but at the same time, demonstrated minimal confidence in the management of diabetes. Nurses noted that a lot of patients who they were caring for were diabetic and they acknowledged that had limited information to take care of them. Aim: The study stoutly supports the significance of education to tackle nurse’s knowledge deficit in best practices for the diabetic patients according to (Chan and Zang 2007). With greater comprehension of evidence-based care giving, nurses who are the principal care givers to diabetic patients who are hospitalized can make constructive impact on the outcome of care. The objective of the assignment is to assess the knowledge and information gaps of nurses in management practices when taking care of diabetic patients. Methodology: The study was carried out in 9 outpatient and inpatient aspects of the Heart and Vascular Institute (HVI) In Pennsylvania. The population of the patients comprised of patients who had passed through cardiothoracic, vascular and cardiac surgery. The protocol of the project was by the board of the institutions and accorded exempt status as a program for educational assessment that will not identity characters. Before providing the education, researchers organized an electronic needs evaluation to the nurses who are employed at HVI. The needs evaluation comprised of 13 questions tackling risk factors, cardio vascular disease, etiology, medication, current guidelines, hyperglycemia results and nursing care associated with diabetes. The key relevant needs highlighted by the nurses include; nursing care, medication management, current guidelines, hyperglycemia outcomes and pathiophysiology. Emails were sent to the HVI nurses asking them to attend the lecture or may choose to complete an online process. Flyers are posted in all the departments in HVI so as to inform the staff about the upcoming educational presentation. The initiative was knowledge and value augmentation to establish if staff nurses gained from the education offered on present evidence-based processes as they care for the diabetic hospitalized patients. The subjects were arranged in 2 groups depending on the time correspondents attended the didactic meeting. The group that took pat in the live session will be termed as the didactic session. The rest who did the online process will be termed as online session. The education offered to employed nurses was the independent determinant, and their knowledge was the outcome determinant. Satisfaction surveys and quiz were given after respondents had gotten the education (Griffs et al. 2007, Chan & Zang 2007; Spollett 2006; Manchester 2008 and Hass 2006). Sample selection A convenient sample was drawn from the staff nurses. All the participants were informed that the process was voluntary and there was no requirement for any indentifying material. Consent was indicated by completing the satisfaction survey and quiz. All the respondents offered direct patient care and are registered. Table 2: The results of the quiz for the educational program Education module N Mean raw score SD Mean percentage score Didactic session 1 5 13.4 (out of 15 elements) 1.14 89% Didactic session2 5 13.0 out of 15 1.22 87% Online education 36 18.9 out of 20 1.24 95% Table 3: The didactic and online session 1. Introduction i) Present diabetic statistics and fact ii) medical diabetic manifestations 2. pathophysiology i) type 1 diabetes ii) type 2 diabetes iii) medical manifestations iv) gestational diabetes 3. the risk elements for establishing various kinds of diabetes 4. patients outcome and hyperglycaemia i) thrombosis ii) immune function iii) the brain iv) endothelial dysfunction v) oxidative stress 5. present procedures for management of diabetes i) blood pressure ii) glucose control iii) dietary management iv) lipid management 6. cardio vascular disease and diabetes i) dyslipedemia ii) C-reactive protein iii) Anti-platelet therapy iv) Managing hyperglycaemia v) Lifestyle modification 7. Medication management i) Oral anti-diabetic elements ii) Insulin 8. Nursing care i) Identifying symptoms of hyperglycaemia and hypoglycaemia. ii) hypoglycaemia treatment iii) taking care of the patients being administered insulin infusion iv) Taking care of patients who have the diabetes history or have just been diagnosed. v) The resources that the institution has to handle diabetic patients. Curriculum development 2 didactic schedules were delivered by use of PowerPoint (comprising respondent’s handouts), drug prices and medications (oral agents and insulin). Session comprised cardio vascular disease, diabetes, risk factors, pathophysiology, hyperglycemia and patients’ outcomes, present procedures for nursing care, diabetes medication and diabetes management as described in table 2. The materials were taken from peer-reviewed journal articles (Griffs et al. 2007, Chan & Zang 2007; Spollett 2006; Manchester 2008 and Hass 2006), (Center for Disease Control and Prevention 2008), American Diabetes Association ADA (2009), and the Penn State Hershey Medical Center 2008). The web-based learning procedure Nursing Care Guidelines for Diabetic Patients included 8 compartments drawn from similar evidence-based studies as the presentation of diabetes. In addition, patients’ handouts and reference list were incorporated in the online procedure. A fifteen element was established based on the content of the session ((Griffs et al. 2007, Chan & Zang 2007; Spollett 2006; Manchester 2008 and Hass 2006, ADA 2009), and issued to all staff nurses at the end of the didactic session. The test for the manual (online procedure) comprised of 20 elements uploaded online to be completed by staff and appraisal of the course information. Since it was provided post a time demanding submission of an independent assessment module, the web-based test had more respondents and questions getting much continuing education (CE) credit. The CE credit was also accorded the nurses who submitted complete didactic sessions. Staff nurses were requested to submit a complete 6-question satisfaction study to examine respondents perceived education mastery. Incorporated were assessment of goals, effectiveness of the presenter and integration of knowledge when caring of diabetic patients. Subjects were requested to rate every element applying a Likert Scale (5=strongly disagree and 1 being strongly agree). For every question, the respondents who were not able to rate the element as strongly agree were requested to provide suggestions for development of prospective presentations. The 6 questions to be completed online were linked to their comprehension of the material, the effective of the manual in achieving their expectations, the relevance to the practice, usefulness of the resources, and their capability to integrate information into practice so as to deliver improved care. Disparity in the satisfaction study quiz was based on the various education delivery approaches. Results Ten participants took pat in the didactic session whereas 50 registered for the online session. Every participant from the didactic session completed the satisfaction survey and knowledge quiz. Among those who registered for the online session, 36 participants submitted complete knowledge quiz and 30 of them completed the satisfaction survey. Table 3 has the report of the information. The group in the didactic learning session was greatly satisfied (100%) with the material and the presenter. In the online process, nurse satisfaction indicated that 58% of the participants were greatly satisfied while 42% were satisfied with the material. Discussion: This program offered present evidence-based learning to staff nurses on how to take care of patients with diabetes in hospital. The online process and education session were established based on a need evaluation carried out before the beginning of the education project. This evaluation established that knowledge gaps of nurses concerning the care of diabetes were the same to the findings obtained in the literature (Griffs et al. 2007, Chan & Zang 2007; Spollett 2006; Manchester 2008 and Hass 2006). Subsequently, the education programs integrated information from literature so as to attain the nurses’ spotted needs. The systems applied to educate the staff nurses on this program offered current evidence-based procedures for diabetic hospitalized patients (Griffs et al. 2007, Chan & Zang 2007; Spollett 2006; Manchester 2008 and Hass 2006). Both the education approaches demonstrated success looking at the knowledge quiz results and scores. More precise is that the online education reflected higher knowledge scores in general in comparison to the online session. The online project proved well-situated to complete since the nurses were able to access the materials at their personal convenient moments. The results for the quiz in both methods indicated that a lot of nurses posed acceptable knowledge when discharging care to the hospitalized diabetic patients. Acceptable knowledge was taken to be 80% or more scores on the quiz. The results of satisfaction survey showed that staff nurse respondents attained their learning needs and they were highly satisfied or just satisfied with the materials discussed. Findings illustrate that information was pertinent to the nurses’ practice and novel materials had been delivered that will encourage nurses to advance their care for the diabetic patients. This program deployed Spollett,s (2006) proposal that multiple methods be applied to educate nurses regarding diabetes. The requirement for the online procedure was sustained by the inability of the nurses to excuse themselves from duty in order to participate in education schedules. The online procedure attracted 50 interested respondents, where 36 of the whole lot completed the quiz. This agrees with the findings of (Hart et al. 2008), who established that online program was efficient in educating nurses concerning evidence-based procedures. Moreover, Brumini et al. (2005) suggested that nurses have positive mind-set with computers. Thus, computer based teaching should be considered seriously when developing future education program to nurses. The online education convenience renders it very likely that the nurses will readily access the educational opportunity, besides a longer period of accessibility of the online material would be required to give nurses adequate time to appraise the information. As (Hass 2006) pointed out, the diabetic hospitalized patients will get progressive care if nurses get improved education. The reward of progressive education credits may also have been a constructive element to enhance the participation of nurses. Due to the massive participation, the online learning process will be accessible to all nurses across hospitals in the future for ample duration of time and also the CE credit rewarded the respondents the will complete the survey and other requirements. Despite being an educational provision regarding diabetes, this program contributed to narrowing the deficit for the sample group of nurses. Such learning processes are vital aspects of delivering the latest evidence-based care for diabetic patients. Limitations Though the absolute objective of the education offered to nurses in this program was to improve the outcome for the diabetic hospitalized patients, there was no effort to examine the patient’s results directly. This program was limited to assessing the nurses’ satisfaction and the education procedures. The other limitation was the minute number of nurses who participated in the didactic session. Nonetheless, the participants were satisfied with the knowledge acquired and hinted that they would deploy the knowledge in their practices. Further study is required to establish if diabetic education outcomes in enhanced knowledge that is maintained for a period of time impact competence and skill attainment in real practice. Investigations which evaluate the connection between patient’s outcomes and nurses’ diabetic education are also needed. Besides, no pre-test was applied to assess nurses’ knowledge before conducting the education. Focusing on the knowledge deficit outlined by way of needs evaluation, the approach appeared most effective in this research was multiple choice knowledge tests. Future studies in educating nurses regarding diabetes need to develop pretest and posttest to establish if the material delivered leads to quantifiable knowledge enhancement. Nursing implications It is clear that nurses are interested in diabetic learning and approaches that allow them to take part in a busy program are especially desirable. Online learning provides staff nurses the suppleness in accessing evidence-based processes and can develop to improve participation as opposed to didactic sessions. Projects such as the one illustrated here can be adapted easily for deployment in different settings. A need evaluation should be carried out to establish subjects of interest to the nurses. Moreover, approaches applied to educate the staff nurses need to be determined focusing on the information that concerns their fields of practice. References: Centers for Disease Control and Prevention.(2008). National diabetes fact sheet:General information and national estimateson diabetes in the United States,2007. Retrieved from http://www.cdc.gov/diabetes/pubs/pdf/ndfs_2007.pdf Chan, M.F., & Zang, Y.L. (2007). Nurses’ perceived and actual level of diabetes mellitus knowledge: Results of a cluster analysis. Journal of Clinical Nursing,16(7B), 234-242. Griffis, S., Morrison, N., Beauvais, C., & Bellefountaine, M. (2007). Identifying continuing diabetes education needs of acute care nurses in Northern Ontario.Canadian Journal of Diabetes, 31(4), 371-377. Haas, L.B. (2006). Improving inpatient diabetes care: Nursing issues. Endocrine Practice, 12(Suppl. 3), 56-60. Hart, P., Eaton, L., Buckner, M., Morrow, B.N., Barrett, D.T., Fraser, D.D., … Sharrer,R.L. (2008). Effectiveness of a computerbased educational program on nurses’ knowledge, attitude, and skill level related to evidence-based practice. Worldviews on Evidence-Based Nursing, 5(2), 75-84. Joslin Diabetes Center. (2010). Clinical practice guidelines for adults with diabetes.Retrieved from http://www.joslin.org/ joslin_clinical_guidelines.html Manchester, C.S. (2008). Diabetes education in the hospital: Establishing professional competency. Diabetes Spectrum, 21(4),467-789 Spollett, G. (2006). Promoting continuing education in diabetes management. Endocrine Practice, 12(Suppl. 3), 68-71. Penn State Hershey Medical Center. (2008). Insulin infusion regimen: Adult non-ICU and intraoperative, policy number: I-6 CPMN. Retrieved from https://access. hersheymed.net/policy/ClinicalPractice/ DanaInfo=.aiohrrjzGpvmK1580uua+inde x/H-14-10_Hypoglycemia_Protocol_Adult.docx Read More