Literature

A comprehensive training program for diabetes teaching nurses

Description
A comprehensive training program for diabetes teaching nurses
Categories
Published
of 2
0
Categories
Published
All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
Share
Transcript
  Track 1. Education, Nutrition & Psychosocial Aspects of Diabetes Care $21 diabetes in selected AAPI communities. Results will also identify gaps between people living with diabetes and health care providers'perception of the self-management of diabetes in these communities. The results will be used in implementing culturally and linguistically appropriate diabetes awareness activities to prevent and manage diabetes in AAPIs. Conclusion: Gathering information from the community is an important step to ensure that appropriate approaches are used for preventing and managing diabetes in these communities. The data is currently being analyzed and the report will be available by May 2000. rally was rated as amusing even though it lasted as long as 90 minutes by 4.8 players/game. It was observed that at least 2 sessions were needed to reach the incentive and complete the game. The competitive spirit of the game captured the players so much that it facilitated the educators ability to evaluate the degree of self management of participants and forecast eventual problems. Conclusion: facing the challenge of continuing edu- cation in chronic disease, any tool able to capture the attention of children enables health professionals to monitor the compliance of treatment. The rally game could easily be adapted to the web. P161 Developing Nursing Management Guidelines for Elderly People with Diabetes Hospitalised or in Residential Care: The Long Road Ahead MICHELLE L. ROBINS. Traditionally, nursing management guidelines have focused on acute med- ical issues related to Type 1 diabetes, for example, ketoacidosis. A review of current diabetes nursing management guidelines at a ten campus aged care facility was undertaken to address aged specific management issues. The process coordinated by the Diabetes Nurse Educator involved collab- orative input from a variety of stake holders including specialised medical, nursing and allied health professionals. The result was the development of nursing management guidelines that promote quality practice in aged specific diabetes management. These guidelines differ greatly in some key areas when compared to acute tertiary institution guidelines. Areas of management including capillary blood glucose monitoring regimens, hypoglycaemia detection and treatment, enteral therapy, inter-campus transport and discharge planning have been identified as requiring a different approach. The guidelines also identified the different client needs with respect to management goals between sub-acute and residential care. This process has also highlighted the enormous deficit in best practice and evidence based management of the elderly person with diabetes. The prevalence of diabetes is highest in the over eighty years of age population. Access to specialised diabetes health professionals can often be very limited for the elderly person with diabetes. Providing quality care to the elderly with diabetes requires complex management strategies and an innovative approach to service provision. At present limited guidelines exist. The lack of consensus with respect to standards of care for the elderly with diabetes continues to place challenges along the road ahead. P162 The Rally Game: An Alternative Method of Education for Young Diabetic Patients MAXINE J. SCHLAEPPI, Claude A. Brocard, Luz Perrenoud, Sylvie Masmont, Yolande Cherica, Gerald E. Theintz. Unit of Endocrinology-Diabetology, Dept. of Pediatrics, University Hospital, Lausanne, VD, Switzerland Purpose: a diabetic child's life is not easy being punctuated with auto- controls, injections and dietary limitations. Integrating games into the educational process helps remove some of the stress and difficulty of learning. Method: The rally game was created to benefit children between the ages of 8 and 15 years, instigate the interest in diabetes self management and create a link between the pathophysiology of the disease and dally life. The game is based on Trivial Pursuit © using a concept of questions and answers for 2-6 players in interactive sessions inducing a competitive spirit. It consists of a playing board with a central door locked by a golden key giving access to an incentive. This key can only be obtained by exchanging 6 different coloured keys representing a set of correct answers related to areas of diabetes care. The game was tested by 79 children aged 11.7 + 4.6 yrs (M 4- SD) including 55 children in their home setting under the supervision of the diabetes community nurse: parents and siblings also participated. The remaining 24 children used the game during the annual diabetic children's camp. Results: the P163 Educational Admission System of Diabetic Patients Using Critical Path and Practical Guideline KENICHI NAKATA, Tatsuaki Nakatou, Tatsuya Itoshima. Diabetes Center, Okayama Saiseikai General Hospital, Okayama City, Okayama, Japan The importance of education of patient is well recognized in managing di- abetes mellitus. In Japan, hospital admission for the education of diabetic patients is now widely provided. The purpose of this study is to establish the quality and effective educational admission system using critical path and practical guideline. We dealt with 100 patients admitted to the Okayama Saiseikal General Hospital for the education of the diabetic therapy from June 1997 to May 1998. The average age was 58.4 years and 92.0% of them were type 2. The average duration of therapy for diabetes at the time of admission was 7.0 years, and 38 patients were without any treatment. Patients were educated and treated for two weeks according to the critical path and practical guideline of our own hospital. We estimated the ap- propriate control of blood glucose of the patients, comparing hemoglobin Alc of before and after education. Using critical path, education and treatment were accomplished equally and effectively. The healthcare providers could cooperate each other easily. Patients were without anxiety because they were noticed the path previously. Before admission, 12 patients were treated with diet, 33 with oral antidiabetic agents, and 17 with insulin. After admission, 15 patients were treated with diet, 47 with oral antidiabetic agents, and 38 with insulin. The average value of hemoglobin Alc was 10.6% at admission, and recovered to 8.1% one month, 7.1% three months, and 7.3% six months after the education. We concluded that the implementation of critical path and practical guideline is beneficial for educational admission of diabetic patients. P164 A Comprehensive Training Program for Diabetes Teaching Nurses DAN CHETA 1, Tiberiu Mogos I, Emil Trifan 1 Daniela Boboc 1, Rodica Perciun 2, Rodica Strachinariu l, Mariana Costea 1, Mafia Sima I, Madalina Andronescu 1, Tudor lures 3, Simona Blaj s, Andrei Moroti3. t N. Paulescu ' Institute, Bucharest, Romania; 2 'Malaxa Hospital, Bucharest, Romania; s Novo Nordisk, Bucharest, Romania Taking into account the difficulties of diabetes education in Romania and the objectives of the St. Vincent Declaration, N. Paulescu Institute and Novo Nordisk Representation Office initiated a training program for diabetes teaching nurses in 1994. The Ministry of Health and some other institutions has supported its implemetation. The candidates have been gradually recruted and divided into groups. It consisted in 10 classes (2 classes dally of 3 hours each, from Monday till Friday) and included the main educational topics in diabetes, starting with diabetes types and going to psychological and social features. Between 1994 and 1999, 199 persons (15 groups) have been trained: 149 from all districts, 45 from Bucharest and 5 from the Republic of Moldavia. The organizers have established several proceedings in order to continue the exchange of information with the graduates. Their work has been sustained by the setting up, in several  $22 Poster Session 1 centers, of some modem educational consulting rooms. The training program for diabetes teaching nurses represents a major contribution to the improvement of diabetes care in Romania. The experience gained by us could be useful to other countries interested in developing similar projects. P165 Improving Physician-Patient Communication in Diabetes Management RENEA A. BRADLEY 1, Helenruth Schuette 2, Gregg D. Simonson t, Todd Weaver t, Stuart Sundem i, Angela Sharp i, Roger Mazze ]. Patient participation in diabetes management has been recognized as important in predicting successful outcomes. In spite of patient advocacy efforts, patients remain relatively uninformed about their condition and the treatment options available. The purpose of this study was to determine if physician-patient communication could be improved using a written plan of treatment agreed upon by both parties facilitated by an educational tool called the Staged Diabetes Management (SDM) Owners Manual. The core of the Owners Manual is the Master DecisionPath, which was used to develop a written individual treatment plan. During the SDM training process physicians were introduced to the Owners Manual and how to stage therapy, develop timelines for improvement, set targets for HbAlc and Self-Monitoring of Blood Glucose (SMBG) as well as expectations for follow-up. The investigators recruited 9 newly diagnosed patients who were given the Owners Manual and entered into a written agreement with the physician specifying their individual treatment plan. These pa- tients were compared to a control group of 23 newly diagnosed patients who were not given an Owners Manual and written agreement. Both groups were referred for diabetes education and given a baseline diabetes knowledge test. The intervention group scored higher in all aspects of the knowledge test compared to the control group: Test Question Control (n=23) Study (n=9) P-Value Knew Diagnosis 78% 100% 0.065 Knew Type of Diabetes 39% 89% 0.006 Knew SMBG Target 9% 89% <0.001 HbAlc Target Known 4% 17% 0.002 Knew Stage of Therapy 57% 88% 0.042 Furthermore, interviews with both the patient and physicians indicated they were satisfied with this tool as a means to facilitate communication. Providers indicated that the written agreement helped focus the discussion about diabetes, increased knowledge and took the mystery out of diabetes management for the patient. These findings were used to further develop the SDM Owners Manual, incorporating the written agreement into a set targets and track progress, and a glossary of diabetes terms. P166 How To Empower Persons with 2~pe.2 Diabetes to Self-Care in Practice: A Patient-Centered, Outpatient Weight-Control and Self-Care Program LIISA HEINONEN, Pirjo Ilanne-Parikka, Maija Ojala, Kirsi Heinonen, Riikka Turku, Jaana Huhtanen, Anja Majala-Eklund, Juha Kauppila. The therapeutic role of patient-centered education has been widely ac- cepted in the treatment of diabetes. The treatment is largely based on self-care. Among persons with type-2 diabetes weight control, reasonable eating habits and physical excercise are the most important issuess in self-care. The implementation of these matters is a question of lifestyle. Merely providing information has very little significant effect on eating and excercise in real life. There is an enormous need to improve the educational strategies for persons with type-2 diabetes in a practical way in order to elicit the life-style changes. Purpose and strategies used: The purpose of this educational program was to find optional methods rather than simply providing an informa- tion overload so that the patients could motivate themselves to make lifestyle changes. The purpose was also to improve metabolic control. Our strategies were: - the use of a multi-professional team approach: a physician specialized in diabetology, a nurse specialized in diabetes education, a psychologist, an exercise instructor, a foot therapist, a nutfitionist and a dietitian specialized in kitchen skills -the topics of the program were solicited from patients and the program was constructed with them - weekly group-meetings for a two months period and home tasks between the meetings (learning by doing) - self-assesment questionnaires were used to evaluate their own prefer- ences: they were asked where self-care should start. - individual appointments with the physician and other members of the team when needed Patients and Methods: 24 persons with type-2 diabetes(14 men and 6 women) were sent from Helth Care Centers. The mean age was 49 years (range 36-62). The mean duration of diabetes was 7 years (range 2-6). The mean BMI was 32.6 and the mean HbalC was 7.9% All the patients were on medication (Sulfonylureas and/or Metforem). HbalC and BMI were measured also after 5 months. Results: Though the program and its targets were built in a patient-cen- tered way, the means of Hbal c and BMI didn't change. At any rate 9(37%) of the patients decreased their Hbalc-values at least 0.2%. Among them the mean decrement was 1.2% (range 0.2- 2.7). Conclusions: The effect on metabolic control was only modest. The number of participants was too small to support the making conclusions on the program thus far. To empower the persons with type-2 diabetes is a continuing challence. In this program 37% of the patients were able to improve their glycemic control. The questions for further consideration are: is the effect lasting and how is it possible to influence the rest of the patients? What are the factors that could increase the effect of education and empowerment? P167 Oral Hygiene in Diabetes Mellitus Patients H. KHOLODOVA, T. Shinkevich, I. Karlovich. Minsk Medical Institute Belarus The objective of the study was to investigate he diabetes patients attitude towards their own oral cavity conditions. Methods and materials: 85 diabetes patients, 16-45 years old, treated at Rehabilitation and Education Diabetes Centre were questioned in order to find out habits influencing the oral health. Hygienic oral cavity conditions were assessed according to OHI-S index (Green, Vermilion, 1964) Results: Diabetes patients questioning have shown that 15.4% of patients assess their oral cavity conditions as good, 44.2% of patients assess their oral cavity conditions as satisfactory, 40.4% of patients assess the their oral cavity conditions as poor and very poor. 33% of questioned patients visit a dentist twice and more per year, 67% - less than once a year. 84.6% of them visit a dentist only in case of teeth's pain and problems. 15.4% of diabetes patients visit a dentist regularly with preventive purpose. Only 53.8% of patients provide systematic hygienic oral cavity care. 13.5% of them were motivated and instructed by a dentist, 30.7% of them - by TV advertising and other mass media information, 55.8% - were not taught to do this at all. Objective examination of oral cavity have shown that average hygiene index (OHI-S) was 2.744-1.17, that may be interpreted as poor oral cavity hygiene. Conclusions: Low level of diabetes patients' hygiene have shown insuffi- cient oral cavity care. Lack of dental education and due attention to oral cavity hygiene questions was a justification to process and implement a special dental curriculum into the work of Rehabilitation and Education Diabetes Centre.
We Need Your Support
Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

Thanks to everyone for your continued support.

No, Thanks
SAVE OUR EARTH

We need your sign to support Project to invent "SMART AND CONTROLLABLE REFLECTIVE BALLOONS" to cover the Sun and Save Our Earth.

More details...

Sign Now!

We are very appreciated for your Prompt Action!

x