Diabetes Care And Management Essay Examples

Diabetes Care and Management

Introduction
Diabetes is a chronic ailment caused by the diminished effectiveness or deficient production of the hormone insulin in the body. The characteristics of the disease include the presence of sugar glucose in blood at levels that are abnormally high. The disease reveals itself in complex symptoms such as hyperglycemia as a result of the pancreas not producing enough insulin or poor synthesis of 1secreted insulin in the body (Stoppler, 2014). This disease may lead to serious complications that include eye disease, nerve disease, kidney disease, dental problems, heart disease, and high blood pressure. The major risk factors that raise the prevalence of diabetes include obesity, hypertension, cancer, and decreased immune resistance to infectious diseases (Bilous 2002). In addition, diabetic patients are at a greater risk of neuropathic diseases of the blood vessels (National Diabetes Education Program NDEP 2000). The prevalence of diabetes in Oman in 2010 was 66,702 cases (Oman Ministry of Health, 2010), and the global diabetes prevalence stood at 11.1 cases (International Diabetes Federation, 2010). Educating patients and self-management are two crucial ways of increasing the quality of life for diabetics and extending their life span (Roberts et al. 2005). According to the National Diabetic Report (2014), diabetes can be cured by availing appropriate medications that help in reducing blood sugar levels and self-managed by the patients through eating a healthy diet.
The objective of the paper is evaluating the effectiveness and importance of health care education about diet for diabetic patients (NICE, 2004), as well as critically appraise the result of the evidence-based practice (Appendix I). Assessment of the clinical practice is done to identify the benefits of educating patients in the current clinical service with the use of the mini clinical audit managed in the health center. The model for clinical education in diabetes is a program that is planned, graded and whose scope is comprehensive and responsive to a person’s psychological and clinical needs (NICE 2004). In addition, the program has a flexible content and is adaptable to the cultural and educational background of the patient. It is necessary to carry out the appraisal so as to assess the existing conditions and, therefore, establish a management that is effective and suitable (IDF, 2011). Guidance for the appropriate exercise instruction can result in the successful treatment of chronic diseases and conditions that accompany diabetes. In addition, it can have a positive influence on the functional capability of slowing or preventing intolerance to exercise (The American College of Sports Medicine, 2009).

Audit

Diabetes mellitus can be controlled and managed by eating a healthy diet, engaging in physical and weight exercises, attending regular checkups in a medical health care facility. Taking medications is also recommended, and patients must follow the prescriptions of healthcare practitioners strictly. Clinical audit is a process that is effective and is focused on identifying ways to improve patient outcome and service (Professional Development Organization, 2012). The audit involves reviewing healthcare systematically in relation to change implementation and criteria. It evaluates health care service to ascertain if it is being implemented in accordance with established standards. The purpose of it is to allow quality perfection of health care to take place where more effectiveness will be realized therefore improving outcomes of users of the services (National Health Service (NHS), 2014). One research study noted that clinical audit results in moderate improvements in health care for both patients and the healthcare professionals (Achille, 2009). Clinical education evaluation is the theme for mini audit since it has a strong influence in the management of diabetes. As previously mentioned, patients can self-manage diabetes by adapting to a healthy lifestyle encompassing healthy diet, engaging in physical and weight exercises and getting appropriate medication.

Audit design

Clinical education evaluation is exciting to audit and review in Oman because of the prevalence of diabetes in this country. The purpose of conducting this study was to evaluate if health professionals in the audited health center were following the most recent guidelines geared towards improving health care services so as to ensure that patients had the potential to self-manage diabetes. To counter the prevalence of diabetes in Oman, these prevention methods should be incorporated in healthcare education. The audit is focused on identifying if dietary education was given to diabetics or not. The purpose of conducting the audit was to establish whether health care professionals take interest and incorporate the latest guidelines of care for diabetes patients in order to improve their lives. The objective the mini-audit was initially not clarified to the nurses so as to find out the adherence of clinical staff to the current healthcare protocols. In addition, it was conducted to evaluate the quality of the healthcare practice and to identify the gaps in healthcare provision. The files of patient’s and direct observation were used to obtain data for analysis. The first method used was direct observation, and this was to ascertain that indeed patients attended the clinics to get medical attention. The sample used in this audit was 15 diabetics, and 10 received dietary health education and 5 of them had not received the education (Appendix I).

Results (Appendix 2)

Fifteen diabetic patients were audited, 10 had received clinical education while 5 had not. The audit results indicated that a majority of the patients, 66%, received healthcare education. The ten patients who received the education were enrolled in the clinic for treatment or had made their regular or annual visits. The results were not in tandem with set standards, but 66% of the patients who received healthcare education had come for their initial examination, or were attending regular or annual follow-ups. Other assessment areas that should be included in future audits are the person performing the assessment and the assessment technique employed.

Discussion

Healthcare education is among effective methods for managing the prevalence of diabetes. This kind of education plays a crucial role in preventing the emergence of complications that accompany diabetes (NICE, 2004). Diabetes disease has an enormous economic impact, and there exist gaps in the prevention and treatment of diabetes. Because of this, the National Diabetes Education Program (NDEP) was prompted into action to develop Guiding principles in collaboration with other organizations (Anderson et al. 2014). An observational analytical study was done by Afridi MA and Khan MN (2003) to evaluate the awareness level of patients with diabetes about their illness and to see the association between different levels of knowledge, frequency of complication, and metabolic control. A total of 100 patients were included in this study. Questionnaires for each type of diabetes were designed, and the participants were grouped according to their level of knowledge and awareness about their illness. The results of the study showed that 58% of the patients had inadequate knowledge, and they had poorly controlled diabetes mellitus. Twenty percent of them had good knowledge and hence they had good control of their diabetes. The study concluded that health education is associated with good metabolic control and prevention of complications related to diabetes and its treatment (Afridi and Khan, 2003).
Another study was done in Oman, and it aimed to examine the effectiveness of lifestyle and dietary counseling of Omani adults with type 2 diabetes to the management of diabetes (Al-Sinani et al., 2010). A cross-sectional survey involving 98 participants with 65% of them illiterate was conducted. In 2005, dietary intake, metabolic parameter, and exercise level were evaluated and re-evaluated in 2008. The results of this research show that educating diabetic patients about the impact of their illness made them adapt good control measures for their diabetes. It is clear that improving dietary awareness in patients with diabetes improves the success rates of diabetes management (Al Sinani et al. 2010). One way to ensure dietary compliance for diabetics is to focus on increasing their number of follow-up visits to health education departments (Al Sinani et al. 2010). This study included a small group of patients, and some of them failed to adhere to the diet advised by the dietician. To further identify the effectiveness of healthcare education on control of diabetes, it is necessary to conduct more studies that use larger samples. Furthermore, the studies should be done over a longer time frame. Additionally, good patient awareness enables in-depth understanding of the mechanisms of the disease and the particular required. This in turn increases the self-confidence of patients thus motivating them to self-manage the disease (Prato et al. 2005)
American Diabetes Association (2012) published the national standards that should be followed in administering healthcare education about self-management of diabetes. The purpose for developing these guidelines were to determine the quality of healthcare education on self-management of diabetes, to support initiatives on self-management of diabetes, and to assist the healthcare professionals to provide training that is effective and that is guided by available evidence. The advantage of these guidelines is that they can be conveniently be applied by educators engaged in private practice and also by those who work on large programs that encompass many health centers. It is also crucial that appropriate education for controlling the levels of blood sugar is provided since it is the main parameter that is investigated in the analysis of diabetes (Weisenberger, 2014). Globally, the HbAlc test’s indication for the preceding 30 years has been to determine the level of control for glycemic for diabetics. This is used as a follow-up strategy in cases of diabetes that have recently been diagnosed and also conditions that have been there for long. This approach is useful in determining how effective treatment plans for healthcare providers and patients are (Christopher et al. 1989). Self-management education that is systematically administered encourages diabetics to be keen on their blood sugar levels and purpose to control it. Because of this, education on self-management of diabetes should be continuously be promoted (Chen et al. 2009). The education on self-management of diabetes encourages patients to be in control of their welfare and thus it should be promoted (Canter et al. 2000). There is evidence that support the necessity of self-management education. Researchers conducted a review of trials that were randomly controlled in an effort to identify the effectiveness of type 2 diabetes self-management training (Norris et al. 2002). The review’s studies indicated that self-management education for diabetics is effective in tackling diabetes. Essentially, the purpose of health education on diabetes is to ensure that people protect themselves from this disease and their quality of life is improved thus lowering the need for costly treatment (Boren et al. 2009). The audit aims at enhancing the understanding of the economic benefits that accrue due to providing diabetes education.

Nursing Role

Nursing have a crucial role to play in providing healthcare services to patient with diabetes hence their quality of lives. They are at the forefront of providing healthcare education since it is an important component of nursing care. Many observational and clinical trials indicate that nurses have the capability to provide effective and quality care to diabetics at all health service levels. Furthermore, the trial research indicates that nurses can be successful in the role of care education and diabetes management (Peimani et al. 2010). Another responsibility of healthcare educators is to evaluate how effective the education is. The evaluation is essential because it gives the perfect proof of how the varying qualities of diabetic patient education result in varying outcomes for patients. Improvement in self-management of diabetes by patients can be realized if they get a good understanding of the disease (Jacqueline 1980). In Oman, nurses involved in the care of diabetes patients must be trained and certified. They have to sit an examination that is used to judge their eligibility of providing healthcare education. Therefore, it is recommended that not only should the Ministry of Health send nurses to focal points but should also ensure that the nurses have a good background and deep understanding about diabetes. Training nurses on how to supervise and guide patients on self-management of diabetes translates into improved outcomes for patients (Davidson et al. 2003). Nurses have the capacity to explain to patients how to practice health behaviors every day so as to achieve visible results in the long-term (American Association of Diabetes Educators 2014). For nurses to qualify as effective members of teams involved in diabetes management, it is necessary that they have particular qualities. These qualities include good communication and interpersonal skills, ability to enhance learning and educate others, ability to negotiate and direct patients, and being sensitive to the needs of patients (Royal College of Nursing 2006). In addition, patients and nurses should form collaborations and partnerships that act as foundations for succeeding in patient care. Nurses have the responsibility of adopting care that is focused on patients especially in diabetes management. This can be achieved by considering the preferences of patients and respecting their decisions when coming up with a diabetes management strategy. The role of nurses in the management of diabetes has assumed a new perspective; it is now more expanded and advanced. Currently, the role includes directing the patients to proper resources and services that are available and coordinating the care of patients. Additionally, the role encompasses monitoring a patient’s glycemic control, ensuring that patients do follow-up visits, monitoring the patients’ progress, and offering counseling services and more education. Nurses who advanced skills engage in diagnosis of patient’s conditions, establishing the type of treatment to give, and making decisions on whether the patients should be referred to other healthcare providers (Royal College of Nursing 2006). The community plays the role of continuing nursing care in health centers. Furthermore, to ensure that good control of diabetes is maintained, it necessary to involve a team of healthcare experts that can include psychologists, nutritionists, physicians, nurses, podiatrists, and endocrinologists (Peimani et al. 2010). The successful working of the team requires coordination and teamwork, and this collaboration among professionals in this team can result in early detection of diabetes disease. For the team to achieve good outcomes in the care of diabetic patients, they should be excellent communication among the members and with the patients under their care (Royal Australian College of General Practitioners 2012). Patients occupy a central position in this team, the focus is on them. If their efforts to manage diabetes succeed, then the team will have succeeded. A working partnership has to be created between the patient and the healthcare provider in order to enhance the understanding or comprehension of the needs of patients. This is crucial in developing an appropriate treatment strategy (Royal Australian College of General Practitioners, 2012).

Conclusion

Major components in managing diabetes include dietary therapy, physical and weight exercise, lifestyle modification and providing appropriate medication. Providing patients with health education on these components enables them to self-manage their conditions. This paper has critically reviewed the benefits of offering healthcare education to patients with diabetes. A mini audit also conducted in a health center laid bare the weak areas in healthcare service that should be worked on. The clinical audit evaluated the quality of healthcare service and discovered weak points in the service. The results of the audit are: nurses should be proactive in providing healthcare education on self-management of diabetes to patients in order to achieve effective patient’s outcomes. Nurses and other healthcare practitioners should form collaborations in order to enhance the care of patients. Patients are the focus of these collaborations. Future improvement in the healthcare education services can be achieved through developing guidelines on diabetic education that can apply in all environments. A guideline for offering education to diabetic patients who only come to clinics to collect medications or to seek blood investigation services should also be developed. This is because, these are considered as full visits done to seek medical attention for control of diabetes.
Furthermore, there are other areas that need to be audited for future success of healthcare education programs to patients. These areas include partnerships that will yield good outcomes, the skills and training levels of professionals involved healthcare education, the education tools used, and if these tools meet current evidences and guidelines. In addition, the pathway used to refer and manage patients should be audited to establish its effectiveness. Any attempts to establish a pathway for referring patients should be guided by guidelines that are informed by available evidence which health organization should have (National Institute of Clinical Excellence 2004). Community nurses are a crucial component of the health management team. Their role is to empower diabetic patients be active participants in preventative care and healthcare education (Fitzgerald et al. 2009). The healthcare education in diabetes management is crucial in helping diabetic people learn how to self-manage the disease (American Association of Diabetes Educators 2014). The education on diabetes focuses on self-care behaviors that enhance the quality of life of the patients. These behaviors include taking medication, healthy diet, physical exercises, keen monitoring, healthy coping, and problem-solving. To evaluate the extent of healthcare education among patients, it is imperative to conduct clinical audits in healthcare facilities. Additionally, nurses have an important role in providing healthcare education to patients with diabetes. To ensure the advancement of this education, nurses, patients, and other healthcare practitioners should form strong partnerships to achieve the best results. The collaboration of healthcare professionals, utilizing available resources providing public education is the recipe required in managing and reducing the prevalence of diabetes.