Evidence-Based Nursing Education Plan - Term Paper Example

Evidence Based Nursing Education Plan Student’s name Institution Lecturer’s name Date Evidence Based Nursing Education Plan Introduction Diabetes mellitus is a growing health concern in Australia (AIHW, 2012). AIHW continues to mention that Type 2 diabetes is characterized by insufficient levels of insulin or the body's ineffective use of insulin, a hormone that controls blood glucose levels (2012). This essay expounds an education plan with evidence-based strategies related to type 2 diabetes. The main areas of discussion include type 2 Diabetes’ pathophysiology, its treatment regimes, education intervention to clients and family regarding client knowledge deficit, and evidence–based educational strategies that would improve the contemporary care of patients with DM. Background The major factors that increase the risk of type 2 diabetes are over weight, family history, and unhealthy diet. According to McGowan 2007, the risk is attributed to the above factors; that is why some people develop diabetes while others do not. The main symptoms of type 2 diabetes include excessive thirst, fatigue, frequent illness or infections, poor circulation, wounds that do not heal and blurred vision (Family and Community Health, 2005). These symptoms are not just a medical condition to the client living with Type 2 Diabetes Mellitus, but also pose problems and challenges from different aspect of his life. The client’s problems can be categorized into five notable areas which are; medical problem (acute and chronic complications), social problem (Child care problem, hard to maintain usual social life due to Diabetes Mellitus), physical problem (activity limitations), psychological (isolation due to Diabetes Mellitus, low self-esteem issues) and financial problem (work reduction, medical expenses). Assessment of the client with respect to these five areas, identifying his problems and provision of education and organize supports is the main focus of this education plan. According to American Diabetes Association (2012), current evidence-based treatments regimes includes: proper goal setting, dietary and work out adjustments, medications, proper self-monitoring of blood glucose (SMBG), habitual monitoring for complications and laboratory assessment. It is a healthy requirement that blood glucose should be maintained at close to standard levels (pre-prandial levels of 90-130 mg/dL and hemoglobin A1C [HbA1c] levels < 7%) (Brink, and Chiarelli, 2004). The maintenance of glucose alone does not provide sufficient treatment for victims of diabetes mellitus. Essential management of diabetes mellitus entails a number of purposes; that is, glycaemia, lipids, blood pressure hghghgh. However, according to World Health Organization 1986, health is a resource for living. It is not just a state of absolute physical, but also of mental and communal well-being and not simply the nonexistence of disease or frailty. Therefore, McGowan (2007) states that regardless of treatments and the medical condition, patient education and family support are also considered as an important part in treatment methods for diabetics. It is therefore true that people can develop abilities to reduce the physical, emotional impacts of chronic illness such as diabetics, through inputs from health care givers. Education with specific focus on knowledge deficits Education of diabetic patients with specific focus on their inadequate understanding is very crucial. The education should not just focus on their health conditions but also the consequences that result from their psychological, physical and financial problems related to Diabetes Mellitus (Polonaky, Fisher, Earles, Dudl, Lees, Mulian, and Jackson 2005). According to American Diabetes Association (2012), the successes in providing care for the patients with diabetes mellitus includes elimination of the symptoms and prevention or slow down the development of complications. In order to achieve this, it is indispensable to make out the areas that the patient is kin short of knowledge, and make appropriate nursing evaluation. After assessing the client, the educational interventions should focus on his knowledge deficit related to the disease process and risk factors. Other areas of focus include lifestyle change, self-care management, cardiac risk factors, and skin disease prevention. The client should be educated on how to reduce distress arising from other life aspects like psychological, social and financial problems. An education plan is needed to be set up for him and his family. Because he is a newly diagnosed Type 2 DM patient, it is vital to educate and provide information concerning the disease process, risk factors and diabetes complications. This can help the patient prevent and early diagnose Diabetes complications (Perlmuter, Flanagan, Shah and Singh, 2008). Also, the patient needs a structured weight management program, such as a diet plan, while he is educated together with his family on how to calculate the diet, and referrer to dietitians. He is therefore recommended diets that are very low in saturated fats because they have been claimed to reverse insulin opposition (Neal, 2007). In the other hand, sets up an exercise plan according to his integrating personal exercise preferences (Paterson, 2001), and organize appointment with exercise class. In addition, self-care management is another area he lacks knowledge. By educate him of self-care management, such as Blood glucose level monitor, Insulin regime, time, dose and side effects for his OHA, it can reduce the spends on allied health care, and also can lead better control of his Blood glucose level. (Caleb, Sega, Maloney and Stafford, 2007). Furthermore, because coronary artery disease is a major risk factor in the development of myocardial infarction in people with diabetes, especially in the middle to older adult with type 2 Diabetes according to Miller and Rollinck (2002), it is necessary for him to understand the importance of healthy dietary and regular exercise, which can reduce the risk of such complication. Observational studies suggest that greater physical activity is associated with a lower risk of cardiovascular mortality. Last but not least, skin infections occur in 20% to 50% of diabetic patients, more often in those with type 2 diabetes. It is significant to know of potentially staid skin problems associated with the type 2 Diabetes Mellitus. Because for the diabetic patient, skin disease often causes significant distress due to its appearance, itching and ulceration (Briscoe, 2006). It also can act as an important marker of complications in other systems (Janet et al., 2011). In the majority of cases, diabetes related skin complications can be dealt with through early diagnosis and treatment. Apart from the medical issues stated above, his social, emotional and financial distress are also need to be managed and supported with input from multidisciplinary health care professionals. Because he is a middle aged man, the stress from childcare and reduced financial income needs to be addressed throughout the process (Surwit, Schneider & Feinglos, 1992). Seek assistance from his family for childcare, emotional support and physical support contributes a significant part to reduce the stress and improve his total health outcomes. Furthermore, Community agencies appointments need to be organized for continued education and support, such as social worker, Pharmacist, dietitians, local GP, psychologist, physiotherapist and local government supports such as Centrelink. Because of the support from multidisciplinary health care teams, which allow individuals with specialized training to maximally utilize their strengths within an organized diabetes treatment team, it may increase efficiency, effectiveness and may improve outcomes in people with type 2 diabetes. Education strategies Adequate education is essential to diabetes patients regarding the disease process, underlying risk factors and its complications. A comprehensive education strategy that involves health professionals is also needed to provide required references for the sake of patients understanding. The patient education pamphlets focused on diabetes control and prevention creates a better understanding of the patient’s condition by the family members. Although it is not certain that the patients will use the materials provided, Client centered education is one of the strategies to increase the likelihood that they will benefit from such resources. Client-centered counseling is an education strategy that is designed to help individuals gain confidence through self-management of Diabetes Mellitus (Miller & Rollnick, 2002).According to (Polanski et al 2005; Fisher, 2007), diabetes distress can impact a person’s motivation to engage in self-care and management activities. To support Diabetes Mellitus self-management, it is necessary to get patients to involve in the education plan, and allow patients to self-explore their own health goals, and achieve better health outcomes. The cost effectiveness of group based education can be analyzed through a comparison between group education and one to one teachings. It is evident from studies that group-based education is more cost-effective, leads to Greater client/patient satisfaction. Moreover, it may be slightly more effective for lifestyle changes and quality of life (Tang, Funnel, Anderson 2006; Kiers et al 2005; Trento et al 2002). Conclusion/Recommendations The ultimate focus of a diabetes education programme is to provide skills, tools and competencies required by the patients in order to lead health lives. Through one-on-one counselling by a team of professionals, individuals are able to gain self-management skills. This is possible through identification of the patient’s problems when the entire exercise is conducted through evidence based education, using appropriate support services. It helps reduce their symptoms and delay and prevent onset of diabetes complications. In doing so, the patient will ultimately reach a state of absolute physical, mental and social welfare. References American Diabetes Association. (2012). Standards of medical care in diabetes Care. Retrived from http://care.diabetesjournals.org/content/35/Supplement_1/S11.full. American Diabetes Association (2004). Physical activity/exercise and diabetes. Retrieved from http://care.diabetesjournals.org/content/27/10/2518. Brink, S.J., and Chiarelli, F.G. (2004). Education and multidisciplinary team approach in childhood diabetes: Acta Biomed, 75, 7–21. Colayco, D.C., Niu, F., McCombs, J.S., Cheetham, T.C. (2011). A1C and cardiovascular outcomes in type 2 diabetes: A nested case-control study. Diabetes Care, 34(1):77-83. Cleveland Clinic Journal of Medicine November (2008). Skin manifestations of diabetes. Cleveland Clinic Journal of Medicine November 75(11), 772-787 Diabetes Care. (December 2010) 33 (12), e147-e167 Family & Community Health (2005). Diabetes prevention materials. Retrieved on Jan-Mar; 28 (1): 98-100 (journal article). Miller, W.R., Rollinck, S. (2002). Motivational Interviewing: Preparing people for change. New York, NY: Guilford Press. McGowan, P. (2007). The Chronic Disease Self-Management Program in British Columbia (79-90), In John Dorland & Mary Ann McColl; Montreal & Kingston (eds), Emerging Approaches to Chronic Disease Management in Primary Health Care: School of Policy Studies, Queen’s University. Keer, J., Groen, H., Sluiter, W., Bouman, J. and Links, T. (2005). Cost and benefits of a multidisciplinary intensive diabetes education programme. Journal of Evaluation in Clinical Practice 11(3), 293-303. Polonaky, Q., Fisher, L., Earles, J., Dudl, J., Lees, J., Mulian, J., Jackson, R. (2005). Assessing Psychosocial Distress in Diabetes: Development of the Diabetes Distress Scale. Diabetes Care 28(3), 626-631. Sibbald, R.G, Schachter, R.K. (1984). The skin and diabetes mellitus. Int J Dermatol 23, 567–584. Sheri, R.C., Sigal, M., Bo.F, Judith, G. R., Bryan J. B. (2010). Exercise and Type 2 Diabetes. In Richard R. R, Lisa C.T, , Ann L. A (Eds). The American College of Sports Medicine and the American Diabetes Association: joint position statement doi: 10.2337/dc10-9990 World Health Organization & International Conference on Health Promotion. (1986). Ottawa charter for health promotion: First International Conference on Health Promotion, Geneva: World Health Organization. Retrieved on 21 November from www.who.int/hpr/NPH/docs/ottawa_charter_hp Read More