Tuesday, October 22, 2019
Determining the Right Quantity of Food (Home Remedy) To Give a Diabetic Patient In Case Of a Hypoglycaemic Episode The WritePass Journal
Determining the Right Quantity of Food (Home Remedy) To Give a Diabetic Patient In Case Of a Hypoglycaemic Episode Introduction Determining the Right Quantity of Food (Home Remedy) To Give a Diabetic Patient In Case Of a Hypoglycaemic Episode ; Cryer, 2012; Frier, Schernthaner Heller, 2011; Yakubovich Gerstein, 2011, Heller, 2008). There are studies that have directly found links between hypoglycaemia and high mortality rates in diabetic patients and those that link it directly through other complications. According to Mccoy et al., (2012), severe hypoglycaemia has been associated with 3.4 times increased threat of death. This was a conclusion obtained from self-reports on hypoglycaemia. Additional information from patient-reported hypoglycaemia from hospitals could only mean that the risk is higher (Mccoy et al., 2012). Any health management officer would think of preventing hypoglycaemia so that this increased risk is reduced. One way of preventing it is through access to relevant information about its management. This proposed idea will contribute to the reduction of severe hypoglycaemic cases that may then lead to death. The same information about 3.4 fold risks is communicated in Cryer (2012). The study also indicates that hypoglycaemia is an impeding factor in the glycaemic management of diabetes. It damages the defences that can protect an individual from subsequent hypoglycaemia, therefore, causes recurrent hypoglycaemia. It causes morbidity in many with advanced type II diabetes and in most people with type I diabetes. It prohibits the maintenance of euglycemia and reduces the quality of life; the benefits of glycaemic control are never realized by the patient. Cryer (2012) also reviewed information from various reports about hypoglycaemia and found out that one in every ten or one in every twenty-five people with type I diabetes die from hypoglycaemia. It concluded that hypoglycaemia episodes need not to be life threatening for them to cause devastating effects (Cryer, 2012). This only emphasises the impact that this proposed innovation may have on diabetes patients. It has the potential of preventing any devastating effects, including death. Hypoglycaemia also has other health effects, for example, the effect on the cardio -vascular system, which in turn contributes to increased mortality. According to Frier, Schernthaner and Heller (2011), hypoglycaemia cause hemodynamic changes such as peripheral systolic blood pressure, and increased heart rate, reduced peripheral arterial resistance, a fall in central blood pressure and increased stroke volume, myocardial contractility and cardiac output. If such high work load finds an already weakened heart, like the ones found in type II diabetic patients with coronary heart disease, dangerous consequences should be expected. Hypoglycaemia has also been associated with abnormal electrical activity in the heart, therefore, has high chances of causing sudden death (Frier, Schernthaner Heller, 2011; Yakubovich Gerstein, 2011). All these evidences support the importance of preventing hypoglycaemia, at all levels. Prevention or good maintenance of blood glucose levels can enhance the quality of life. Risks and Benefits of the Innovation Provision of the leaflets is a way of providing high-quality information recommended for self-care and helps in decision-making. In this case, there will be a variety of fast-acting carbohydrates with the right quantities. A patient may get tired of taking non-diet soda all the time, and decide on other options such as fruit juice, glucose tablets, and honey. The leaflets will improve: health literacy, clinical decision making, patient safety, care experience, self-care, service development, and access to health advice for both the patient and the family members (Greenwood, 2002). Research evidence has shown that chronic conditions cause anxiety, but understanding of the condition and how to manage and treat it improves the ability of the patient to cope with the condition or to recover from it. It is for this reason that the leaflets with information on what to take when attacked by an episode of hypoglycaemia are very important for diabetic patients. Patient information leaflets merge information (Lowry, 2005). The leaflets also act as health promotion devices and will assist nurses in their health education and promotional activities (Greenwood, 2002). This innovation has other advantages, such as they contain information relevant for the individual, ensure consistency of information, are cheap and easy to produce and can be easily updated. This proposed innovation would also allow readers to work through their own pace. According to Lowry (2005), they provide the carer and the patient with a focus for shared knowledge and discussion, and can also be used as a resource to healthcare organizations for informing their new staff members. In order to ensure that the leaflets have specific information specific to an individual patient, it will make use of a structure that allows for a variety of options to be included. Disadvantages of Leaflets Some are usually produced for general issues, therefore not individualised. This may be a problem to diabetic patients who need special attention or have specific restrictions when it comes to taking some fast acting carbohydrates. Some may be allergic to some foods. This may not be a problem in this case since the leaflet will provide a variety of food and their quantities. The leaflets can remain unused unless those they are meant for are motivated to use them. In the case of managing hypoglycaemia among diabetic patients, for those who do not suffer hypoglycaemia, these leaflets may remain unused. To avoid this problem, here will be monitoring of the use of the leaflets (Lowry, 2005). The leaflets may do more harm than good if they are badly produced. There are specific recommendations on how to produce a health information leaflet. If the leaflets are, for example, produced in a manner that can lead to the misconception of information, they may not achieve their aims as expected (Lowry, 2005). This will be avoided by a series of tests with the draft leaflet to ensure they are not misunderstood. Leaflets can be lost or misplaced easily. A proposed idea to eliminate this is to encourage the users to stick some of them on walls where they can easily be seen and have others in their bags, or wallets. Those that require professional attention may take longer to update and may also be costly. It needs some groundwork done before the resource is developed. As in the case of the proposed leaflet, there will be the groundwork needed to determine those with diabetes in the community, the number of the patients, and complications that they suffer. Groundwork will also find out about the family members around, their current self-care practices, and other important information that can inform the development of this health promotional resource (Lowry, 2005). Potential Resources Needed to Implement the Innovation A research study will be conducted on the community to find out the number of people with diabetes, what they know about hypoglycaemia and how they currently manage the episodes. There is also need to prepare for an education program for these people and their family members on how to manage such episodes and get the neighbours, and friends involved. One can experience a hypoglycaemic episode unexpectedly and can need help. It is important to know how to relay relevant information, and quick to the person that the patient may seek help. Resources needed, therefore, are; Field researchers or interviewers Health educators or just nurses Financial resources to undertake the research and educational program activities The innovation development and implementation have about five main stages. There is the planning stage, the writing stage, conducting final checks, the consultation, and finally the distribution stage. Planning This is the initial preparation stage where the leaflet developer will consider the kind of information he or she will need, and for what purpose, the kind of resources, needed and the people who will be involved. It will entail identification of those who will be involved and how each of them will be involved, for example, the research will need interviewers who will seek specific information from the patients. The person has to state why specific information is needed from a clinician, patient or carers. It is while planning that the individual should review all relevant and available information from relevant sources, for example, the NHS, peer-reviewed journal articles and Diabetes associations. He or she should also think of distribution methods, for example, if the leaflets will be given to the patients directly, placed on the rack where they can easily be accessed, emailed, or even just posted (NHS, 2008). Writing This stage involves writing down patient information and assessing its effects. One can look for recommended frameworks to guide the development of patient information. With the evidence from previously conducted research, the leaflet should contain the right information and should be easy to read. It involves a series of writing and testing until the right product is finally produced. When assessing readability, the developer can check the draft against leaflet development guidelines, and then check with team members, and maybe members of the public. When assessing whether it is good for patients, the developer can test it on people who are not familiar with the condition. The draft can also be checked by clinicians, patient support groups, experts, to confirm that it is right for the targeted patients (NHS, 2008). Conducting Final Checks Whatever is to be done in this stage depends on the contents in the leaflet and the purpose of producing such leaflets. In this proposed innovation, the leaflets are meant to improve patient self-care. Final checks may include confirming the patientsââ¬â¢ and family membersââ¬â¢ numbers and checking if the information conflicts with other information from influential and reliable health sources (NHS, 2008). Consultation In this stage, the draft is given to the patients and interested groups for feedback. Changes can be made depending on the responses received from the parties (NHS, 2008). Distribution This stage is all about identifying the right distribution strategies in relation to the aim of developing the leaflets. For example, if the leaflets are meant for improving self-care, the healthcare professional will have to think of how these leaflets will reach the targeted patients. The perfect method is to deliver each leaflet to each patient and family members after consultation with them, and educating them on its benefits. They should also be informed about the whole project of improving health care delivery. The stage also involves monitoring to identify how the information is used, and if there is a need for any improvements (NHS, 2008). Additional resources that will be needed are; writing materials, human resource for distribution, and financial resources for distribution and other project activities such as testing the leaflet draft. à Implementation Difficulties There are no current implementation difficulties except for finding adequate resources to conduct the research in the community and identify the patients. It may also be difficult to convince all diabetes patients to come to educational programs on how to manage hypoglycaemia alongside the management of diabetes. According to the NHS guideline, the best approach is educating the patients and their families on a one-on-one basis, but this is expensive and time consuming. It may depend on the patients visit to the hospitals, which is an unsure way of reaching the patients. Leadership and Management Skills Needed The leadership and management skills belong to one category of management which is; project management. Under this category, these skills can again be classified under technical project management skills, general management skills, and leadership skills (Hallows, 2002). Technical project management skills are such as project planning and execution skills. Planning skills gives one the ability gather and assess information for estimates, identify dependencies, develop a work breakdown structure, assign and level resources, and analyse the risks among other abilities. Project execution skills give one the ability to develop estimates at completion, gather and evaluate data, prepare meaningful reports, and monitor the progress of the project (Hallows, 2002). These technical skills are very important for planning and execution of the proposed project. Project leadership skills involve managing the expectations and relationships of the participants. Hallows (2002) indicates that project m anagement leadership requires the ability to engage the main stakeholders involved in the project in each phase. An example, is, in the planning stage, the project manager has to get all the relevant departments involved, and any other parties that will be involved. Like in the leaflet development case, the project manager has to find a way of engaging the patients, the carers, family members and the health care organization supporting or sponsoring the project. The project manager can decide when it is necessary to share ideas, and the communication strategy that is necessary for attainment of the objectives of the project (Hallows, 2002). The project manager of this proposed project should have the ability to convince others about the benefits of the project, and explain the value of their roles. General management skills are such as; the ability to listen, delegate, goal setting, time management, communications, negotiation, and meeting management. There is also the need for huma n resource management skills. Project planning and implementation will require people to perform different duties. The performance of the project depends on the employees activities, without good management skills, the outcome of the project may be affected negatively (Hallows, 2002). References Ali, Z. H. (2011). Health and Knowledge Progress among Diabetic Patients after Implementation of a Nursing Care Program Based on their Profile. Journal of Diabetes and Metabolism, 2:121. Boughton, B. (2011). Patients with Diabetes Lack Knowledge about Hypoglycemia. Medscape Medical News. Retrieved from: medscape.com/viewarticle/740881 Briscoe, V. J. and Davis, S. N. (2006). Hypoglycemia in Type 1 and Type 2 Diabetes: Physiology, Pathophysiology, and Management. Clinical Diabetes, 24 (3): 115-121. Cryer, P. E. (2012). Severe Hypoglycemia Predicts Mortality in Diabetes, Diabetes Care. 35(9): 1814-1816. Fonseca, V. (2010). Diabetes: Improving Patient Care. New York: Oxford University Press. Frier, B. M., Heller, S. and McCrimmon, R. (2013). Hypoglycaemia in Clinical Diabetes. (3rd Ed.). West Sussex, UK: John Wiley Sons. Frier, B. M., Schernthaner, G. and Heller, S. R. (2011). Hypoglycemia and Cardiovascular Risks. Diabetes Care, 34(2): S132-S137. Greenwood, J. (2002). Employing a Range of Methods to meet Patient Information Needs. Nursing Times. Retrieved from: nursingtimes.net/employing-a-range-of-methods-to-meet-patient-information-needs/200054.article. Hallows, J. E. (2002). The Project Management Office Toolkit. New York: AMACOM Div American Mgmt Assn. Heller, S. (2008). Sudden Death and Hypoglycaemia. Diabetic Hypoglycemia, 1(2): 2-7. Kalra, S., Mukherjee,J. J., Venkataraman, S., Bantwal, G., Shaikh, S., Saboo, B., Das, A. K. and Ramachandran, A. (2013). Hypoglycemia: The Neglected Complication. Indian Journal of Endocrinology and Metabolism, 17(5): 819ââ¬â834. Lowry, M. (2005). Knowledge that Reduces Anxiety: Creating patient information leaflets. Professional Nurse, 10 (5): 318-320. Mccoy, R. G.,à Van Houten, H. K., Ziegenfuss, J. Y., Shah, N. D., Wermers, R. A. and Smith, S. (2012). Increased Mortality of Patients With Diabetes Reporting Severe Hypoglycemia. Diabetes Care. 35(9):1897-1901. NHS. (2008). Quality and Service Improvement Tools. Retrieved from: institute.nhs.uk/quality_and_service_improvement_tools/quality_and_service_improvement_tools/patient_information.html Onwudiwe, N. C., Mullins, C. D., Winston, R. A., Shaya, F. T., Pradel, F. G., Laird, A. and Saunders, E. (2011). Barriers to Self-management of Diabetes: A qualitative Study among Low-income Minority Diabetics. Ethnicity Disease, 21: 27-32. Werner, J. (2013). Diabetic Status, Glycaemic Control Mortality in Critically Ill Patients. ESICM News. Retrieved from: esicm.org/news-article/Article-review-ESICM-NEXT-Diabetic-status-Glycaemic-Control-Mortality-WERNER. Yakubovich, N. à and Gerstein, H. C. (2011). Serious Cardiovascular Outcomes in Diabetes: The Role of Hypoglycemia. Circulation, 123: 342-348.
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