Sam's Compliance Case Study

A teaching plan is one of the most important steps in nursing process. It is a vital tool used to achieve the best quality of patient care. A nurse should teach the patient what they need to know about their disease or disorder, diet, treatment, medication regimens, and self-care (Taylor, LeMone, Lillis, & Lynn, 2008). In this paper, I will explain teaching plan for diabetes patient with regular insulin injection including with the purpose of plan, outcomes, behavioral objectives, and teaching method.

Diabetes is a serious medical condition that can also be a risk factor for the development of many different diseases and conditions including dementia, heart disease, and CVA. Thus, effective management of diabetes is very important. Patient compliance can be difficult to achieve if the person affected with diabetes is not educated about the illness or treatment, has not fully accepted the diagnosis or its severity, will not change habits or believes that the prescribed treatment regime is too difficult or ineffective, has cultural beliefs conflicting with the treatment regime, experiences stressful events, lacks social support, or suffers from psychiatric issues unrelated to diabetes (Gerard, Griffin, & Fitzpatrick, 2010). As one may expect, adequate education programs are essential tools when dealing with diabetics. Solid education will provide the patient with information as well as teaching the necessary skills to manage the disorder. The primary focus of any diabetes education program must be to empower patients as a part of the multidisciplinary team. This team should be focused at integrating diabetes into the lives of the patients and this focus should be based on the decisions made by the patient, otherwise the treatment plan can be looked on as forced (Gerald et al., 2010). Every patient stricken with diabetes has the right to benefit from an education program of this type. First, basic education and facts should be administered directly following the diagnosis of

Diabetes has become an epidemic in today’s society. Diabetes affects almost every system in the body, and with an estimated 346 million people in the world with diabetes, healthcare has been heavily affected by the disease (Ramasamy, Shrivastava, P., & Shrivastava, S., 2013). One of the biggest issues for healthcare workers when it comes to diabetes, is that it is such a complicated disease. With so many different systems being affected, medical professionals have had to learn how the disease process works, what causes diabetes to work through the systems, and the best treatments to address all these issues. Through much research, the healthcare system has grown very knowledgeable on diabetes. One important aspect of treating diabetes has been in the introduction of diabetic education. In the past, nurses and dieticians had been responsible for educating patients on diabetes, but now that role is also extended to other people in the healthcare team, including the patient (Tomky, 2013). In fact, patients taking an active role in the education process, including learning to self-care has now become a priority in diabetes treatment. The following paper will discuss diabetic education, the importance of self-care and how this affects a patient’s compliance.

The RN diabetes educator makes a plan of care to teach Amanda to monitor her glucose levels. The RN diabetes educator discusses the use of self-glucose monitoring and gives Amanda verbal and written guidance about optimal glucose levels at each glucose testing point throughout the day. The nurse also provides instruction about calibration of the glucose monitor, fingerstick technique, and use of the monitor for testing. After reviewing the instructions and a successful return demonstration, the diabetes educator and Amanda agree to meet after Amanda's prenatal appointment to follow-up on today's teaching/learning.

It also shows that not having someone to help these patients manage their diabetes as an obstacle to good diabetes management. This study created a plan and this plan was able to be tested to show its effectiveness in diabetes

He told me that he was diagnosed with type 2 diabetes in December 2010. Since his doctor prescribed rapid acting insulin for his diabetes, I asked him if it is acceptable to talk about his medical condition in front of his family. He gave me consent to talk about his medical problems in front of his wife and children. I suggested to him the need to take his insulin shot right before eating a meal. I informed him about the insulin medications that he was taking which was lispro. It has an onset of 10 to 30 minutes, peak time of 30 to 3 hours and a duration of 3 to 5 hours. Furthermore, I emphasized the need for him to eat a balanced diet, and the importance of exercise. I encouraged him to eat small amounts of carbohydrates during 30 minutes of exercise to prevent hypoglycemia. I also taught him that the signs and symptoms of hypoglycemia are tachycardia, irritation, excessive hunger, restless, diaphoretic and depression. He told me that he did not like to walk and do any activity besides going to his job. I brought some articles about how eating healthy, taking his medication, and regular exercise has shown to prevent, slow down the progressive process on type 2 diabetes. I suggested to him to start walking around his neighborhood, and later he could find a support group of friends can walk together with. For instance, Lewis, Sharon, Margaret Heitkemper, and Linda Bucher. "Medical-Surgical Nursing: Assessment and Management of Clinical

Whilst nursing this particular female it was apparent that when her mental health deteriorated so did her management of diabetes, Walker & Rodgers (2010) state that one in five people with diabetes are likely to suffer from depression (pg 186) .The biggest pre-disposing complication that exacerbated Lizzies long term conditions was her medication non-compliance and her inability to give consent for treatment that would promote her recovery and prevent hospital admission. The definition of compliance is a term used to describe how well a patient’s behaviour is following medical advice (The free dictionary, 2008).A shared decision was made that established that Lizzie lacked capacity and safeguarding provisions were implemented to

Assessing the importance of the behavior changes in the patients diagnosed with diabetes was an objective met during the patients interaction. During clinical hours the patients were evaluating for the readiness in behavior changes by identifying the stage the patients were at the time of the visit. Agenda setting was an approach chosen to help a diabetic patient to identify behaviors to change (physical exercise or diet) and set a realistic goal to achieve. BATHE technique helped to identify a new problem during the interview like losing weight in a patient with diabetes. PLISSIT model implemented for helping a transgender individual help to express sexual problems and providing integrated care.

Patient- centered direction is much needed in all areas of nursing practice, however; is gravely required in proving case management services to insulin diabetic patients (Lauver, Ward, Heidrich, Keller, Bowers, Brennan, & Wells, 2002). In a review of his writer’s PICO statement, please see as follows: In with uncontrolled insulin dependent diabetes (P), How does the allotment of patient centered case management, providing patients with tools to take charge into their treatment (I) compared to the approach of disease management(C) influence overall treatment compliance, and increase compliance with oral medical management (O) Over the course of treatment (T)? Also, as mentioned in Selection B, in effort of gaining insight into client response to medical management approach to patient outcomes, this writer plans to make the following available consent forms prior to implementing questionnaires. See components of a client questionnaire as follows:

B. Cooke is a 16 year old male who has a new diagnosis of diabetes mellitus. Her blood glucose levels so far have been in range. The treatment regimen discussed by her physician and nutritionist is understood by her parents, while she works at understanding. Her blood glucose is checked numerous times a day as instructed and insulin is administered based on the reading. She is attempting to complete care independently. She is in sports and has a daily exercise regimen with the goal of weight loss. One intervention for this patient was to have her attend additional education with a nutritionist and other teens her age allowing the nutritionist to assess “self-care” progress. The outcome for this patient thus-far is positive with the hope of acceptable diabetes maintenance in the future. It is the belief; teens with a new diagnosis will accept education and self-care easier if other people the same age and

Another topic that is underlined throughout the book was Andie’s non-adherence to her insulin shot and other medications. Throughout the book, Andie has demonstrated many incidences of non-adherence. Andie does not use her needles properly and has intentionally miss insulin shots to lose weight. The reason behind her behavior can be explained by the “Health Belief Model” in the Adherence and Behavior section of PHRM 826 Patient Centered Care. For patients to take action, they need to have high perceived threat from not taking the action. Threat is influenced by severity of non-adherence and susceptibility of those severities. For Andie, she definitely has high perceived severity from knowledge of possible complications of diabetes from

Diabetes is associated with wide range of complications such as chronic renal failure, blindness, amputations, heart disease, high blood pressure, stroke, and neuropathy (Alotabi, A., et al., 2016). There is no known cure for diabetes, but the disease can be controlled through health management that includes multiple perspectives of care such as medications, blood glucose monitoring, diet, nutrition, screening for long-term complications and regular physical activity (Alotabi, A., et al., 2016). Managing diabetes may be complicated and requires the knowledge and skills of both healthcare providers and the clients. Studies have shown that to prevent or delay diabetic complications due to diabetes, counseling and other lifestyle interventions are the effective therapy. Even with many policies set up for diabetes, 8.1 million Americans are undiagnosed with diabetes mellitus, and approximately 86 million Americans ages 20 and older have blood glucose levels that considerably increase their risk of developing Diabetes Mellitus in the next several years (CDC, 2015). For diabetes care to be successful there needs to be a good understanding of the disease and management by both patients and healthcare providers,

I really enjoy and love the book, Cheating Destiny, Living with Diabetes by James S. Hirsch. We have Diabetes and Metabolic Syndrome course this semester where we learn the physiology and pharmacology background of diabetes, the treatment guideline of diabetes. however, I have a personally feeling that we do not address enough what diabetes patients’ experience and concerns are, how different culture and ethnic background would influence patients’ response and react to diabetes, how can we effectively convey the knowledge to patients in a patient-friendly and acceptable way. After finishing reading the book, I know the process of setting the blood glucose goal by experiment and trials, such as Diabetes Control and Complications Trial (DCCT).

In spite of the wide choice of effective and well-tolerated diabetic treatment large proportion of treated patients, do not achieve satisfactory Glycemic control. Poor therapeutic adherence is a major contributor for insufficient Glycemic control. Only 8.2% of people with diabetes adhere to self-monitoring of blood glucose levels.[4] ( Kim, & Jeong ,2003) Adherence has the largest effect on hyperglycemia.[5] (Brown & Hedges ,2004)The term adherence might imply a more holistic view about self-care than compliance because it places the patient in a central position.[6] (Toljamo & Hentinen,2001). Studies on adherence in patients with diabetes indicate that lack of knowledge and management skills are the main contributing factors to non-adherence.

By reviewing TRACS, and based on the email received from the SSP East Self Sufficiency (3501) Branch Managers, there are two potential issues that are penalizing the client: