1 EVIDENCE GROUNDED SOLUTION Self-management of diabetes: An evidence based solution Self-management of diabetes can be classified as a solution for diabetes in King County, Seattle. Diabetes is a chronic disease which needs medical care lifelong as well as active involvement of patient. The risk of diabetes can be reduced if the person suffering from diabetes or having a family history with diabetes have an access to monitor their blood glucose in regular intervals (Powers et al., 2016). If the person can check their blood glucose by selves, monitor their weight, control the diet, reduce tobacco intake and increase physical activity; then the chances of getting affected with diabetes decreases. The healthcare provider can also check the blood pressure, deportment eye exam for noticing diabetic eye impairment, early dealing of kidney damage due to diabetes, conducting foot exam, prescribing lower dose of aspirin as well as scrutiny cholesterol yearly as well as treating elevated cholesterol (Kingcounty.gov. 2020). Recent researches have shown that self-management have helped in controlling blood sugar that can prevent complications of diabetes. Previous records have shown that self- management in insulin intake have resulted in check in blood sugar daily for 93% of people and among rest 7% of the population who did not visit healthcare of do not follow the self- management policies have experienced sever outcomes(Lin et al., 2017). In total the ration of people accepting self-management and those who did not follow the self-management procedure were 23 to 29% respectively. Hence, improvement in the patient care can be fulfilled by grounding self-management system of diabetes at medical care in addition to assimilating with community assets. The management systems can track patient care to guarantee that all constituents of an inclusive care plan given to every individual (Strawbridge et al., 2015).
2 EVIDENCE GROUNDED SOLUTION Rationale for choosing self-management Self-management is chosen as a solution to control Diabetes in King county. This self-management includes proper medication intake, physical activity, eating healthy foods, and checking blood glucose. This self-care would help in resolving the problems related to diabetes, reduction in the chronic as well as acute complicacies, as well as various psychosocial features of existing withdiabetes(Chrvala et al., 2016). Previous researches have shown that diabetes can be controlled if the person follows some rules. Modification in life-style can help in keeping the blood glucose level under control, regular exercise helps in the insulin to work efficiently and effectively, as well as causes reduction in blood pressure and heart diseases. Self-management tells people about controlling glycaemia however, it corresponds with prevention of disability complications along with rehabilitation. Self-management on individuals suffering from diabetes showed to produce an affective impression over the advancement in addition to expansion of their disease by contributing in self-care. In spite of the fact, acquiescence or observance of these happenings found to be less, specifically considering long-term vicissitudes(Diabetes Care, 2018). However, socio-economic, multiple demographic, in addition to social sustenance factors is considered to be a positive provider in King County to facilitate self-care accomplishments in diabetic patients. The main role of clinicians is to promote self-care, which is vital as well as accentuated. Comprehending the multi-faceted features of the problem, an integrated, systematic, and multi-pronged methodology is needed in order to promote self-management practice amid diabetic individuals to prevent long-term difficulties. Determine the feasibility of self-management The feasibility of self-management can be determined by following hospital discharge. The interposition comprised home visit for one in-person in addition to continuation weekly simulated diabetes mellitus self-management for four extra weeks. The
3 EVIDENCE GROUNDED SOLUTION knowledge of diabetes was dignified at baseline in addition to achievement of the policy implementation. Questionnaire might be designed to understand the response of the people suffering from diabetes(Pereira et al., 2015). The A1C level of hemoglobin was taken from health record as well as three months’ hospital discharge. The readmissions at hospitals were calculated for 30 days. Enrollment of about 20 patients need to be conducted. Patients completing the intervention need to set a score and analysis must be conducted depending on the data received. Patient need to know about the program that is to be conducted and their views need to tracked(Hou et al., 2016). The individual interested must be chosen for the record study and analysis need to be done. If the results outcomes demonstrate that regular exercise, good health regime as well as monitoring the glucose lvel by oneself is making the blood glucose to be under control, then self-management will be chosen as feasible program for keeping the blood glucose under control. Ways to integrated self-management into the programme Educating people and gaining their support would be the best way to integrated self- management of diabetes.Diabetes is a protracted sickness, which needs a person to follow restrictions in their daily life. Diabetes self-management education is the best tool to make the people aware of various guidelines that would help them in keeping the disease in control without regular medical visit (Greenwood et al., 2017). Once, the self-management policies become acceptable it will be easy to integrated it into the programme. DSME/S (Diabetes self-management education and support) provides a platform to make people aware and help themto navigatediabetes. Hence, the activities and decision made would help in the enhancement in health outcomes. This DSME is defined as a process to facilitate te knowledge, ability and skill for diabetes self-care. In this project, this DSME can be implemented by having an interaction with people suffering from diabetes or with individual having chances of diabetes. Educating people is
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4 EVIDENCE GROUNDED SOLUTION necessary for positive implementation. People must have a knowledge about the usage, which exercise are necessary for insulin activity, the kind of food to eat and not to eat for keeping the diabetes under control, and ways to use glucometer as well as when to visit a doctor. As a health professional it must be made sure that patient understands about implementation and provisions of managing skills in addition behaviors that are required for self-management. Even though different participants in the health care team in addition to community might subsidize in the process of implementation, it is necessary for health care providers in addition to their practice situations to maintain a systematic referral and resources to ensure that patient receive both DSME and DSM (Strawbridge et al., 2015). Once the individuals have clear idea about the self-management policies, then the implementation would be possible with practitioner programme.
5 EVIDENCE GROUNDED SOLUTION References Chrvala, C., Sherr, D., & Lipman, R. (2016). Diabetes self-management education for adults with type 2 diabetes mellitus: A systematic review of the effect on glycemic control. Patient Education And Counseling,99(6), 926-943. https://doi.org/10.1016/j.pec.2015.11.003 Diabetes Care. (2018). 5. Lifestyle Management: Standards of Medical Care in Diabetes— 2019.Diabetes Care,42(Supplement 1), S46-S60. https://doi.org/10.2337/dc19-s005 Greenwood, D., Gee, P., Fatkin, K., & Peeples, M. (2017). A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support. Journal Of Diabetes Science And Technology,11(5), 1015-1027. https://doi.org/10.1177/1932296817713506 Hou, C., Carter, B., Hewitt, J., Francisa, T., & Mayor, S. (2016). Do Mobile Phone Applications Improve Glycemic Control (HbA1c) in the Self-management of Diabetes? A Systematic Review, Meta-analysis, and GRADE of 14 Randomized Trials.Diabetes Care,39(11), 2089-2095. https://doi.org/10.2337/dc16-0346 Kingcounty.gov. (2020). Public Health Data Watch. Retrieved 20 April 2020, from https://www.kingcounty.gov/depts/health/data/~/media/depts/health/data/documents/ diabetes-in-king-county-april-2007.ashx Lin, K., Park, C., Li, M., Wang, X., Li, X., Li, W., & Quinn, L. (2017). Effects of depression, diabetes distress, diabetes self-efficacy, and diabetes self-management on glycemic control among Chinese population with type 2 diabetes mellitus.Diabetes Research And Clinical Practice,131, 179-186. https://doi.org/10.1016/j.diabres.2017.03.013 Pereira, K., Phillips, B., Johnson, C., & Vorderstrasse, A. (2015). Internet Delivered Diabetes Self-Management Education: A Review.Diabetes Technology & Therapeutics,17(1), 55-63. https://doi.org/10.1089/dia.2014.0155
6 EVIDENCE GROUNDED SOLUTION Powers, M. A., Bardsley, J., Cypress, M., Duker, P., Funnell, M. M., Fischl, A. H., Maryniuk, M. D., Siminerio, L., & Vivian, E. (2016). Diabetes Self-management Education and Support in Type 2 Diabetes: A Joint Position Statement of the American Diabetes Association, the American Association of Diabetes Educators, and the Academy of Nutrition and Dietetics.Clinical diabetes : a publication of the American Diabetes Association,34(2), 70–80. https://doi.org/10.2337/diaclin.34.2.70 Strawbridge, L., Lloyd, J., Meadow, A., Riley, G., & Howell, B. (2015). Use of Medicare’s Diabetes Self-Management Training Benefit.Health Education & Behavior,42(4), 530-538. https://doi.org/10.1177/1090198114566271