Interprofessional Health Care Team: Diabetes - Essay Example

Diabetes is now a very common disease in the world and in Australia. It is a disease which affects different organs and systems in the body. It is a problem which involves the pancreas’ production of insulin and how the body manages the blood glucose levels. It is a disease which, if unmanaged, has the potential for creating serious and deadly complications for the patient. Hence, in applying the principles of interprofessional health care, the management of diabetes involves the integration and coordination of functions of the nurse, physician, dietician, social worker, and the pharmacist. The nurse is there to coordinate care, to deliver bedside care, and to educate the patient and his family about the disease and its treatment; the physician is there to issue orders on treatment and to coordinate with the members of the team for more effective interventions; the social worker helps to manage the patient’s mental health; and the dietician is there to manage the patient’s diet. These members help ensure that the patient’s food, medication, basic care, mental health, and blood glucose is maintained and sustained at healthy and optimum levels. Their coordinated working approach indicates that the interprofessional practice in health care can effectively manage diabetes. Interprofessional Practice Health Introduction Interprofessional health care practice involves the integration of the separate and distinct approaches of care into a single consultation (Jessup, 2007). This means that “the history-taking, assessment, diagnosis, intervention and short and long-term management goals are conducted by the team, together with the patient, at one time” (Jessup, 2007). In the interprofessional health care approach, the patient is made a part of the decision-making process. The interprofessional health care team is obliged to come up with a coordinated understanding of all the aspects of the patient’s care and from a common and holistic understanding, to explore and discuss interventions and alternatives in the patient’s care. The interprofessional health care approach allows the members of the team to question each other and to step out of their comfort zones and work towards what is best for the patient (Jessup, 2007). This paper shall discuss the disease diabetes and how the members of the interprofessional health care team can work and apply their separate and collective skills in order to manage the patient’s disease. Diabetes is one of the most alarming diseases in the world, mostly because of the increase in its prevalence and also because of the health complications it can cause. Based on the World Health Organization (WHO, 2010), the year 2000 revealed that there were about 171 million individuals with diabetes around the world; and the WHO projects that by 2030, these figures will double to almost 366 million. In Australia, the WHO (2010) revealed that in the year 2000, there were 941,000 individuals diagnosed with diabetes and by 2030, such figures are also set to double to more than a million diabetics. The changes in society and on lifestyle have largely contributed to the increased prevalence of this disease. Decreased physical activity and unfavourable diet have caused the increase in obesity and consequently, increased the risk for diabetes (Zimmet, 2002). And now, this disease has been recognized as the most common cause of renal dialysis; of blindness among people under the age of 60; of non-traumatic lower limb amputation; and it is one of the most common chronic diseases among children (Zimmet, 2002). An AusDiab study was also able to establish that in every case of diabetes, there is almost always another case which is not diagnosed; there are about 940,000 individuals who are more than 25 years of age who are diabetics in Australia; diabetic cases have increased greatly since a blood survey study was carried out in 1981; and that about 1 in 4 Australian citizens 25 years and over has either diabetes or a disease involving impaired glucose metabolism (Zimmet, 2002). This is an alarming scenario because the above conditions are linked with an alarming increase in the risk of heart disease including the increased risk for diabetes in the future (Zimmet, 2002). This topic was chosen because it is current and it is one of the most common and, unfortunately, imposing concerns in health care. Diabetes was also chosen as a topic because it is one of the diseases which rely on the functioning of the different members of the health care team. Different systems and organs are affected by this disease and the interventions and treatment for the patient’s condition require the coordination of the members of the interprofessional team – including the nurse, the doctor, the dietician, the social worker, the pharmacist, and in some cases, the physiotherapist. With all these members needed, this topic fits best an application and assessment of interprofessional health care team approach. This paper shall discuss the basic details of diabetes. It shall also discuss the roles of the different members of the interprofessional team, particularly focusing on the role of the nurse, the doctor, the dietician, and the social worker. This paper shall discuss the importance of these roles in the management of the different manifestations of this disease. The paper will end with a discussion on the recommendations based on the previous evaluation of the subject matter. Discussion Diabetes Diabetes mellitus is actually a “set of related diseases in which the body cannot control and regulate the amount of sugar (specifically glucose) in the blood” (eMedicine Health, 2010). It has two types: Type 1 and Type 2 diabetes. Type 1 diabetes is seen when the body, more specifically, the pancreas, does not create insulin or does not create sufficient insulin in order to manage the blood glucose level. It is the less common type and mostly manifests during childhood or adolescence. These individuals require a daily treatment of insulin in order to sustain their lives (eMedicine Health, 2010). On the other hand, type 2 diabetes occurs when the pancreas produces insulin however, the body cannot partly or completely use it. It is the more common type of diabetes and its onset is usually after the age of 45 (eMedicine health, 2010). The causes of diabetes have not been fully established but Type 1 diabetes is considered to be an autoimmune disease because the immune system is attacking cells in the pancreas which produce insulin. Its causes are largely genetically-linked and also environmentally-linked. Type 2 diabetes is also genetically-linked. Risk factors for the disease include hypertension, high cholesterol levels, aging diabetes during pregnancies, high alcohol intake, limited physical activities, obesity (eMedicine Health, 2010). Symptoms of this disease “include fatigue, unexplained weight loss, excessive thirst, excessive urination, excessive eating, poor wound healing, infection, altered mental status, [and] blurry vision” (eMedicine Health, 2010). High blood sugar can lead to long-term damage on the retina, the kidneys, and also the nerves (eMedicine Health, 2010). It can also lead to blindness, kidney failure, nerve damage causing foot ulcers (leading to amputation), damage to the autonomic nervous system (causing paralysis of the stomach, chronic diarrhoea), acceleration of atherosclerosis (leading to stroke, heart attacks), and diabetic ketoacidosis (leading to coma, and then death) (eMedicine Health, 2010). Roles of the members of the interprofessional team: Nurse The role of the nurse in the interprofessional team caring for a diabetic patient is basically to carry out doctors’ orders. Since she spends the most time with the patient, her role is to listen and to educate the patient and his family about his disease and the interventions which are being carried out for the management of his disease (Arab, n.d). The nurse’s role is also to build knowledge on diabetes care; to establish skills in clinical history taking and to implement interventions; to acquire special talents and attitudes related to team working; to establish knowledge of causes, symptoms, diagnosis, prevention of diabetes; to assist in the conduct of diagnostic tests for diabetic patients; to instruct patient and family members on prevention measures; to make appropriate decisions in coordination with the health care team and the patient; and to instruct patient on foot care, weight bearing, and walking dynamics in order to prevent injuries (Arab, n.d). The role of nurses in the interprofessional team is to work with the patients and their families within the health care facility or the hospitals, also in the community, homes, and even the patient’s workplaces in order to coordinate the different components of care (Peeples & Seley, 2007). It also includes carrying out physical assessments, setting up patient education on diabetes, coordinating care and managing outcomes for the patient. Nurses are there to teach the patients on the self-management of diabetes in various settings (Peeples & Seley, 2007). They are there to prevent the worsening of symptoms and the prevention of complications. They have the necessary skills in “translating the disease-specific interventions into patient-centred plans” (Peeples & Seley, 2007). The nurse has to make the plan of care based on patient needs; and this is an important step in the process of care because patients often suffer from multiple symptoms due to the various systems affected by diabetes (Peeples & Seley, 2007). The nurse is there to help the patient take control of his blood sugar levels; to coordinate treatment; and to guide the patient in the administration of medications like insulin (Rea, 2008). Role of the doctor, dietician, and the social worker The role of the doctor in the management of the diabetic patient is to administer medical advice, set-up treatment options, and set forth resources for treatment (Chronic Disease Management, 2007). He is there to coordinate with the patient and assist the latter in monitoring his symptoms; encouraging the patient to report such symptoms accurately; and to assist the patient in the daily management of his disease (Chronic Disease Management, 2007). The role of the dietician is to educate the patient on food which is appropriate for intake based on the patient’s condition. The dietician also assists the patient in following the daily meal plan. They coordinate with the health care team in order to ensure that the correct diet is recommended to the patient (Rea, 2008). Finally, the social worker functions as a mental health professional – to help the patients manage stress and to deal with other emotional problems prompted by their condition (Rea, 2008). Applying the Interprofessional team approach A discussion by Cooper and Fishman (2003) illustrates an actual application of the interprofessional team approach on a diabetic patient. First of all, a patient (with diabetes, congestive heart failure, arthritis, hypertension, and elevated cholesterol) is admitted to the health care unit along with a carer who reports that the patient’s blood sugar has increased. The team who has cared before for the patient is called in. The pharmacist suggested that the increase in blood sugar may be caused by the recent addition of cortisone to the patient’s medications. However, the physician did not want to stop the patient’s cortisone intake because the patient’s arthritis was not responding to treatment, and cortisone was needed to relieve the pain (Cooper & Fishman, 2003). The social worker then suggested that the increase in blood sugar may be caused by elevated stress levels as the patient’s daughter was about to obtain a divorce and was too stressed to personally care for her mother. The patient was also not getting on well with her daughter-in-law who was now taking over her care. The dietician suggested that since the daughter-in-law was the one preparing the patient’s food, she may not be paying attention to the type of diet which the patient should be taking in (Cooper & Fishman, 2003). In the midst of all this, the nurse was there to coordinate the patient’s care with the members of the health care team. The nurse was monitoring and assisting the patient in her daily activities. Through the nurse’s close interaction with the patient, she was able to assess the psychological well-being of the patient and make her own suggestions to the team based on her own observations. Because of the different probable causes of the patient’s elevated blood sugar levels, the members of the team were prompted to meet and device a treatment strategy which would first address the patient’s change in diet and then consider the possible removal of cortisone in her medication arsenal (Cooper & Fishman, 2003). The social worker’s role was to counsel the patient and the daughter-in-law; the nurse’s role was to coordinate the patient’s care and to monitor the patient’s blood sugar; the doctor’s role was to coordinate with the pharmacist with regard to the patient’s cortisone intake; and the role of the dietician was to monitor the patient’s diet and food intake. Conclusion After considering the above discussion, I believe that the interprofessional team approach is an effective approach to the management of diabetes. Diabetes affects many systems and its management also involves the different members of the health care team. In order to ensure the effective management of diabetes, the members of the health care team have their own roles to fulfil both separately and as members of the health care team. These members are required to perform their roles based on their skills and based on their place in the health care team. Their responsibility is to coordinate with the other members of the team in order to ensure that the care of the diabetic patient is effective, comprehensive, and patient-centred. Works Cited Arab, M. (n.d) The Role of Nurses in Diabetes Care and Education. Bibalex.org. Retrieved 28 May 2010 from http://www.bibalex.org/diabetessupercourse/DiabetesPPTLectures/The%20Role%20of%20Nurses%20in%20Diabetes%20Care%20and%20Education.ppt Cooper, B. & Fishman, E. (2003) The Interdisciplinary team in the Management conditions of chronic conditions: has its time come? Partnership for Solutions. Retrieved 28 May 2010 from http://www.partnershipforsolutions.org/DMS/files/TEAMSFINAL3_1_.pdf eMedicine Health (2010) Diabetes. eMedicine Health.com. Retrieved 28 May 2010 from http://www.emedicinehealth.com/diabetes/article_em.htm#Diabetes%20Overview Jessup, R. (2007) Interdisciplinary versus multidisciplinary care teams: do we understand the difference? Australian Health Review. Find Articles. Retrieved 28 May 2010 from http://findarticles.com/p/articles/mi_6800/is_3_31/ai_n28446050/ Peeples, M. & Seley, J. (2007) Diabetes Care: The Need for Change. American Journal of Nursing, 107 (6), pp. 13 - 19 Province of British Columbia. (2007) Diabetes: Working with Your Doctor. Health.gov.bc.ca. Retrieved 28 May 2010 from http://www.health.gov.bc.ca/cdm/patients/diabetes/doctor.html Rea, C. (2008) Health professionals involved in diabetes care. Healthwise. Retrieved 28 May 2010 from http://health.msn.com/health-topics/articlepage.aspx?cp-documentid=100080012 World Health Organization (2010) Diabetes Programme. WHO. Retrieved 28 May 2010 from http://www.who.int/diabetes/facts/world_figures/en/ Zimmet, P. (2002) Diabetes Mellitus - One of Australias top six health priorities. Health in site. Retrieved 28 May 2010 from http://www.healthinsite.gov.au/expert/Diabetes_Mellitus___One_of_Australia_s_top_six_health_priorities Read More