Diabetes Management and Diabetes

Teaching Proposal on Diabetes

In recent years, an increase in demand for expansion of education programs for diabetes patients has been observed and for Federal Government or third party payers to support these programs. A survey by Veterans Administration Hospital evaluating the capability of patient for diabetes management, reported lack of formal training in over 35% of patients interviewed (Miller, Goldstein & Nicolaisen, 1978, p. 275). Similarly, accomplishing proper management of self-administration of insulin also continues to be a critical concern. Therefore, an educator needs to set appropriate and reasonable, specific, mutually agreed goals; and should remain sensitive to individual fears and anxieties while setting these goals.

Project Narrative

Introduction

Diabetes education is a lifetime learning process, which is developed and modified as per the requirements of people afflicted with diabetes. However, assessment of these requirements is time-taking, still vital for customizing diabetes education. Thus, to determine one's educational requirements and recognize his current and potential future problems, it is essential to collect all information including demographic data, work schedule and conditions, diabetes information, self-management abilities and behavior, medical history and present health status, physical activity, health opinions and attitudes, personality and social condition, willingness to learn, cultural factors, cognitive skills, financial status, and physical limitations. This valuable information can be gathered by reviewing their medical records, regarding their general health history and previous experiences of diabetes management. Details of people's physical appearance, relaxation activities, literacy level, family relations, his thoughts, feelings and efficacy of self-care can be collected through observation. The observations made should be objective and shared with the person to confirm its validity, and words like 'appears,' 'looks like,' 'seems' should be avoided. Similarly, proper management of self-administration of insulin is also a critical task to accomplish. Therefore, an educator needs to set appropriate and reasonable, specific, mutually agreed goals; and should remain sensitive to individual fears and anxieties while setting these goals (Ozcan & Erol, 2007, pp. 23-24)

Objective of proposed activity

Diabetes self-management education and support (DSME/S) provides the base to support people with diabetes and improve health outcomes. It's not only cost-effective, reducing hospital admissions and readmissions, but also reduces lifetime health-care costs and a lower risk for complications. It also helps inhibit the onset and advancement of complications pertaining to diabetes; improves regular physical activity; enhances self-efficiency and empowerment and decreases diabetes-related depression and distress (Powers et al., 2015). Therefore, this activity aims to train patients to administer insulin therapy and improve their quality of life by imparting diabetes management education to them.

Plan

In recent years, an increase in demand for expansion of education programs for diabetes patients has been observed and for Federal Government or third party payers to support these programs. A survey by Veterans Administration Hospital conducted a survey to evaluate the capability of patient for diabetes management reported lack of formal training in over 35% of patients interviewed (Miller, Goldstein &Nicolaisen, 1978, p. 275). A careful planning of methods of teaching and learning (individual/group), techniques (discussion/ short lecture/ role-play/ problem solving/ case study), and materials (printed/ games/ audiovisual) is essential to achieve self-management goals in this learning process (Ozcan & Erol, 2007, p. 24). Consequently, some recommendations for training patients to administer insulin therapy, which reflect best practices, are as follows:

• The therapy should be initiated after a thorough patient assessment, including numeracy skills and health literacy. Therapy initiation should be followed by follow-up phone calls.

• Treatment adherence should be measured during follow-up visits to recognize adherence issues, changing barriers or other problems due to poor recall of instructions etc. Injection practice should also be observed and re-trained, if required.

• They should be well-instructed about the site rotation and its importance; also sites inspection is crucial for any signs of lipohypertrophy or lipoatrophy during all follow-up visits.

• Appropriate language should be used while teaching injection technique avoiding technical terms like "spearing" or "throwing a dart." Moreover, psychological discomfort can be reduced by minimizing delay in injecting.

• Dose should be prepared by insulin inspection, manufacturer's directions for rolling to suspend insulin and evading air bubbles.

• Insulin-mixing should be as per American Diabetes Association.

• Different creative strategies in insulin storage like applying colored dots or rubber bands, or colored vial sleeves to insulin vials, may be helpful in avoiding patient's confusion about different insulin types.

• Risk stratification table can be used to identify patient's target blood glucose level.

• Unused Vials needs to be refrigerated. Recapping is critical while reusing the needles, while needles should be removed in extreme climates (Siminerio et al., 2011, pp. 5-6).

Importance of project to patients

Proper insulin administration is important because individuals that require insulin should be given additional education so that insulin treatment can be synchronized with eating pattern of patients and their physical activity habits (Powers et al., 2015).

Activities and Timeline

Teaching plan for diabetes would include 2-3 hours' sessions in 6 day/evening classes, which would contain education and group discussion. The areas of education and discussions would be as follows:

Day 1: General outline and overview of diabetes (2 hours).

9.00 am -- 11:00 AM/ 5:00 PM -- 7:00 PM

Day 2: Monitoring blood glucose and objectives of blood glucose monitoring (3 hours).

9.00 am -- 12.00 noon/ 5:00 PM -- 8:00 PM

Day 3: Insulin and Medications (2 -- 3 hours)

9.00 am -- 12.00 noon/ 5:00 PM -- 8:00 PM

Day 4: Complications with/from Diabetes (1 hour)

Diabetes and Exercise (1.5-hour)

Skin and Foot Care (0.5-hour)