Diabetes and Multi-Professional Diabetes Services - Essay Example

Diabetes, A Contemporary Approach Introduction Diabetes is a chronic disease that affects persons with the disease and their families. Different health sectors have set standards for the provision of quality, adequate care in different health care centres to ensure patients receive enough medical education and best treatment. By doing all these, they will end up with skills and experience to deal with in the area of diagnosing and managing diabetes efficiently. Diabetes as a disease causes a lot of medical complications to people among them; blindness, kidney failure and limb amputation and increases the risk of coronary heart disease and stroke (Melinda, 2012). It is a threat to a success result of pregnancy. Diabetes, like HIV/AIDs, accounts for a greater percentage of healthcare costs. A lot of resources are used a hospital inpatient resources to care for people with diabetes. Diabetes type one results from a number of factors among them an insufficient or insensitivity to, insulin hormone, resulting in an inability to regulate the use of and storage of glucose - blood glucose levels therefore goes up. There are two main types of diabetes: type one and type two. Multi-Professional Diabetes Services The care for diabetic patients needs a helping hand from all sectors of the economy. It starts with train medical practitioners who have adequate knowledge of assessment and treatment. Doctors, nurses, dentists, clinical officers, teachers; all have a role to play, Funnel,M (2010). General practitioners play the major role in diabetes management. people having diabetes and their caregivers too have a role to play. The realization of best results for persons having the disease depends on the provision of well-planned and coordinated health services that draws on the experience, attitudes and skills of health care workers working in the health sector. General practitioners have a major role of taking care of diabetic individuals.they monitor the daily routine of diabetic persons to provide effective mechanisms of care. This forms part of their responsibility of ensuring that any person(s) with diabetes recorded on their monitoring list, are receiving planned diabetes care. The other responsibility for general practitioners and supportive members of the healthcare group is monitoring. The general practitioners are persons with the duty to make the initial diagnosis of diabetes. Usually the general practitioners are responsible for deciding on where and when to meet with the person who is under treatment. This ensures consistence in medication to promote immunity is maintained. For general practitioners to support and encourage self management and care, all healthcare staff should: offer medical treatment to individuals with the due respect and dignity, ensure that diabetic individuals have someone to refer to when their case becomes complicated, issue high quality care with regularly reviewing both their hospital and psychological wants, be answerable to any issue raised about the quality of services they offer, provide relevant information and about diabetes management and local health care related services, ensure that diabetic individuals are informed about their state of health on a regular basis, ensure that a patient gets a good referral in case of; if any is required. Pass information about Diabetes services and fine details of local support groups and non-governmental organisations (Moattari, 2012). The responsibilities of a diabetic patient mainly are take care of his condition on a daily basis as possible. When a person is aware of the diabetic condition in his body, it because easier to manage it. do more research and practice self-care, this involves taking medication as prescribed, diet management, exercising, monitoring of glucose levels by blood or urine testing, at the same time understanding possible actions to be taken. Being ready to make critical decisions is also important. One should examine their feet on a regular basis or have them checked by someone else. A diabetic individual should know how to manage their condition and when to seek assistance if they are ill. for example, if they develop flu,a chest infection, vomiting or diarrhoea, they should learn to incorporate the advice given to them. Make consultations whenever they feel they have any issue to inquire for them to have a clear information. They should also ensure that they attend to appointments from their caretakers and general health practitioners. Aims of Diabetes Care The main aim of diabetes care is to give individuals who have been affected by the condition, something to smile about and be able to led normal lives. They can be able to handle the pain and suffering with easy. They will also enjoy the benefits accrued to other society members. General practitioners and medical professionals should ensure equitable access to quality diabetes prevention and care for patients, as vital attributes of a good diabetic service. Also by promoting equitable access for vulnerable individuals, such as the ones living in clinical care and those experiencing social-emotional deprivation. By ensuring normal normal glucose in blood is maintained, prevention of the microvascular complications of diabetic retinopathy, diabetic renal disease and diabetic neuropathy, and diagnosising of symptoms of diabetes and the avoidance of the acute metabolic crises (hypoglycaemia and ketoacidosis) are easily taken care of, as discussed by the american diabetes education document (2008). Regular monitoring and evaluation, for and reduction of cardiovascular hazardous factors is also important – this will include, where indicated, the provision of smoking cessation advice, healthy weight management, the promotion of physical activity and treatment of dyslipidaemia and hypertension (Groop, 2002). Different players in a country should ensure active involvement of individuals with diabetes in the provision of their own care. This is the cornerstone of good diabetic management. Through giving sufficient health care and management educational skills and support, with the individual’s ability to learn and identify the need of the individual’s lifestyle, culture and religion. Persons having diabetes need to be empowered to gain maximum benefits from healthcare services so that they are able to participate in activities organised for those who do not have diabetes. Whenever their would be early detection and treatment of diabetes, many of the long-term complications would be reduced greatly, morbidity and healthcare costs. for example, in diabetic retinopathy, when early detected, sight (eye) threatening retinal condition should be followed by laser treatment to prevent diabetic individual from blindness. Structured foot care evaluation may prevent foot ulcers and amputations. A well organised system of treatment will ensure treatment is given with ease. Provision of Diabetes Care Diabetes health department in most countries has allowed individuals to give their views on the kind of treatment they expect and the implications of the present treatment on their well being. This has enabled most governments to improve on their services in the provision of quality health care to diabetic individuals. The care is person centred since each individual’s condition varies from another. Health centres are encouraged to help individuals manage their own conditions in the best way they can. Co-operative consultance isallowed for individuals with similiar type of condition. Once patients are incorporated in management of their conditions, it will reduce the work load of health professionals. Different issues need to be addressed among them; recognising the existence of diabetic individuals and diagnosis. People world wide with diabetes unaware remain untreated and a high percentage of doubt amongst all members of the necessary healthcare team is therefore important. Moreover , practices need to have systems in place for identifying persons with undiagnosed diabetes. Main priority should be focused on persons who at increased risk of developing diabetes. The first assessment should be accompained with diagnosis and care. when a treatment is being given, persons with the disease need to be evaluated whether to be transferred to a clinician or health control proffessionals. Treatment and care then needs to be started . The provision of education about diabetes, its control and treatmentshould be inclusive, and the provision of dietary advice. Educational Strategies Diabetes as a disease needs diferent professsional approaches to take good care of the condition. self-management procures, education and training is a process that needs collaboration through which persons with or at risk for diabetes acquire the relevant knowledge, attitudes, behaviours and skills needed to govern their ways and achieve self-management of the disease and its related conditions. The theory underlying the diabetic management education Self-Care Behaviors framework is one in which diferrent procedures are culturally appropriate and empowers patients to achieve optimal health status, gain access to an improved- quality life while lowering the cost of healthcare services Different strategies have proved to be strategic in giving support to patients when used by nurses and other health cares. The collaborative duty operates to empower people who can understand what to expect from their health care and what is expected of them in recognition of risk factors and do their best to evade attacks through a monitored plan. By understanding this, patients develop a sense of empowerment in managing their health situation. Promoting positive self-care behaviors directed at successful diabetes control was formally adopted as a desired outcome of education. Diabetes management recommends prevention to be accompained with treatment and education from the various general practitioners and clinicians. Diabetes education further recognizes that diabetic strategies should be offered by a number of individuals to ensure shared responsibility and specialisation for effective handling. Hence, there is a need to clarify the roles/responsibilities of all persons involved in the facilitation in delivery of diabetes education management and care from one state of management to another level. Say from a caregiver to a clinician. Diet provision to new diagnosed diabetic patient is the responsibiity of dietitian. This people best understands the damages that diabetes can cause to an individual. s/he understands on how tocounter this by way of meals. Diabetes is a health condition that influences the way we feed.. General practitioners, practicing and community nurses too have a role to play in the provision dietary advice. The provision of consistent and accurate dietary information is important.it is also required that once they get the medication, they should regulary check on their health care providers to be adviced on the necessary approaches to give the life.this will start from the point where they feel they have stabilised with their new health condition. They should also be checked for metabolism factors and cardiovasucular risk factors for prevention from causing more harm. Individual’s targets should be management of weight, blood glucose, blood lipids and blood pressure The ideals of diabetic education should be principally adult based to promote active participation in learning. Structured training need to be put in place and be directed as a responsibility to general practitioners and other expert professionals who can administer it. The services of dietitian; which are mainly diet based, and a diabetes specialist nurse; who mainly understands what diabetic principles of education for the patient say. For the provision of enhanced diabetic care and medication for patients, necessary materials need to be in place.The curriculum recognises the importance of having right equiments in place for surgery. The Lists of required educational resources can be acquierd from all diabetes care and treatment centres. Once an individual has been diagnosied with diabetes, a personal care plan program needs to be set in place, since it will be the respponsibilty of the person to take care of his condition. This will ensure the routine program is followed by the patient without ignoring ant process as the patient was involved in setting it. The responsibilities of each part must be set clear. The responsibilities should be revised on regular occassions since they composed the main part of the diabetes management process. Taking care of diabetes patients is an act of togetherness and can never be an individual responsibility. It involves the patients, health professionals, teachers and family members.The appropriate needs of the patient determines the setting s/he will require at that particular time. It is the responsibilty of health professionals and other relate specialists to set up a plan with the patient, through making formal agreements on where they should receive their care and medication treament when feeling strained.these should be in line with the frameworks they have put in place. In essence, different diabetes policies need to be agreed on cases of referral and the criteria that should be used including the timing and route of such referrals. Some issues need though to be addressed first. The account on which the referral should take place needs to be understood and the level of professional skills and competence of the one being referrred to. Diabetes cases should be dealed with deligent care to avoid complicating the condition of the patient and putting his life in risk. General health practitioners should follow up special cases of diabetes. These includes cases of: children and young people who have the diabetes condition, women who are diabetic and want to get pregnant or already pregnant women, risk person as the case may be considered by the nurse and may require specialist advice regarding management of metabolism regulation, cardiovascular hazardous factors and diabetic complications without forgetting people who are suffering from complex psychological problems. Diabetes education aim at providing competent health care to patients and ensuring the right conditions and a condusive environment is in place for the person to thrive on well. Diabetes is not a case for making mistakes but an issue that needs to be reckoned with. Patients of diabetes are encouraged to maintain a regular contact with their suprvising health care professionals and specialist.by doing these, their condition is monitored and the appropriate medication will be administered whenever the case many be detected as severe.any case of any behaviour, the pateint is usually advice to contact a clinician for check up. Problems may emerge at any point and this is the reason why general health practitioners and midwives are in place. Follow up is the duty of a health clinician and specialist. He needs to make a regular check up of his patients to monitor their conditions. Communication among key parties in administering care to a diabetic person and the supportive care team is the key to achievement of diabetic care. New methods are being improvised to help this process, among them the development of electronically computerised patient records. The system should have the ability to enable the records to be shared with and accessed by all the health care team professionals involved in the administering of a patient’s care – as well as patients themselves. Meanwhile, an individual diabetes management record, held by the patient of diabetes, can assist to facilitate this process and must be an updated one to avoid repeating of the old process which may risk the life of the patient. General practioner and their staff should provide an organised follow-up for every individual who has been diagnosed with diabetes to ensure best procedures are adherred to during medication. Diabetes care is organised depending on the environmental set up. Many healthcare teams have discovered that the care of persons with diabetes is most efficiently done in specialised diabetes clinics, while other diagnostic clinicians prefer to see patients within their homesteads or agreed places. Whichever mechanism is taken, an extend of flexibility will be required to meet the requirements of all sets of patients. A good example are those who are working and may find it difficult to attend a given clinic or seen a designated practitioner. Patients that do not attend to their invitations by their doctors need to be followed up too also. Depending on the attitudes of the person suffering from diabetes, the nurse should be able to recognise how to handle the clients mood and try to cool them down. Organising for regular meetings when noting an unusual behaviours should be the responsibility of the nurse. It is never a simple task to deal with diabetes by both the patient and the health specialist. Members of the local healthcare team providers are among them registered podiatrists, district nurses,dietitians, midwives, health visitors and school nurses and counsellors, also have an important role to play in the provision of diabetes care. Studies have it that a nurse, and in this case a practicing nurse, is so important to the successful administering of diabetes care within the local environment of the patient. The general practitioner needs also be to actively involved, particularly in the regulation of blood glucose and lipid management, control of hypertension and identification and control of diabetic complications. Pharmacists in large numbers are increasingly becoming active members of the healthcare professionals. The pharmaceutical services contract includes usuallly important services like dispensing, signposting and sharps disposal. Adequate time should be allocated and funding provided to enable all members of the health care team to attend appropriate career training on the management and control of diabetes. Experience in the same line of training is so critical. The planning and provision of diabetes services needs the cooperation of various professionals and involvement of people with diabetes in order to ensure the delivery of diabetes services that meet the standards of care that persons with diabetes expect. In offering an effective management healthcare education and skills the following services need to be provided: a coordinated planned vision for future provision of diabetes services needs to be developed involving all stakeholders. The vision must address the diagnosis, prevention of diabetes, and treatment and care of persons with the disease. A diabetes procedure and implementation framework should be agreed upon and set out the aims and objectives for services and clear plan for delivering this vision over a given period of time, including the necessary resources that will be used. The plan should reflect the requirements of the local population that is affected and an evaluation of the scope and quality of the existing services. The development of the framework should be informed by the skills and experiences of persons with diabetes. The roles and responsibilities of all parties concern in the delivery of diabetes services should be agreed and particular attention should be given to the organisation of a retinal screening service coordinated across the whole healthcare system Good leadership and working together forms the core process of ensuring that the needs of the diabetes persons are never compromised. Championing depends on the political climate and democracy in the perspective society.these are the essential factors of having a successful diabetes society. The involvement of diabetes patients should go beyond the recruitment of a single diabetes champion. All parties must be involved in the fight against these disease if the globe is to acheive effective results in the fight against diabetes. In conclusion, monitoring A system should be in enacted for collection of data and monitoring the trending of patients. Their electronically organised and monitored data will ease the work of nurse making them have a control over the process. References Department of Health 2001, National Service Framework for Diabetes. http://www.publications.doh.gov.uk/nsf/diabetes Diabetes Control and Complications Trial Research Group 1993, ‘The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus’, New England Journal of Medicine, vol. 329, pp. 977-986. Groop, L 2002, Epidemiology and Clinical Heterogeneity of Adult-Onset diabetes. In: Wass, J A H and Shalet, S M eds. Oxford Textbook of Endocrinology and Diabetes. Oxford University Press. pp. 1688-1695. National Institute of Health 1998, ‘Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults’, The Evidence Report. Bethesda: NIH Publication. The Diabetes Prevention Program Research Group 2002, ‘Reduction in the incidence of Type 2 diabetes with lifestyle intervention or metformin’, New England Journal of Medicine, vol. 346, pp. 393-403. Tuomilehto, J, Lindstron, J, Eriksson, J G and the Finnish Diabetes Prevention Study Group 2002, ‘Prevention of Type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance’, New England Journal of Medicine, vol. 344, pp. 1343-1392. Appendix: Case Study A 69 year old patient, who suffers with type one diabetes, self administers insulin and has done for many years. When admitted to the ward for wound management for leg ulcers, it became apparent that she regularly experienced hyperglycaemia and demonstrated poor technique when delivering her insulin, when this was discussed with the patient she did not seem to acknowledge there was a problem. It had been reported from the district nursing team that she had been non-compliant with bed rest at home. Due to the patients poor management of her diabetes and technique the nursing staff referred her to the diabetic nurses, dietician, tissue viability specialist and also the community mental health team. Read More