Evidence-Based Education Plan of Diabetes - Term Paper Example

Evidence-Based Education Plan Name Institution Date Part B: Evidence-Based Education Plan Introduction Diabetes necessitates lifestyle changes, in particular in nutrition and physical activity. The key objective of education is to help the patient in making self-directed behavioural changes that will improve his overall health (Fox&Kilvert, 2003). The patient is a newly diagnosed case thus he and the family needs to understand what diabetes is. In order to be able to adhere to the prescribed course of therapy through education, the family can help the patient in adjusting his lifestyle and ensuring that the patient adheres to the treatment regime. Therefore, the educational plan will consist of diet, drug administration, any likely adverse effects of drugs, exercise, monitoring of blood glucose, hygiene in addition to preventing and recognizing hypoglycemia and hyperglycemia for the patient. Background Type 2 diabetes mellitus is characterized by unstable levels of insulin and deficiency of insulin. The primary defect in the pathogenesis of type 2 diabetes mellitus is impaired insulin action or insulin resistance(Huther, 2008). Resistance to the insulin action leads to damaged insulin mediated glucose intake with the periphery, deficient suppression of hepatic glucose output as well as impaired triglyceride uptake by fat. To counter insulin resistance, beta islet cells increases insulin secretion. Increased circulation of insulin overcomes the impedance to the insulin action(Huther, 2008). Subsequently, the condition of high insulin and euglycemia continues for a long time. Abnormal metabolism of energy takes place if there is adisproportion between insulin prerequisites, which results from insulin resistance, as well as supply of insulin through the beta cell function. As a result of insulin resistance and insulin deficiency comparative to the resistance, type 2 diabetes mellitus develops (Huther, 2008). The patient isa middle aged man newly diagnosed with Type 2 Diabetes Mellitus, and thus the main focus will be stopping and delaying the development of the disease. This can be done by controlling primary causes as well as risk factors (Gray, 2004).This educational plan is to focus at assisting the patient to make improved lifestyle choices and changes that will encourage both health and stable blood sugar level (Thompson, 1993). A middle aged man may have a high possibility habit of smoking, taking alcohol as well as a condition of obesity and such issues can deteriorate type 2 diabetes. Therefore, the patient needs to be educated on the effects of smoking, alcohol and obesity to on his condition. Medications for type 2 diabetes mellitus includeMeglitinides, SulfonylureasDipeptidy peptidase-4 (DPP-4) inhibitors, Alpha-glucosidase inhibitors and injectable medications such as Amylin mimetics and Incretinmimetics (Bryant & Knights, 2011). Family members can provide their support by cooking low-fat meals; encourage patients to exercise, and ensuring that the patient is adhering to his treatment regimen (College of Nurses’ of Ontario, 2009). Studies have established that educating of diabetic patient on how to use their data interpretation promotes patients to perform self-glucose monitoring regularly and thus Blood Glucose Monitoring will be an important subject while educating the patient(Gillar et al, 2004). Testing of blood glucose levels before and after meals will assist the patient in making healthier food choices according to how his body is responding to certain food (Gillar et al, 2004). The patient and the family will be taught on how to use the BGL tool and how he canobtain enough blood samples and what to do with the readings he gets (normal range 4-8, best put in a normal range with). The patient will be reminded to record the readings of his blood glucose, together with the date, time and any related symptoms that he will be experiencing at the time of obtaining the specimen. The family will be advised to always ensure that one of the family members is present when the patient is taking his blood glucose and ensure that the values are recorded correctly(Gillarl, 2004). A diabetic patient needs to be reminded that the medication to assist in managing his diabetic condition is not a result of his failing diet management(Harr, 1999). Several diabetic patients get depressed when they start taking oral hyperglycemic drugs and insulin and thus educating the patient on diabetes medications and insulin is essential (Harr, 1999).The educational sessions will include reviewing a range of oral diabetic medications and insulin and how insulin should be mixed. The patient will be given a list of symptoms and signs of both hypoglycemia and hyperglycemia and what to do for each condition. Additionally, the family and the patient will be educated on the subject of drug dosage, time to take the drugs, routine of drug administration, drug class, drug action and the likely side effects of the drugs andits’ interactions and contraindication(Harr, 1999). Essentially, there are complications likely to result from the patient’s diabetic condition(Lewis, 2006). The patient and the family will be taught on management of the patient’s diabetic condition any time he has a minor illness, for instancehypothermia or gastrointestinal virus. The patient will also be taught on how to observe any effect of his diabetic condition in cardiovascular system, such as stroke, peripheral vascular disease, etc.Skin and foot problems are two of the most common complications in diabetes(Lewis, 2006). The patient and the family will be taught on how to care for his feet through and to report any changes to his health care provider promptly. The patient along with the family will be informed that foot problem is common in diabetic patients and the signs and symptoms of foot problems to look for (Lewis, 2006). Weight management is also very important in people with diabetes because there is a risk of the patient being overweight (Gray, 2004). Losing weight is a vital goal since it will improve insulin resistance, glycemic control, and lipid profiles and also lower blood pressure(Gray, 2004). Moderate weight loss will improve fasting blood glucose for the patient since there is a likelihood of him becoming overweight. Physical activity and behavior adjustment are crucial aspects of weight loss programs and thus will be very useful in maintaining weight loss (Gray, 2004). The family will be emphasized to ensure that the patient performs regular physical exerciseand be advised to ensure that the patient performs the physical activities every week in the company of at least one family member as this will make the patient to beanswerable to somebody on his progress and thus he will improve his capacity to be successful in the physical activities (Tang et al, 2005). Diabetic patients should also maintain a healthy diet(Nettles, 2005). The patient and the family will be educated on the type of diet the patient is supposed toconsume. The key goal of maintaining a healthy diet is to achieve and maintain the levels of glucose, blood pressure and also lipid/lipoprotein within the normal or close to normal range (Essig, 2002). Carbohydrate intake should be reduced to control hyperglycemia (Fenn, 2008). Intake of saturated fatty acids, trans-fatty acids as well as cholesterol within meals should be limited to lower the probability of atherosclerotic cardiovascular disease(Fenn, 2008). Most of the every day fat intake is supposed to be monounsaturated or polyunsaturated. The finestsources of protein are poultry, fish, eggs, milk along with soy products. Amino acids obtained from proteins raise the secretion of insulin(Gray, 2004).A high amount of soluble fiber is important in reducing blood cholesterol and can reasonably lower hyperglycemia and insulin resistance (Davis, 2000). Assisting the patient to cope with diabetes will be one of the most important interventions because being diagnosed with diabetes, just like any other chronic disease, can be unanticipated and potentially distressing(Abbate, 2008). The patient and the family ought to know that diabetes is a life long disease process requiring a lifetime commitment and changes in his usual lifestyle. His family will be advised to support the patient for the reason that family and friends’ support have an effect on the long-term acceptance of the illness progression. The patient and the family will be educated regarding empowerment and this will assist him in reflecting on his overall life satisfaction and the social worker will perform this role (Abbate, 2008). The patient will also be educated on stress management concepts to enable him deal with any emotional stress; a psychotherapist will tackle stress management issue (Registered Nurses’ Association of Ontario, 2006). According to Hartzell (2007), adult learning theory, is used in developing skills for self-directed lifelong learning and thus if an adult patient knows the answers for learning, reason and motivation, they will learn better in predicting the outcomes of definite health education interventions. So for teaching middle-aged adult, the education will aim at providing the patient and his family with information and skills of coping with the patient’s diabetic condition and their impact on the family as well as promoting voluntary changes in attitude and behavior in every strategy (Powers et al, 2006). There are several teaching strategies used in educating patient and family, such as, print media, one-to-one teaching, audio-visual media, computer assisted learning, and such (Nemshick, 1992). However, one to one teaching and audio-visual media are the major methods in education this case. One to one teaching is a mode of teaching where an individual learner is taught privately by an educator (Marshall, 2011). This means that by using one to one teaching method, there will be ample time to educate the patient and the family (Hawthrone & Tomlison, 1997). According to Hawthrone & Tomlison, (1997), one to one teaching method can improve knowledge regarding diabetes, increase self-caring behaviour in addition to affecting some characteristics of attitudes to diabetes. In this study, the patients were able to improve their knowledge about diabetic foot complications and glycaemic control because the patients could discuss their foot problems with the link-worker, who consequently would refer them to the diabetes foot nurse. Additionally, patients were knowledgeable about groups of food and individual foods (Hawthrone & Tomlison, 1997). Therefore, one to one teaching will be important during education in that the patient and the family will be able to be taught effectively about the diet, weight management, stress issues, diabetes complications and how to monitor their blood glucose levels using the BGL tool. The educator will be able to spend quality time with the patient and the family on education, covering each and every educational topic. The one on one education will also facilitate personal communication with the family and the patient and this it will bring out important information about the health beliefs of the patient and thus underpin education regarding his diabetic condition and his treatment regimen (Hawthrone & Tomlison, 1997). Accordingly, one on one teaching will be so useful in handling weight management, diet, stress issues, and management of the patient’s likely diabetes complications. Audio visual media teaching is another teacher method that will be used in this case. In audio visual media teaching, the educator provides the audio through speaking and uses images projected onto a screen from a slide projector or a computer to provide the visual (Barman, 2011). Recently, several clinical studies, such as Bowles et.al (2002) show that using audio visual media during education helps home cares professionals to deal with factors that influence self-management behaviors in diabetic patients. Additionally, audio visual media has been found to improve patients’ compliance to treatment regimen. This teaching strategy will be most effective in teaching the patient and the family how to monitor his blood glucose levels, by practically displaying to the patient how the BGL tool is used (Bowles et al, 2002). In conclusion, the key objective of educating the patient and his family is to influence his behaviour change as will enable the patient in making positive lifestyle changes in order to manage his diabetic condition effectively and promote health. Adult learning theory will be applied to patient education using a one-on-one teaching. The learning needs will focus on teaching the patient on how to manage his glucose levels, weight management, adapting a healthy diet and prevention of diabetes complications. References Abbate, S. (2008). Changing systems, changing lives: improving the quality of diabetes care. Diabetes Spectrum.Vol. 17/89.( Is this a book>? Journal article?) book. Bryant, B. & Knights, K. (2011).Pharmacology for health professionals(3rded.). Mosby Elsevier: Australia. College of Nurses’ of Ontario (CNO).(2009). Teaching Plan for Diabetic Patient. Ontario: College of Nurses’ of Ontario. Davis, E. (2000). A quality improvement project in diabetes patient education during hospitalization.Diabetes Spectrum, 13, 228 –231.doi? Essig, G. M. (2002). Diabetes education; older type 2 diabetic adults learn disease management through dietician program.Diabetes Week, 10-10. Retrieved from http://search.proquest.com/docview/205523967?accountid=13380 Fenn, P. (2008). Assessment and Management of Abdominal Obesity in Patients WithType II Diabetes. Nursing Standard, 21(25), 37-44.doi? Fox, C., &Kilvert, A. (2003).Intensive education for lifestyle change in diabetes.British Medical Journal, 327(7424), 1120-1. Retrieved from http://search.proquest.com/docview/204035499?accountid=13380 Gillar, M, et al. (2004).Informal diabetes education: impact on self-management and blood glucose control.Diabetes Educ. Vol. 30/136. Gray, E. (2004). Survival skills: a patient teaching model for diabetes mellitus. Ostomy Wound Manage. Vol. 40/67. Harr, J. (1999).Teaching patients with life threatening illness.NursClin North Am. Vol. 24/ 639- 644. Huther, S. (2008).Understanding Pathophysiology of Diabetes. Sydney: Sage Lewis, S. (2006).Medical-surgical nursing in Canada: Assessment and management of clinical problems. St. Louis: Mosby. Nettles, A. (2005).Patient Education in the Hospital.Diabetes Spectrum. Vol. 18/1. Powers, M, et al. (2006). Diabetes BASICS: Education, Innovation, Revolution. Diabetes Spectrum.Vol. 19/2. Registered Nurses’ Association of Ontario (RNAO).(2006). Diabetic Care.Ontario: Registered Nurses’ Association of Ontario. Tang, T, et al. (2005).Developing a new generation of ongoing diabetes self-management support interventions: a preliminary report.Diabetes Educ. Vol. 31/91–97. Thompson, A. (1993). Setting standards in diabetes education.Nurs Stand. Vol.25/28. Barman, R. (2011). Slide-Tape Presentations on a Classroom Budget. California: University of California Press. Bowles, K. et al. (2002). Teaching Self-Management of Diabetes. Home Healthcare Nurse. Vol. 20/1. Hawthrone, K & Tomlison, S. (1997). One to one teaching with pictures; Flashcard health education for British Asians with diabetes. British Journal of General Practice. Vol. 47/301-304. Hartzell, J. (2007). Adult Learning Theory in Medical Education. The American Journal of Medicine. Vol. 120/11. Nemshick, M. (1992). Designing Educational Interventions for Patients and Families. New York: Rutledge Hill Press Read More