Diabetes mellitus
Diabetes mellitus is one of the non-communicable diseases that affects a large population in the world, and the numbers of the people suffering from the condition are anticipated to rise in the future (Azami, et al, 2018). Management of the condition is thus critical, both at clinical and community setups to improve the health outcomes of the affected individuals. Mrs. Z is an American woman of age 42 years and she has suffered type two diabetes mellitus for a long period. She reported having had the condition for the past of has even years. Mrs. Z has been in and out of the hospital for all this time, however, her blood glucose has not stabilized. One of the possible reasons for poor blood glucose control can be the failure to strictly adhere to medications as well as inactive lifestyle and failure to follow dietary recommendations (Settineri, et al, 2019), some of the factors highlighted by Mrs. Z during the interview. The first encounter with the patient was during a community sensitization program and she was introduced to me by a close friend. Ever since then, Mrs. Z became my friend too.
Nevertheless, diabetes mellitus has both personal and professional significance in the scope of nursing. First, the condition affects a large population of both genders and various ages, which is an eye-opener to the practitioners to come up with better strategies for its management. Additionally, diabetes mellitus also helps one to come up with personal objectives such as lifestyle changes to prevent disease contraction since poor lifestyle choices are one of the risk factors (Munshi, et al, 2016). The condition also allows one to set personal practice goals such as attaining blood glucose control for the patients.
Literature, as well as other professional sources, provide plausible evidence of the nursing actions necessary to address diabetes mellitus. However, the selection of these materials was based on specific criteria. First, peer-reviewed resources were selected for the evidence, which included government publications, research papers, and journal articles. Second, only resources not old than five years were considered credible for the analysis of the nursing actions. Some of the proposed nursing actions for the management of diabetes include self-care support, shift from reactive to proactive service care delivery approaches as well as patient-centeredness, only to mention but a few. According to American Diabetes Association, 2016, nurses should take an active role in patient education on home-based management of the condition by showing the importance of personal care, which includes foot care, proper drug administration, and lifestyle modifications.
Additionally, Azami, 2018, states that diabetes management should be patient-centered. Factors such as medication preferences, Lifestyle changes, and the entire process of management must actively involve the patient’s choices to achieve the best health outcomes. Medications and treatment plans should be timely and based on evidence while considering potential barriers such as economics, culture, literacy, and numeracy.
The main aim of the intervention is to attain blood glucose control in Mrs. Z’s case. However, this is not exclusive since the overall health is expected to improve as well as minimizing the risks of other comorbidities secondary to diabetes mellitus. The underlying conditions must also be monitored throughout the management plan, to achieve positive overall health outcomes. Concerning this, certain strategies will help improve blood glucose monitoring outcomes in Mrs. Z’s case. First, educating the patient on personal care will help improve the outcomes. Integration of personal care, on top of the normal diabetes management routine, helps the patients attain more control of their condition, as they can take care of themselves at home, of course with monitoring from the nurses.
Second, ensuring a patient-centered communication style is another approach to attain better health outcomes in diabetes. Patient-centered communication strategy assesses literacy and numeracy, incorporates individual preferences, and considers potential barriers that hinder the patient from attaining the goals of diabetes management (Krikorian, 2016). For instance, in this case, this strategy will be employed by assessing the context of Mrs. Z that makes her not to adhere to medications provided and lifestyle recommendations. Other alternative strategies include team-based care support by health systems as well as advocacy for patients with diabetes. However, the two strategies discussed above are more critical and thus chosen for the management intervention since they allow the patient to understand the rationale of personal care.
Finally, the state board provides nursing practice standards that govern the management of diabetes. These standards include assessment, which outlines the context of the patient as well as any other relevant information concerning his or her health status. Another standard is the identification of the desired outcomes, which includes goal setting, both at personal and professional levels. Planning, implementation, evaluation, and documentation follow thereafter. The nursing practice standards ensures a systematic approach in the management of diabetes mellitus as well as other conditions. According to Krikorian, 2016, nursing practice standards allow the practitioners to keep track of all the activities during an intervention and can easily identify and predict challenges and barriers and thus avoid them. Therefore, these practice standards are relevant to the intervention of Mrs. Z’s diabetes management.
References
American Diabetes Association. (2016). 1. Strategies for improving care. Diabetes care, 39(Supplement 1), S6-S12.
Azami, G., Soh, K. L., Sazlina, S. G., Salmiah, M., Aazami, S., Mozafari, M., & Taghinejad, H. (2018). Effect of a nurse-led diabetes self-management education program on glycosylated hemoglobin among adults with type 2 diabetes. Journal of diabetes research, 2018.
Krikorian, A. (2016). Standards of medical care in diabetics. J Am Diabet Assoc, 39(Suppl 1), S1-S2.
Munshi, M. N., Florez, H., Huang, E. S., Kalyani, R. R., Mupanomunda, M., Pandya, N., … & Haas, L. B. (2016). Management of diabetes in long-term care and skilled nursing facilities: a position statement of the American Diabetes Association. Diabetes care, 39(2), 308-318.
Settineri, S., Frisone, F., Merlo, E. M., Geraci, D., & Martino, G. (2019). Compliance, adherence, concordance, empowerment, and self-management: five words to manifest a relational maladjustment in diabetes. Journal of multidisciplinary healthcare, 12, 299.