NURS 615: CNL Role: Educator (Diabetes Educational Program)
Goal: Teach cohort of licensed nurses in facility on proper diabetic education and plan of care.
The group of licensed nurses will be able to:
Demonstrate the correct procedure for teaching one how to test blood glucose levels at home.
Properly identify risk factors for unstable blood glucose levels upon patient assessment.
Provide instructions of prescribed regimen for monitoring blood glucose levels and how to realistically
incorporate this into one’s day-to-day life.
Verbalize how to educate a patient on how to interpret an insulin sliding scale and when to notify
doctor.
Demonstrate how to instruct a patient the correct procedures to safely self-administer prescribed
medications and monitor for their effects.
Verbalize the signs and symptoms of hypoglycemia and how to instruct a patient on these
signs/symptoms such as serum glucose <60, pallor, tachycardia, diaphoresis, jitteriness, blurred vision,
chills, irritability, clamminess, and confusion.
Verbalize the signs and symptoms of hyperglycemia and how to instruct a patient on these
signs/symptoms such as serum glucose >300, acetone breath, headache, polyuria, polydipsia,
polyphagia, weakness, and lethargy.
Provide education to patient on the identification of date, time, and location of follow-up appointments,
which will be provided to patient upon discharge.
Educate patient on proper actions to be taken in the event of an illness.
Successfully provide instructions to the patient on the importance of changing modifiable risk factors
Instruct patients on proper diabetic diet choices and recommended exercise regimen.
Demonstrate the proper assessment of patient’s level of understanding of illness, complications, and
recommended treatments to determine if there’s still a knowledge deficit after providing educational
program (possibly an end of program quiz for the patient to complete as part of the nurse’s evaluation
of outcome).
Provide education to the patient and family on other community resources, such as local support groups.
Instruct patient on how to prevent and treat above normal blood glucose levels.
Instruct patient on how to prevent and treat low blood glucose levels.
Collaborate with the patient to identify potential obstacles that may interfere with adherence of diabetic
regimen.
Collaborate with patient to identify and prioritize goals, then develop a realistic plan for achieving those
goals as part of educational program. For instance, short term goals of no ketones in urine for 90days,
and an A1C within normal limits after a 6month period. A blank section will be available at end of
educational program for patient to complete with nurse bedside.
Background:
It was first discovered within my clinical microsystem that, as of presently, there isn’t a newly diabetic
teaching process that exists. Matter of fact, there is no diabetic teaching tool or education monitoring that is
being provided to our patients at admission, or at discharge. Also, many licensed nurses at this facility lack the
necessary knowledge to effectively teach a diabetic patient upon discharge. As a result, the facility sees many of
these patients readmitted and many times, the evidence of unmanaged disease process is clear when patients are
returning to facility for further rehabilitation related to amputations; weakness and falls at home; diabetic
ketoacidosis; or unmanaged blood sugars at home, all of which leads them back to the emergency room, and
the high readmission rates and long-term effects of continued unmanaged disease process within the
community.
The need for further diabetic education is evident in the statistical value of the cost of managing diabetes
in America, according to one source, the estimated total economic cost of diagnosed diabetes in 2012 was $245
billion, a 41% increase from our previous estimate of $174 billion in 2007. The same source states that the
largest components of medical expenditures are hospital inpatient care (43% of the total medical cost);
prescription medications to treat complications of diabetes (18%); anti-diabetic agents and diabetes supplies
(12%); physician office visits (9%); and nursing/residential facility stays (8%) (American Diabetes Association,
2015). The impact of implementing more diabetic education on the community is astronomical and
immeasurable. Not only would more diabetes education aid in the control and management of the disease, but it
will also in turn, cause a reduction in medical costs in local emergency rooms, prescription medications,
anti-diabetic agents, anti-diabetic supplies, physician office visits, and lastly, nursing facility stays. The costs it will save
the patient themselves is also worth mentioning with diabetics incurring on average medical expenditures of
about $13,700 per year, of which about $7,900 is attributed to diabetes. Also, people with diagnosed diabetes,
on average, have medical expenditures approximately 2.3 times higher than what expenditures would be in the
absence of diabetes (American Diabetes Association, 2015).
As a future Clinical Nurse Leader, the nurse essentially assumes sole accountability for patient-care
outcomes by applying evidence-based information which aids in the designing, implementing, and evaluating of
a given process that relates to patient care and models of care delivery. The CNL is largely a manager of care to
individuals and cohorts of patients in a variety of healthcare settings. To further allow the CNL to implement
this new diabetes educational program within the community, and not only effect a larger cohort of patients, but
developed, and then instructed to the group of nursing that work at this facility, who will then carry out the
educational program bedside to the patients themselves.
Data to support the project
The need for further diabetic education is evident in the statistical value of the cost of managing diabetes
in America, according to one source, the estimated total economic cost of diagnosed diabetes in 2012 was $245
billion, a 41% increase from our previous estimate of $174 billion in 2007. The same source states that the
largest components of medical expenditures are hospital inpatient care (43% of the total medical cost);
prescription medications to treat complications of diabetes (18%); anti-diabetic agents and diabetes supplies
(12%); physician office visits (9%); and nursing/residential facility stays (8%) (American Diabetes Association,
2015). The impact of implementing more diabetic education on the community is astronomical and
immeasurable. Not only would more diabetes education aid in the control and management of the disease, but it
will also in turn, cause a reduction in medical costs in local emergency rooms, prescription medications,
anti-diabetic agents, anti-diabetic supplies, physician office visits, and lastly, nursing facility stays. The costs it will save
the patient themselves is also worth mentioning with diabetics incurring on average medical expenditures of
about $13,700 per year, of which about $7,900 is attributed to diabetes. Also, people with diagnosed diabetes,
on average, have medical expenditures approximately 2.3 times higher than what expenditures would be in the
absence of diabetes (American Diabetes Association, 2015).
At HCR Manor Care, more than 93 percent of the rehabilitation patients are discharged home (compared
to a national average of 75 percent), showing a significant need for continued education for many diabetic
patients discharging home within the community. After some further research, it was estimated that the average
number of admissions on a given month within this clinical microsystem was a reported 185 individuals
needing acute medical services, with HCR Manor Care having significantly more admissions per month than a
peer group of for-profit nursing centers and significantly more admissions per deficiency (HCR Manor Care,
and education for the staff providing care. One aspect to further research would be to gain more access to the
percentage of readmissions at this facility, as well as percentage of diabetic patients whom are returning. Part of
the vision at this facility is to fill a critical gap in the health care continuum and help to improve transitions of
care by addressing chronic disease processes and uncontrolled disease management. A diabetic educational
program incorporated in the discharge process at this facility would largely contribute to their vision by having
newly educated staff trained on this specialty.
Evidence to support the project:
According to the American Diabetes Association (ADA), the need for further diabetic education is
evident in the statistical value of the cost of managing diabetes in America with an estimated total economic
cost of diagnosed diabetes in 2012 totaling $245 billion, which is a 41% increase from our previous estimate of
$174 billion in 2007. In fact, according to the ADA, the largest components of medical expenditures are
hospital inpatient care (43% of the total medical cost); prescription medications to treat complications of
diabetes (18%); anti-diabetic agents and diabetes supplies (12%); physician office visits (9%); and
nursing/residential facility stays (8%) (American Diabetes Association, 2015). The costs it will save the patient
themselves is also worth mentioning with diabetics incurring on average medical expenditures of about $13,700
per year, of which about $7,900 is attributed to diabetes. Also, people with diagnosed diabetes, on average, have
medical expenditures approximately 2.3 times higher than what expenditures would be in the absence of
diabetes (American Diabetes Association, 2015). By implementing a diabetes educational plan in practice and
educating staff on how to effectively teach individuals with diabetes, the microsystem is creating numerous
cost-saving initiatives on a state, federal, individual, insurance provider, and macro and microsystem level.
As defined by the Centers of Disease Control and Prevention (CDC), self-management of diabetes
includes patients knowing when and why they take certain medications, the potential side effects of these
medications, as well as knowing enough about their condition to recognize the early warning signs to notify
they are more likely to be readmitted to the hospital due to lingering or new medical complications exacerbated
by a growing population suffering from multiple co-morbities. The cost of these readmissions is prohibitive to
the health care system and a target of government agencies to remove cost from the system. One program
nationally accepted and made available to the public, is the National Diabetes Prevention Program led by the
Centers of Disease Control and Prevention. The initiative set forth encourages collaboration among federal
agencies, community-based organizations, employers, insurers, health care professionals, academia, and other
stakeholders to prevent or delay the onset of type 2 diabetes among people with prediabetes in the United States
(CDC, 2015). Some aspects of this national initiative program include the following: teaches participants
strategies for incorporating physical activity into daily life and eating healthy; helps participants to identify
emotions and situations that can sabotage their success, and encourages participants to share strategies for
dealing with challenging situations (CDC, 2015). The creation of a diabetes educational program in this given
facility will allow the newly trained staff to contribute to this national initiative approach of effective diabetes
education, prevention, as well as disease management.
According to the article, “How Proven Primary Prevention Can Stop Diabetes,” diabetes is a growing
epidemic that brings with it both individual suffering and extraordinary economic consequences with a reported
26 million people in the United States having diabetes presently, as well as an additional 79 million individuals
diagnosed as being pre-diabetic. The authors of this article note that every 17 seconds, another American is
being diagnosed with diabetes and, if current trends continue, one in three Americans will have diabetes by
2050 (Anderson, et al, 2012). So what do these statistical numbers suggest? That this disease isn’t being
effectively prevented in the outpatient setting and more preventative strategies must be emphasized. The authors
also illustrate the goal for diabetes advocates, including health care professionals, is to convince those who
create our public policies that slowing these alarming trends and focusing on prevention of type 2 diabetes must
be a national priority (Anderson, et al, 2012). In an era of increasing health care costs compounded with
top public priority. The importance of such initiatives are illustrated in the above article through the promotion
of diabetes education, prevention, and management.
According to Jacqueline Dudly, author of the article, “The Diabetes Educator's Role in Teaching the
Diabetic Patient,” diabetes educators have become a necessary cost-effective addition to the health care team
whose efforts are directed toward the improvement of the total care provided to the diabetic patient with
specific responsibilities in the evaluation of each diabetic patient (Dudly, 2015). In order to start the
teaching-learning process, the nurse educator must be skilled in this teaching-teaching-learning process and have a good
background and understanding of diabetes, including diabetes complications and problems. An assessment of
not only what that individual knows about his illness and where his educational needs lie, but also of each
person's readiness to learn must be incorporated in this diabetes educational plan as this educational approach
has proven to be most effective (Dudly, 2015). The suggested diabetes educational plan at this facility will
incorporate these vital skills and knowledge base to create effective diabetes educators within the community.
Learning Theory to Support the Project:
Social Learning Theory:
The initial phase of this type of learning theory will include gathering the group of nurses in this facility
to include 8 registered nurses and 10 licensed vocational nurses. The group will first discuss their views on the
current diabetes education being provided to patients and then brainstorm on their own ideas of an effective
diabetes educational plan. The teacher will then introduce the proposed diabetes educational plan to the group
and role model to a volunteer how to effectively carry out this educational plan. The teacher will demonstrate
the educational process in regards to lifestyle modifications, proper diet, and other disease management
strategies. The entire proposed educational plan will be presented to the volunteer to show how to teach one on
proper diabetes management. The diabetes educational plan will be presented sequentially to ensure
McCarthy’s 4MAT system is utilized throughout the course. The 4 types will be addressed to include why,
with Type 1 to instill personal meaning related to the content. Then, Type 2 will be included where the teacher
assists the learner in the acquisition of the new knowledge being taught, followed by Type 3 to practice the new
content and show the group “how,” lastly, Type 4 will be included by showing “if,” which includes alternative
outcomes to problem solve through when teaching this new plan to patients (Bastable, p 151).
According to one source, the first step in the social learning theory is to physically model the behavior,
acting out the process they hope those under them will follow. By seeing the behavior modeled, employees can
develop a more defined understanding of what the behavior entails and experience more success in carrying out
the behavior in question (Schreiner, 2015). The content that will be role modeled will be related to specific
content in this educational plan to include teaching on effective diabetes management in the outpatient setting.
The teacher will encourage group members to imitate the teacher’s behavior throughout the session. When
asked to demonstrate back, the teacher will recognize those whose behavior is modeled correctly and commend
them on their practices in the hopes of encouraging the rest of the group to replicate similar behaviors, i.e.,
effective diabetes teaching. After the attention phase has occurred where the learner’s observe role modeling,
the retention phase occurs followed by reproduction and motivational. In the motivation phase, the learners in
this group are influenced by reinforcement from peers, as well as the teacher. The outcome of the learner’s
success in this teaching group largely depends on the influence of their surroundings and positive
reinforcements; therefore, it is crucial for the teacher to actively role model intended behavior through the
presentation of the diabetes educational plan as well as guide by positive reinforcements (Bastable, p 76).
Cognitive Theory:
Cognitive learning is a highly active process that is directed by the individuals and involves the learner
perceiving the information, then interpreting it based on the information the learner already knows, and then
reorganizing the information into a newer more profound outlook to enhance understanding of informational
content (Bastable, p 73). The teacher will ask the group to identify how they feel they learn best and use this
understandable terms and in a direct way in order for the learners to adapt the new concept of teaching diabetes
education best. According to Bastable, a basic principle is that psychological organization is directed toward
simplicity and regularity (p 74). The teacher will ask the group of learners to identify a few small personal goals
to accomplish by the end of the learning session to facilitate the learning process.
The teacher will first identify with the group their own personal needs and where they feel they lack in
teaching as well as discuss any past negative experiences they may have had teaching patients in order to have
the group absorb the new teaching style most effectively. By using Gardner’s theory of eight intelligences, the
teacher can assess each individual’s style of learning and individualize the teaching based on the needs
addressed through the following styles: linguistic, spatial, kinesthetic, logical-mathematical, musical,
interpersonal, intrapersonal, and naturalist styles (Bastable, p153). For instance by teaching through quizzes;
statistics provided on a diagram or chart; insulin, syringes, blood glucose monitoring devices to demonstrate;
videos to show how to effectively check one’s blood glucose and administer insulin; and resources to participate
in community events that support diabetes prevention. The teacher will also gain the learner’s attention by
discussing some statistical values in support of this new diabetes educational program to allow the group to see
the need and how this new educational plan can change patient outcomes for the positive. Next the teacher will
provide handouts to the group that includes a list of the day’s objectives and expectations. Half way through the
course the teacher will provide a quiz relating to previously discussed content and pair members in groups to
demonstrate previously discussed teaching strategies to stimulate the learner’s recall of prior learning (Bastable,
p 75). This process will allow the learners to overcome any potential obstacles of learning if content isn’t
retained and also allow the teacher to evaluate the learner’s mistakes to better formulate a plan of correction to
ensure new information is retained and incorporated into future teaching moments.
Content Outline; Method of Instruction; Evaluation:
Objectives and
Sub-objectives Content Outline Method of
instruct
Time allott ed
ion 1. After completing a 2 hour
course on diabetes education, the staff will be able to recognize learning barriers and learning preferences as newly skilled educators (Cognitive)
2. Following the diabetes educational program course, the staff will be able to effectively carry through a new diabetes education plan after 2 hour in-service to include the following:
Demonstrate the correct procedure for teaching one how to test blood glucose levels at home (Psychomotor).
Identify risk factors for unstable blood glucose levels upon patient assessment (Cognitive).
Review through short video how to accurately check blood glucose with meter.
Course outline to include risk factors of: obesity,
hypertension, inactive lifestyle, hyperlipidemia, age, race, gender, family history (American Diabetes Association, 2015).
Course review on when to check blood sugar levels such as before all meals and at bedtime as well as before starting any planned activity/exercise. Educate on tools such as pocket glucose meters to take on the go.
Lecture Lecture Video Lecture /One-to-One instruct 2 hour 45mi n 3min 2min Computer/ outline print out outline print out; prepared end of lecture quiz video, accucheck machine, lancet, gauze, alcohol Outline
Type of Data: Content Evaluation
From whom or what the data will be collected:
Learners; nursing staff
How, when, and where the data will be collected:
Observation proceeding lecture in the classroom.
By whom the data will be collected: Educator (self)
Type of Data:
Content Evaluation
From whom or what the data will be collected:
Learners; nursing staff
How, when, and where the data will be collected:
Quiz after lecture is completed in the classroom
By whom the data will be collected:
Educator (self)
Type of Data:
Process and Content Evaluation From whom or what the data will be collected:
Learners, future educators, nursing staff
How, when, and where the data will be collected:
Direct observation of each nurse role playing how to check blood glucose and how to educate this to patients in the classroom setting. By whom the data will be collected: Educator (self)
Type of Data:
Content Evaluation
Outline instructions of prescribed regimen for monitoring blood glucose levels and how to realistically incorporate this into one’s day-to-day life (Cognitive).
Define proper education on how to interpret an insulin sliding scale and when to notify doctor (Cognitive).
Demonstrate how to instruct a patient the correct procedures to safely self-administer prescribed medications and monitor for their effects
(Psychomotor).
Include in course how to properly use a prescribed sliding scale at home and abnormal glucose readings to report to your doctor right away such as less than 60 or greater than 200 consistently &/or with symptoms.
Review step by step on how to administer insulin with focus on type of syringe, how to draw up insulin accurately, location of administration and how to teach this to a patient.
ion Group discuss ion Demon stration & One-to-one instruct ion Demonst ration and One-to-One instructi on 10mi n 3min 10mi n Outline Outline, sliding scale print out with order Outline, check-list, insulin, syringe, alcohol
Learners; nursing staff
How, when, and where the data will be collected:
Assess for questions after explanation of risk factors in PowerPoint presentation in the classroom
By whom the data will be collected: Type of Data:
Question & Answer
From whom or what the data will be collected:
Learners; nursing staff
How, when, and where the data will be collected:
Observation of group discussion and evaluation of understanding through questionnaires in group discussion in the classroom By whom the data will be collected: Educator (self)
Type of Data:
Question & Answer
From whom or what the data will be collected:
Learners; future educators
How, when, and where the data will be collected:
Through direct observation after demonstration in classroom
By whom the data will be collected:
Educator (self)
Type of Data:
Observation and return demonstration
From whom or what the data will be collected:
Learners; future educators; nursing staff
How, when, and where the data will be collected:
Outline the signs and symptoms of hypoglycemia and how to instruct a patient on these signs/symptoms. (Cognitive).
Define the signs and symptoms of hyperglycemia and how to instruct a patient on these signs (Cognitive).
Illustrate to the patient how to identify the date, time, and location of follow-up
appointments, which will be provided to patient upon discharge on specified diabetic discharge form (Cognitive).
Include in presentation signs and symptoms such as: serum glucose <60, pallor,
tachycardia, diaphoresis, jitteriness, blurred vision, chills, irritability, clamminess, and confusion (American Diabetes Association, 2015).
Include in presentation signs and symptoms of
hyperglycemia such as: serum glucose >300, acetone breath, headache, polyuria, polydipsia, polyphagia, weakness, and lethargy (American Diabetes Association, 2015).
Refer to facility policy and procedure as well as new diabetes educational discharge form. Lecture /Group discuss ion Lecture /Group Discuss ion Role play 3min 3min 2min Outline Outline Discharge instructions form
observation after instruction has been given in the classroom
By whom the data will be collected: Educator (self)
Type of Data:
Question & Answer; Content Evaluation
From whom or what the data will be collected:
All learners; nursing staff
How, when, and where the data will be collected:
Assess for questions after instruction in classroom
By whom the data will be collected: Educator (self)
Type of Data:
Question and answer; Content Evaluation
From whom or what the data will be collected:
Learners; future educators
How, when, and where the data will be collected:
Assess for questions in group discussion and encourage open communication with peers; after lecture, in class room
By whom the data will be collected: Educator (self)
Type of Data:
Content evaluation; Observation and return demonstration
From whom or what the data will be collected:
All learners
How, when, and where the data will be collected:
Implement role play setting in the classroom with the incorporation of diabetes discharge form.
By whom the data will be collected:
Explain to the patient the proper actions to be taken in the event of an illness (Cognitive).
Discuss the importance of changing modifiable risk factors such as weight loss and carbohydrate controlled diet (Cognitive).
Illustrate to the patient the proper diabetic diet and recommended exercise regimen (Cognitive).
Include in presentation education on what to do in the event of an illness such as staying hydrated and checking blood sugars more regularly to prevent alteration in blood glucose levels.
Include in presentation information on modifiable risk factors and community resources to aid in the reduction of these risks through the American Diabetes Association such as:
BMI tool
Kitchen inventory tool
Neighborhood and work inventory
Type II Diabetes Risk Test
My Health Advisor
The CheckUp America program
Include in presentation information on diet and exercise regimen specific to diabetes such as:
Benefits of exercise: Helps keep your
blood glucose, blood pressure, HDL cholesterol and triglycerides on target Lowers your risk for
pre-diabetes, type 2 diabetes, heart disease and stroke Relieves stress Strengthens your
heart, muscles and bones
Improves your blood circulation and tones your muscles Lecture /Role Play Lecture / Website tools Lecture /Role Play 2min 15mi n 15mi n Outline ADA brochures and handouts with questionnaire s ; presentation outline ADA guidelines presented in a handout form
ADA guidelines presented in a handout form
Type of Data:
Content evaluation; Observation and return demonstration
From whom or what the data will be collected:
Future educators; nursing staff How, when, and where the data will be collected:
Through the act of role playing in in the group setting proceeding lecture in the classroom.
By whom the data will be collected: Educator (self)
Type of Data:
Question & Answer
From whom or what the data will be collected:
Learners; nursing staff
How, when, and where the data will be collected:
Assess for questions during lecture and the presentation of ADA
handouts; questionnaires proceeding lecture in the classroom.
By whom the data will be collected: Educator (self)
Type of Data:
Observation and return
demonstration; content evaluation From whom or what the data will be collected:
Future educators; nursing staff How, when, and where the data will be collected:
Assess for questions during lecture and group interactions; evaluate questionnaire from ADA website; direct observation of role play in the classroom.
Demonstrate the proper assessment of patient’s level of understanding of illness, complications, and
recommended treatments to determine if there’s still a knowledge deficit after providing educational program
1. An end of program quiz for the patient to complete as part of the nurse’s evaluation of outcome) (Psychomotor).
Outline to the patient and family on other community resources, such as local support groups (Cognitive).
Keeps your body and your joints flexible (American Diabetes Association, 2015). Kinds of physical activity:
Activity—walking, using the stairs, moving around— throughout the day Aerobic exercise,
such as brisk walking, swimming, or dancing Strength training, like
lifting light weights Flexibility exercises,
such as stretching. Diet instructions to cover the following topics:
Understanding carbohydrates Making healthy food
choices Food tips Gluten-free diet Planning meals Recipes Eating on the go
Instruct group on effective measures to ensure the learner understands the content taught. Then, provide the group with the diabetes quiz that will now be implemented in practice as part of this new diabetes educational program.
Include in presentation community resources to provide to patient such as: Awareness programs, Diabetes expos, Diabetes Camps, Fundraising events, volunteer opportunities; and
Role Play/Gr oup discuss ion Lecture /Role Play 5min Outline Brochures
Type of Data:
Process evaluation; observation and return demonstration
From whom or what the data will be collected:
All learners
How, when, and where the data will be collected:
Direct observation of role playing in group setting proceeding lecture and group discussion in the classroom.
By whom the data will be collected:
Educator (self)
Type of Data:
Observation and return demonstration
List to the patient ways to prevent and treat above normal blood glucose levels (Cognitive).
List to the patient ways to prevent and treat low blood glucose levels (Cognitive).
how to become a member of organizations such as the American Diabetes Association.
Incorporate in teaching causes of hyperglycemia such as:
If you have type 1, you may not have given yourself enough insulin.
If you have type 2, your body may have enough insulin, but it is not as effective as it should be.
You ate more than planned or exercised less than planned. You have stress from
an illness, such as a cold or flu.
You have other stress, such as family conflicts or school or dating problems. You may have
experienced the dawn phenomenon (a surge of hormones that the body produces daily around 4:00 a.m. to 5:00 a.m.).
Incorporate into teaching causes of hypoglycemia such as:
Diet and insulin regimen
Have class list examples of common reasons patients are
Role Play/Le cture Role Play/Le cture 10mi n 10mi n 5min Outline Outline
Future learners; all nurses
How, when, and where the data will be collected:
Evaluation through end of lecture quiz proceeding lecture in the classroom.
By whom the data will be collected: Educator (self)
Type of Data:
Observation and return
demonstration; content evaluation From whom or what the data will be collected:
All learners
How, when, and where the data will be collected:
Direct observation of return demonstration during role playing interactions in group proceeding lecture.
By whom the data will be collected: Educator (self)
Type of Data:
Content evaluation; observation and demonstration
From whom or what the data will be collected:
All learners; future educators
How, when, and where the data will be collected:
Direct observation of role playing interaction in group setting proceeding lecture in the classroom.
Design with the patient ways to identify potential obstacles that may interfere with adherence of diabetic regimen (Psychomotor).
Design with the patient ways to identify and prioritize goals, then develop a realistic plan for achieving those goals as part of educational program (Psychomotor). For instance, short term goals of no ketones in urine for 90days, and an A1C within normal limits after a 6month period. A blank section will be available at end of educational program for patient to complete with nurse bedside.
Initiate diabetes
management protocol for newly diagnosed patients in the facility while in the facility (Affective)
non-compliant with diet, medication, and exercise regimens. Brainstorming activity.
Have class list tentative care plans for their diabetic patients and in groups, map out potential patient goals (both short term and long term) with specified outcomes.
Implement practices to include monitoring blood sugars before all meals and at bedtime & notify MD when glucose levels are <60 &/or >200. When glucose levels fall within this parameter, an automatic review of medications and recent blood sugars must be completed and faxed to MD.
Group Discuss ion/Rol e Play Group Discuss ion/Rol e Play Lecture 10mi n 10mi n 15mi n White board White board Outline Educator (self)
Type of Data:
Observation and demonstration
From whom or what the data will be collected:
All learners; future educators, all nurses
How, when, and where the data will be collected:
Direct observation of role playing in group setting proceeding lecture in the classroom.
By whom the data will be collected: Educator (self)
Type of Data:
Question answer; process evaluation
From whom or what the data will be collected:
Future learners; all nurses
How, when, and where the data will be collected:
Assessment of group care plans on white board and evaluation of individual education methods proceeding lecture in the classroom.
By whom the data will be collected: Educator (self)
Type of Data: Process evaluation
From whom or what the data will be collected:
All nursing staff
How, when, and where the data will be collected:
References
American Diabetes Association. (2015). The Cost of Diabetes. Retrieved from: http://www.diabetes.org/advocacy/news-events/cost-of-diabetes.html
Anderson, J., Everette, T., & Riley, M. (2012). How Proven Primary Prevention Can Stop Diabetes. Clinical Diabetes. 30:7. doi: 10.2337/diaclin.30.2.76. Retrieved from:
http://clinical.diabetesjournals.org/content/30/2/76.full.pdf+html
Bastable, S. (2014). Nurse as Educator: Principles of teaching and Learning for Nursing Practice. 4th edition. Jones & Bartlett Learning
Centers for Disease Control & Prevention. (2015). Retrieved from: http://www.cdc.gov/diabetes/prevention/about.htm
Dudly, J. (2015). The Diabetes Educator's Role in Teaching the Diabetic Patient. Diabetes Care. 38:2. doi: 10.2337/diacare.3.1.127. Retrieved from: http://care.diabetesjournals.org/content/3/1/127
