Developing an Educational Package for Diabetic Patients to Reduce Hypoglycemia Incidence

Running head: FINAL PROJECT REPORT
FINAL PROJECT REPORT
Name of the Student
Name of the university
Author’s note

1FINAL PROJECT REPORT
Introduction
Hypoglycemia is a condition that is caused by low blood sugar level than the
standardvalue ,less than 70 mg/dL (3.9 mmol/L). Hypoglycemia is often related to the treatment
of diabetes. Attempts made at intensive glycemic control increases the risk of the hypoglycemia.
A six fold augmentation I the death due to diabetes is caused in patients experiencing severe
hypoglycemia (Kalra et al., 2013). Related episodes can lead to the impairment of the counter
regulatory system and the development of hypoglycemia unawareness. Worsening of the
hypoglycemia includes symptom like confusion, abnormal behavior, inability to complete the
tasks, visual disturbances like blurred vision, seizures and lack of consciousness. It is found to
increase the chance of cardiovascular functions, loss of vision, the death of the retinal cells
(Rehni et al, 2015). Hence there is an urgent need for examining the clinical spectrum and the
burden of the hypoglycemia such that adequate control measure can be taken against this life
threatening health care complications (Kalra et al., 2013). Hence the main aim and the objective
of the project is to develop an educational package for the diabetic patient, who are on oral
hypoglycemic agents or the insulin therapy for reducing the incidence of the hypoglycemia by
the education of the signs and the symptom of hypoglycemia.
This final assessment will report on the project as a whole, objective of the project, the
methodology of the project, the rationale for choosing the topic. The report will give a vivid
description of how the educational package will be provided followed to the patients followed by
the evaluation of the educational program by using a teach-back method and a survey conducted
with the patients. The survey results will be followed by a discussion of the findings obtained

2FINAL PROJECT REPORT
from the graphs. Finally this would also provide with some possible set of future
recommendations.
Project background
The main aim of the project is to introduce an educational pamphlet for the diabetic
patients who are on insulin therapy or oral hypoglycemic agent by educating the patients with the
necessary signs and symptoms and the management of hypoglycemia. Hypoglycemia can be an
alarming situation for the patients and the resulting fear of the subsequent episodes of
hypoglycemia symptoms might increase the anti- hyperglycemic medication, ultimately limiting
the therapeutic goals (Hulkower, Pollack &Zonszein, 2014). Many patients does not grasp the
fatal consequences of the hypoglycemia on the vascular health and the health care providers
should not assume that the patient has been well educated on the pathophysiology of the
diabetes. In most of the cases, people who are in extreme control of diabetes focus mainly on the
diabetes control but necessarily does not emphasize on hypoglycemia. Hence, it is necessary to
educate the patients regarding some of the fundamental concepts of diabetes like carbohydrates
taken, the role of the hormones in regulating the blood sugar level in the body, by educating
them about the potential clinical manifestations and blood glucose level that can be considered to
be diabetic (Centrella-Nigro& Alexander, 2017). Furthermore, most of the educational materials
providedin the health care sector consisted of fact sheets, limiting the ability of the consumers to
access the range of information. It is again necessary to educate the patients about the risk factors
of hypoglycemia, such as the consumption of the antidiabetogenic agents, alcohol intake without
food, improper diet and diet (Tan& Flanagan, 2013). Hence the educational pamphlets are ideal
to provide the correct amount of evidence based information in a simpler way to the audience.

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Finally, a teach back method and a survey will be conducted for understanding the perception of
the patients and to understand whether the education had been fruitful or not.
Objectives
 To teach the selected diabetic patient by using the educational pamphlet
 To evaluate the patient understanding by a teach back method and a survey conducted after 6
months.
Methods
The patients for whom the pamphletwill be designed, will be recruited from among the
outpatients at the () hospital, present in the metropolitan area of Singapore. The inclusion criteria
for the study consisted of patients diagnosed as type 2 diabetes, receiving drug or insulin
therapy .for the diabetes, between the age 40-70 years and have HbA1c of less than 8. The
diabetic care managers were asked to educate the eligible patients, about hypoglycemia and 17
patients were selected for the conduction of the survey. A teach back method for evaluating the
quality of the teaching provided.
The patient education handouts contained important health messages for the
hypoglycemia, difference between hypoglycemia and hyperglycemia, the causes and the risk
factors for developing hypoglycemia, the potential blood glucose level indicating towards
hypoglycemia (Chow et al., 2018). The information hand-out for the patients also contained
information about the management of hypoglycemia, including the regular monitoring of the

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blood glucose level, adhering to the dietary guidelines. Importantly, the information pamphlet
also contained information about the important associated condition of hypoglycemia including
to obesity, lipidemia, hypertension and cardiovascular diseases (Dendy et al., 2015).All the
information provided in the educational pamphlet are evidence based information extracted from
scientific articles and relevant websites.
After the educational pamphlet has been distributed to the participants and explained via
the diabetic care managers, a teach-back method was used to check and evaluate the patient’s
understanding after the education sessions.A teach back method has been used by the diabetic
care educator to have an understanding whether the pamphlets had been useful to the diabetic
care patients or not (Peter et al., 2015). A teach back is way of confirming that the educator had
explained to the patient what is important and in a manner that is easily understood by the
patient. The understanding of the patient is confirmed when the patient explains it back in their
own words to the educator. A teach back methods assists the clinician to identify theexplanation
and the various communication strategies, that are mostly understood by the patient
(Gibbs,Trotta&Overbeck, 2014).
Before the conduction of the teach-back method, all the patients who had been selected
for the teaching had been educated about the importance of the remaining updated about
hypoglycemic conditions.The teach back session lasted for 60 minutes and the educational
sessions was administered in a private room. In this method the researcher assessed he baseline
understanding of the patient about hypoglycemia. The questions asked were mainly based on
what has been educated by the pamphlet.

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Two questions were asked in the teach-back method for understanding the knowledge of
the patients:-
What are the symptoms of hypoglycemia?
What are the causes of hypoglycemia?
How can we manage hypoglycemia?
Simple question sin English language were asked to the patients. Medical jargons, vague
terms and terms having different lay and medical terms were avoided in the process. After the
response from the patients, we had cross validated their answers by repeating the same answers.
For example, “I always ask the patient to repeat the same thing that I have explained to them.”.
The answers were correct or incorrect, the researcher explained the issue to the participants once
again.
After the conduction of the teach-back process, the emails of the participants were
collected. After a six months follow up a survey was conducted on the same 18 participants for
evaluating the efficacy of the educational material in fostering the control of the hypoglycemia.
The online survey link was sent to the same participants via email. The survey contained 7
closed ended questions related to the education resources that has been provided to the patient.
The online survey was conducted by using the “survey monkey”, an online survey tool.
Closed ended questions were prepared related the information provided in the pamphlet
and relevant topic. 7 multiple choice questions, each of the questions with three choices were
prepared using the “survey monkey”. Survey monkey is an online survey development cloud-
based software, which was founded by the Ryan Finley and Chris Finley in the year 1992.