Introduction
Diabetes diagnosis and management seriously impact the healthcare system due to this disease’s increasing number. It is critically important to investigate the field, define current ethical and organizational problems, and offer effective solutions for diabetic patients. In this project, ethics, leadership, change management strategies, lack of knowledge about lifestyle habits, patient safety related to medication administration, and poor technological awareness of monitoring options will be the major problems in diabetes management. The promotion of training programs for patient-nurse cooperation, self-administration status improvement, and the distribution of educative brochures are the interventions to solve the problems. Cooperation with nurses and education for patients should result in improved knowledge, decreased medication errors, effective monitoring processes, high patient safety levels, and diabetes management quality.
Ethics, Leadership and Change Management Strategies
Much professional and public attention has been paid to diabetes management and treatment for several decades. Although there is no specific medication to cure the disease, people expect to facilitate their condition and predict the development of complications. According to the World Health Organization (2021), more than 420 million live with diabetes, and more than 1.5 million people have already died from this disease, making it the ninth leading cause of death. The nursing code of ethics includes a set of beliefs and practices to identify the right and wrong systems and behavioral issues within the nursing profession (D’Souza, 2017). Public health interventions are required to reduce the diabetes burden and systematize social and economic costs (D’Souza, 2017). Nurses are morally obliged to become leaders, promote the patient’s well-being, and inform about diabetes, its symptoms, preventive techniques, and treatment options. Thus, ethics includes engagement with educational programs, and leadership focuses on explaining significant lifestyle changes for patients.
Democratic leadership in managing diabetes through the ADKAR model of change is an effective solution. Democratic nurses support involvement, communication, and feedback to improve processes and assure performance. Although their decision-making authority is low, their knowledge contributes to the chosen model, including awareness (the importance of change), desire (the intention to support change), knowledge (background), ability (skills and resources), and reinforcement (continuity). This model and leadership style allow for modifying ethical principles as per the patient’s needs and expectations (D’Souza, 2017). Thus, flexibility and adaptation to new conditions are required skills of nurses and other stakeholders.
Intervention/Solution/Professional Product
Three specific interventions can be offered regarding the three problems in diabetes treatment: lack of knowledge about lifestyle changes, patient safety with medication administration, and poor technical preparedness for blood sugar monitoring. First, healthcare providers, including physicians, nutritionists, and nurses, must implement additional training programs for patients and their families. When people are discharged, they should understand what diabetes is, what risk factors exist, and what steps they should never miss in their care. Adequate education does not take much time, and nurses can cover the major issues in several meetings. Information should be communicated verbally and in a written form. Attention should be paid to follow-up visits, situations when life changes are critical, restoration of fluid balance, defining abnormal metabolic functions, and self-care (Dhatariya et al., 2020; World Health Organization, 2021). The material is divided into several meaningful sections, statistics and examples are offered, recommendations are clear and relevant, and the nearest support centers are mentioned.
Second, the improvement of the self-administration status is recommended in hospitals. Diabetes is the condition when blood sugar is elevated because the pancreas is not able to make enough insulin that turns food into energy (World Health Organization, 2021). Thus, all patients with type 1 and type 2 diabetes need to take insulin regularly (Centers for Disease Control and Prevention, 2020). However, besides the positive aspects of insulin taking, patient safety may be challenged by this agent’s excess in the bloodstream, provoking low glucose levels, known as hypoglycemia (Kolb et al., 2020). Hypoglycemia risk factors are based on medical and lifestyle issues, including previous history, impaired awareness, hepatic dysfunction, alcohol, no adequate monitoring, and irregular lifestyle (Dhatariya et al., 2020). Self-administration status is when a patient takes medicines with no experts’ control (Bain et al., 2019). It is recommended to focus on this status in diabetes management and monitoring charts so insulin administration can be easily accessible. When nurses are obliged to fill in this section, they inform and educate patients and their families adequately.
Finally, educative brochures to inform patients on how to monitor their vital signs could effectively predict safety errors and negative outcomes. On the one hand, most nurses provide people with oral guidelines on managing their diabetes. On the other hand, individuals do not always properly remember this information, and some mistakes or shortages occur. When a brief informative guide is offered and available to patients all the time, it is easy to memorize the steps. Hints on maintaining healthy body weight, choosing an appropriate diet, and being physically active are explained (World Health Organization, 2021). Discharge checklists and insulin safety posters become a part of the chosen intervention (Bain et al., 2019). It is impossible or, at least, rather challenging to cover all aspects of diabetes in one meeting, and illustrative examples and reminders will effectively change the patient’s lifestyle.
Diabetes management is characterized by multiple solutions, improvements, and challenges that people need to identify at different stages of their care processes. The solution related to the first problem and the offered intervention is improving knowledge in patients by 70%. It is not always easy to involve all patients and their family members in managing diabetes properly, but most people demonstrate their desire to avoid health complications and other problems provoked by this disease. Thus, 70% awareness improvement can be possible with training programs to be offered to patients.
Insulin-taking cannot be neglected or stopped by diabetic patients if they want to avoid problems and provoke new diseases. Self-administration status is a simple step in discharging patients, and if nurses follow this recommendation, it is planned to reduce the number of medication errors and inappropriate administration processes by 70%. When nurses educate patients about insulin-taking threats and benefits, they reduce additional questions and ambiguous situations. In other words, it is important to prepare patients for making independent decisions and being responsible for diabetes medications after discharge.
The final solution touches upon the possibility of promoting help for appropriate monitoring of blood sugar levels in about 80% of patients. Although nurses need to work with all people, regardless of their age, race, and education level, they cannot ensure that all individuals are ready to cooperate. However, educative brochures and guides need to be equally distributed, and a larger part of patients should use the material regularly. When individuals are asked how to monitor their blood sugar levels and other vital signs, they present several options and demonstrate high-level awareness of the topic.
Best Practice Strategies for Effective Communication and Collaboration
Nurses take responsibility for multiple change processes, and their democratic leadership style promotes effective communication and collaboration at different levels. Self-management in diabetes and other chronic disease depends on how patient-provider collaboration is organized, resulting in patient satisfaction, treatment adherence, and positive health outcomes (Lambrinou et al., 2019). Transparency in healthcare services, gathering feedback, and providing necessary information are the elements of the best cooperative strategy. Instead of giving recommendations and prescribing medications, nurses ask questions and share their observations on how other people cope with similar problems.
State Board Nursing Practice Standards and Government Policies
Today, understanding policies to predict and manage diabetes is important for nurses and patients who have to live with this condition. For example, the World Health Organization (2021) provides specific guidelines for several non-communicable diseases and improves public awareness, marking 14 November as World Diabetes Day. The Affordable Care Act reduces care costs in the United States and offers the best care quality through Medicare and Medicaid insurance programs. It is not enough for nurses to inform patients about the basics of diabetes but to check individual involvement in self-management and medication adherence.
Care Quality, Patient Safety, and Costs of Care
Despite the intention to predict diabetes and create the most effective care conditions, this disease is still associated with multiple complications and problems, affecting care quality, costs, and patient safety. One of the main areas of improvement is the knowledge about diabetes ordinary people have to promote care quality. The Centers for Disease Control and Prevention (2020) investigates what American adults know about diabetes and defines that only 15.3% have appropriate prediabetic awareness. It means that most people remain poorly informed about the risks of diabetes and other hypoglycemia complications and cannot adopt lifestyle changes properly. Regarding the history of the disease and the genetic predisposition, some families understand the threats. Still, if a person has never been exposed to this health problem, it is hard to comprehend how diabetes changes human life. Living with diabetes imposes certain limitations and obligations, and improved care quality requires nurses and other stakeholders to be involved in the care process.
When a diabetes diagnosis is proven, it is important not to panic but consider available treatment options. Patient safety is a vital responsibility for nurses and other healthcare providers involved in the care process. Insulin is one of the most common and effective medications for patients. However, Kolb et al. (2020) admit that too many good insulin characteristics might be bad for body patients if systematic insulin levels are not followed. At the initial stages of diabetes treatment, doctors define doses for patients and ask nurses to take administration steps carefully. People are discharged from hospitals and become responsible for diabetes management and medication arrangements with time. Bain et al. (2019) notice that self-administration status is poorly covered in the electronic prescribing and medicines administration (EPMA) system. Thus, being neglected for evaluation, some diabetic agents could be dangerous for patients and question patient safety issues.
Finally, today, individuals have access to various options to manage diabetes, control their vital signs, and indicate blood sugar levels, which are characterized by different costs. Some people know how to implement recent technological options as a part of mobile health (mHealth) interventions. The proliferation of such commercial diabetes applications empowers patients to self-monitor and promote self-efficacy (Istepanian & Al-Anzi, 2018). It is expected of physicians and nurses to educate individuals and distribute new guidelines and protocols in a short period. In addition to prescribing medications and talking about healthy lifestyles, people need to eliminate their knowledge gaps and be technically ready to manage diabetes and complete monitoring, considering available resources and evaluating costs.
Application of Technology, Care Coordination, and Community Resources
Despite increased attention to self-management and medications, care coordination, application of technology, and the identification of community resources are vital for change management in diabetes care. mHealth technologies support the idea of self-management by addressing major clinical components and reminders of what can be done to manage diabetes (Istepanian & Al-Anzi, 2018). Nurses, doctors, nutritionists, and other medical employees who cooperate with patients and their families promote coordination of care. Community resources are not only medications or monitoring kits but meetings and social support that people might rely on in treating diabetes. Changes in the food industry, healthcare services, and social services are the achievements of modern communities in recognizing diabetes as a serious problem that cannot be solved but might be mitigated with time.
Conclusion
Interventions and solutions to the problems of diabetes regarding patient safety, knowledge gaps, and skill training are critical for modern health care. It is not enough to identify some unclear points and prove that improvements and changes are required. It is more important to help people affect and participate in management processes and learn what steps should be taken regularly. In this project, three problems and three interventions are offered. Poor awareness of diabetes basics among the population can be improved by additional training programs for patient from nurses. Patient safety challenges due to insulin-taking may be reduced by obligatory self-administration status identification. Educational brochures and communication with patients effectively improve patients’ experiences in monitoring vital signs and blood sugar levels.
References
Bain, A., Silcock, J., Kavanagh, S., Quinn, G., & Fonseca, I. (2019). Improving the quality of insulin prescribing for people with diabetes being discharged from the hospital. BMJ Open Quality, 8(3). Web.
Centers for Disease Control and Prevention. (2020). National diabetes statistics report 2020 estimates of diabetes and its burden in the United States. Web.
Dhatariya, K., Mustafa, O. G., & Rayman, G. (2020). Safe care for people with diabetes in hospital. Clinical Medicine, 20(1), 21-27. Web.
D’Souza, R. (2017). Ethical issues associated with diagnosing and managing diabetes. Global Bioethics Enquiry, 5(2), 52-56.
Istepanian, R. S., & Al-Anzi, T. M. (2018). m-Health interventions for diabetes remote monitoring and self-management: Clinical and compliance issues. Mhealth, 4. Web.
Kolb, H., Kempf, K., Röhling, M., & Martin, S. (2020). Insulin: To much of a good thing is bad. BMC Medicine, 18(1). Web.
Lambrinou, E., Hansen, T. B., & Beulens, J. W. (2019). Lifestyle factors, self-management and patient empowerment in diabetes care. European Journal of Preventive Cardiology, 26(2), 55-63. Web.
World Health Organization. (2021). Diabetes. WHO. Web.