Cotter, A., Durant, N., Agne, A., & Cherrington, A. (2014). Internet interventions to support life modification for diabetes management: A systematic review of evidence. Journal of Diabetes and its Complications, 253¬−251.
The authors of this study investigated the significance of providing health education via the internet to patients with diabetes. The methodology used was a systematic review of previous published studies regarding using the internet to educate patients with diabetes about lifestyle modifications, behavioural changes, and managing the disease. A total of 2,841 studies were included in the review, and this wide coverage indicates a major strength of this article. Concerning study weaknesses, some relevant articles could be missing; there is a possibility of bias in the analysis of the findings from the selected articles; and there is heterogeneity in the study measurements, which reduces the quality. The authors found that internet strategies are important in educating patients about the self-management of diabetes since many patients can be reached, in hospital settings as well as at home. By using the internet, more patients can receive information about controlling their blood glucose. If patients’ blood glucose levels are left unaddressed, incidences of diabetes ketoacidosis may increase. A positive correlation exists between educating patients via the internet and decreasing incidences of diabetic ketoacidosis; this results in a reduction in associated morbidity and mortality.
Elliott, J., Jacques, R., Kruger, J., Campbell, M., Amiel, S., Mansell, P., … & Heller., S. (2014). Research: Educational and psychological issues substantial reduction in the number of diabetic ketoacidosis and severe hypoglycaemia episodes requiring emergency treatment lead to reduced cost after structured education in adults with type 1 diabetes. Diabetic Medicine, 847−843.
The aim of this study was to establish the effects of educating patients on dose adjustments during every day eating, to determine how that impacts the occurrences of diabetic ketoacidosis, and to assess the resultant costs incurred by a health care facility. The methodology applied was a prospective research design where study participants were followed for a one year period of after receiving appropriate health education. During the follow-up period, the cost of managing patients with diabetic ketoacidosis in the emergency department was calculated. The strength of this study is that the findings are reliable because the authors were involved in the statistical analysis, meaning that this study is associated with a low degree of information bias. The study is limited in that it did not involve a control group. As a result, the findings cannot be compared. Additionally, the selected sample size of 939 individuals is small given the high prevalence of type 2 diabetes. Thus, the findings cannot be generalised to the target population. The authors claim that patient training resulted in a reduction in the number of patients admitted with diabetes ketoacidosis to the emergency department as well as resulted in a reduction in management costs. The study placed an emphasis on the need to train patients on dose adjustments during every day eating.
Gibbs, J., Trotta, D., & Overbeck, A. (2014). Human patient simulation versus case study: Which teaching strategy is more effective in teaching nursing care for the hypoglycaemic patients? Teaching and Learning in Nursing, 9, 59−63.
In this article by Gibbs,Trotta, and Overbeck (2014), the fundamental objective was to establish an appropriate teaching strategy for patients presenting with diabetes that would aid in controlling blood glucose levels. The research design is quasi-experimental involving two cohorts with different teaching strategies. Additionally, a pre-test and a post-test were used to ascertain the effectiveness of the two strategies: a human simulation and a case study. The strength of this study is the use of a cohort system; it provides an opportunity for comparison, and is also an indication that the best strategy will be selected. The use of a quasi-experimental design strengthens the findings of this study because it applies some characteristics of scientific research like control, manipulation, and randomisation. The limitation of this study is the inclusion of student nurses as study participants because they have inadequate knowledge regarding diabetes management. The authors affirm that both the human patient simulation and the case study are beneficial as teaching strategies in the management of diabetes. It is apparent that during health education, especially the group-based health education, either the human patient simulation or the case study teaching strategy can be used. Either strategy will help the patients acquire the necessary information.
Mills, L., & Stamper, J. (2014). Adult diabetic ketoacidosis: Diagnosis, management and the importance of prevention. Journal of Diabetes Nursing, 18(10), 8−12.
In this article, the authors sought to provide information about diabetic ketoacidosis, specifically its management and prevention. Mills and Stamper (2014) reviewed previously published literature concerning diabetes to achieve their objective of providing relevant information regarding adult diabetic ketoacidosis. The main focus of this article is the occurrence, diagnosis, management of diabetic ketoacidosis, with a special emphasis on the role of nurses in caring for patients with diabetic ketoacidosis, during and after episodes of diabetic ketoacidosis. The wide coverage of this article is a strength, since it offers comprehensive information about diabetic ketoacidosis. The limitation of this article is dependence on using previously published literature, which is typically subject to information bias since the authors were not involved in these publications. The authors conclude that diabetic ketoacidosis is an acute disorder that requires prompt attention. Additionally, they propose that health care providers should empower patients by providing them with information regarding the disorder. There should also be an emphasis in prevention because this is a life-threatening condition that is associated with a high prevalence of morbidity and mortality. The focus of this article on patients’ education makes it significant because diabetic patients must be knowledgeable about diabetic ketoacidosis to reduce the incidences of the disorder.
Sanuth, B., Bidlencik, A., & Volk, A. (2014). Management of acute hyperglycaemic Emergencies: Focus on diabetic ketoacidosis. AACN Advanced Critical Care, 25(3), 197– 202.
Sanuth, Bidlencik, and Volk (2014) provided a comprehensive report on the management of a patient with diabetic ketoacidosis. In this article, the authors have conducted a review of published literature regarding the management of acute hyperglycaemic attacks with a special focus on diabetic ketoacidosis. The authors provided a report on the clinical presentation of diabetic ketoacidosis as well as presented the ways which health care providers can distinguish it from hyperglycaemic hyperosmolar syndrome. Additionally, the management of diabetic ketoacidosis is outlined, and the authors affirmed that treatment should revolve around fluid replacement, electrolyte replacement, insulin administration, and patient education. The strength of this study is that the authors have reviewed relevant, published literature concerning diabetic hyperglycaemic emergencies. This means that the information that is provided is reliable and can be used for evidence-based care. The limitation of this study is that the authors cannot ascertain the authenticity of the published literature because they were not involved in the primary research. It is evident that diabetic ketoacidosis is a medical emergency, and health care providers should always educate patients about prevention to decrease subsequent emergency department admissions.
Steinsbekk, A., Rygg, L., Lisulo, M., Rise, M., & Fretheim, A. (2012). Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus: A systematic review with meta-analysis. BMC Health Services Research, 12(213), 1−19.
The purpose of this study was to compare group education in the management of type 2 diabetes, with routine treatments of clinical manifestations, lifestyle modifications, and psychosocial aspects of the disease. The authors adopted a meta-analysis methodology that involved a review of 21 studies. The strength of this research is that the authors retrieved research articles from scholarly data-bases including MEDLINE (Medical Literature Analysis and Retrieval System Online), Cochrane library, EMBASE (Excerpta Medical Database), ERIC( Education Resource Information Centre), and psychINFO (Psychological Information). This is an indication that the selected studies were reliable. The included studies were either prospective or randomised controlled, both of which are associated with reliable empirical evidence. The weakness of this study is its dependability on information analysed by other researchers, such as statistical errors that are beyond the control of current researchers. The authors found that group-based education is associated with improvements in glycaemic control. This means that at the emergency department, prior to discharge of patients with diabetic ketoacidosis, the nurse can put them into groups where they will be educated on self-management of diabetes. This will provide patients with an opportunity to share among themselves, which in turn will decrease the incidences of diabetic ketoacidosis in the emergency department.
Conclusive Statement
The annotated bibliography has empowered me with skills and knowledge regarding diabetic ketoacidosis, specifically its clinical presentations and the role of patients’ education in its management. According to Mills and Stamper (2014) the incidence rate of diabetic ketoacidosis is very high, and it is a life-threatening condition that is associated with morbidity and mortality. As a registered nurse working at the emergency department, an understanding of the clinical manifestations of diabetic ketoacidosis and an ability to manage patients with diabetic ketoacidosis is very important. It will help to save the patients’ lives because diabetic ketoacidosis is a medical emergency. Sanuth, Bidlencik, and Volk (2014) assert that health care providers should be able to differentiate between diabetic ketoacidosis and hyperglycaemic hyperosmolar syndrome so that they may provide appropriate management. This is an indication that registered nurses should be equipped with knowledge regarding the clinical presentation of diabetic ketoacidosis. It aids in the provision of quality management, and may even save patients’ lives. This also means that registered nurses should also be aware of current management techniques for diabetic ketoacidosis so that in cases of errors, the appropriate health care provider can be advised accordingly. It is evident form the annotated bibliography that nurses play a key role in the health education of patients with diabetic ketoacidosis. Several methods can facilitate learning in patients with diabetes such as group-based discussions (Steinsbekk, Rygg, Lisulo, Rise, & Fretheim, 2012), training concerning dose adjustments for normal eating (Elliott et al., 2014), and simulations and case studies (Gibbs, Trotta, & Overbeck, 2014). Cotter et al. (2014) advocate using the Internet to allow large numbers of people with diabetes to be educated about their health. In the event that all diabetic patients acquire the information that they need and achieve hyperglycaemic control, diabetic ketoacidosis will be eliminated.
Scope of the Practice Statement
As a nurse working in the emergency department, my plan is to develop an educational program not only for patients with diabetic ketoacidosis but also for nurses who provide care to patients with diabetic ketoacidosis. The education program for patients includes the self-management of diabetes and the early recognition of impending diabetic ketoacidosis so that patients can report to their health care facilities for early interventions. In disease management, the patient plays a significant role and should be an active participant in the care being given (American Diabetes Association, 2015). This is the rationale behind giving registered nurses the responsibility of educating patients about the management of diabetic ketoacidosis. The education program for nurses will include learning details about the manifestations of diabetic ketoacidosis and learning about management so that patients’ lives can be saved through early identification and appropriate management. Nurses usually act as patient advocates (Fischer et al., 2012). There is a need for nurses to be empowered with current information regarding disease management. I will work collaboratively with nurses and other health care providers to ensure that patients with diabetic ketoacidosis receive quality care.
References
American Diabetes Association. (2015). Standards of medical care in diabetes 2015: Abridged for primary care providers. Clinical Diabetes, 33(2), 97–111.
Cotter, A., Durant, N., Agne, A., & Cherrington, A. (2014). Internet interventions to support life modification for diabetes management: A systematic review of evidence. Journal of Diabetes and its Complications, 253–251.
Elliott, J., Jacques, R., Kruger, J., Campbell, M., Amiel, S., Mansell, P., . . . & Heller., S. (2014). Research: Educational and psychological issues substantial reduction in the number of diabetic ketoacidosis and severe hypoglycaemia episodes requiring emergency treatment lead to reduced cost after structured education in adults with type 1 diabetes. Diabetic Medicine, 847–843.
Fischer, H. H., Moore, S. L., Ginosar, D., Davidson, A. J., Rice-Peterson, C. M., Durfee, M. J., & Steele, A. W. (2012). Care by cell phone: Text messaging for chronic disease management. The American Journal of Managed Care, 18(2), 4–7.
Gibbs, J., Trotta, D., & Overbeck, A. (2014). Human patient simulation versus case study: Which teaching strategy is more effective in teaching nursing care for the hypoglycemic patients? Teaching and Learning in Nursing, 9, 59–63.
Mills, L., & Stamper, J. (2014). Adult diabetic ketoacidosis: Diagnosis, management and the importance of prevention. Journal of Diabetes Nursing, 18(10), 8–12.
Sanuth, B., Bidlencik, A., & Volk, A. (2014). Management of acute hyperglycemic: Focus on diabetic ketoacidosis. AACN Advanced Critical Care, 25(3), 197–202.
Steinsbekk, A., Rygg, L., Lisulo, M., Rise, M., & Fretheim, A. (2012). Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus: A systematic Review with Meta-analysis. BMC Health Services Research, 12(213), 1−19.
Last Completed Projects
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