Intervention for the Improvement of Hypoglycemic Control
Diabetes complication is one of the top health problems in the United States, and the ADA (American Diabetes Association) recommends that people suffering from diabetes should control their hypoglycemic and maintain A1C to < 7% to avoid diabetes complications. To achieve this objective, the “diabetes self-management education (DSME)”(Ni coll, Raiser, Campbell, ET AL. 2014 p 207) is an effective tool to enhance hypoglycemic control and improve patients’ outcomes. The DSME is an on-going educational process to facilitate the skill, knowledge, and ability of patients to carry out a diabetes self-care. I am a diabetic educator working in the diabetic outpatient clinical setting. My experience has made to understand that patients struggle to manage and control their diabetes after being educated because patients are not allowed to set their goals in order to manage their diabetes. (American Diabetes Association; 2013).
Objective of this paper is to design the DSME (“diabetes self-management education”) to motivate and encourage patients to involve in their diabetes self-care for the improvement of hypoglycemic control.(Ni coll, Raiser, Campbell, ET AL. 2014 p 207)
Diabetes Self-management Education
The diabetes self-care education is an on-going process that facilitates patients’ self knowledge as well as enhancing diabetes self-care. The DSME is very critical for the diabetes management because it assists in enhancing patients’ outcomes. More importantly, the diabetes self education incorporates goals, needs, as well as life experience to enhance patients’ evidence-based standards. Effectively, diabetes education is an effective tool to improve patients quality of life and clinical outcomes. Although, there is no gold standard for the design of self-management education, however, an effective self education programs incorporate behavioral and psycho-social strategies to improve health outcomes of patients. However, people with diabetes still require a greater deal to learn to become self-managers of the their diabetes. An health care organization needs to integrate a collaborative care with education to enhance a behavioral change of patients to make them understanding the strategy to carry out a self-management education for the improvement, maintenance, and sustainability of hypoglycemic control.
Consistence of Organizational Culture with the Proposal
Although, the DSME is very critical for the enhancement of hypoglycemic control, however, there is a need to integrate the organizational culture to enhance an effective implementation of the DSME for the assistance of the overall patients. Organizational culture refers to shared values, assumptions, and beliefs that govern an organizational conducts. Typically, the organizational culture influences the overall employees’ conducts and the strategy that an organization employs to conduct their job. (Funnell, Brown, Childs 2010).
The strategy that my health care organization can employ to enhance patients self education for the diabetes management and hypoglycemic control is to set up the cultural competent committee that will organize the nursing practitioners who will be in charge of the DSME. Moreover, the leadership of the organization should recognize the importance of the DSME for the management of diabetes. The support of the management is very critical for the successful implementation of the program, and management should integrate the implementation of the DSME in the organizational planning. The integration will make the organization to approve financial and human resources that will assist in the implementation of the program. (Norris, Lau, Smith,,et al. 2002).
Moreover, the program coordinator should be set up to oversee the planning, evaluation and implementation of the proposal. The coordinator should assist in making participants having access to the needed resources. Moreover, the instructional staff should be set up to design and plan the DSME. The instructional staff should consist of registered nurses, pharmacists, and registered dietitians experienced in training pertinent to the DSME. Other health care workers can contribute to the DSME, however, they should have appropriate training in diabetes.
3. Expected Outcomes
The expected outcome of the program will be recorded for the improvement, and sustainability of hypoglycemic control among diabetes patients aged between 40 and 60 years. Typically, the risks of diabetes increase with age, and can cause serious problems. Thus, the program will reduce the complication of diabetes because patients will be taught on the strategy to manage their diabetes. The expected outcomes will make patients receiving the “DSME to improve the hypoglycemic to a substantial degree, and the effect will be sustained for up to 6 months.” (Ni coll, Ramser, Campbell, et al. 2014 p 207). The expected outcomes will lead to a significant reduction of AIC for all patients who receive the DSME. (Mason State University, 2014)
In the UK, a reduction of 1% of the A1C lead to a 21% reduction
“in diabetes-related endpoints, an 18% decrease in combined fatal and nonfatal myocardial infarction, a 12% decrease in stroke, a 37% decrease in microvascular endpoints, a 25% reduction in diabetes-related deaths, and a 7% reduction in all cause mortality.” (Nicoll, Ramser, Campbell, et al. 2014 p 210).
This proposal will achieve the similar outcomes within 6 months for diabetes patients receiving DSME, and who are between 40 and 60 years of age
4. Method to Achieve Outcomes
Method of achieving the outcomes is by measuring the patients glycemic level, blood pressures, BMI Index . The reductions in glycemic level, blood pressures, and BMI Index reveal that the proposal is achieving better results. The limitation of the program is that there may be a shortage of financial resources to implement the program. However, the organization can raise fund from health care foundations.
5. Outcome Impact
The outcome of the program is an improvement of quality care improvement, and patient-centered quality care.
American Diabetes Association (2013). Standards of medical care in diabetes — 2013. Diabetes Care 36 (Suppl. 1):S11 — S66, .
Funnell, M.M. Brown, T.L. Childs B.P. Et al. (2010). National Standards for Diabetes Self-Management Education. Diabetes Care. 33: 589-596.
Nicoll, K.G. Ramser, K.L. Campbell, et al. (2014).Sustainability of Improved Glycemic Control After Diabetes Self-Management Education. Diabetes Spectrum 27 (3): 207-211.
Norris, S.L., Lau, J., Smith, J.,et al. ( 2002). Susan Sundae, N.L Norris elf-Management Education for Adults with Type 2 Diabetes meta-analysis of the effect on hypoglycemic control.
Mason State University. (2014). What is a PICOT question?.
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