Diabetes affects 7.8% of Americans, nearly 24 million people, and costs $174 billion yearly. People with diabetes benefit from self-management; disease management (DM) programs are effective in managing populations with diabetes. Little has been published on the intersection of diabetes education and DM. Our hypothesis was that diabetes educators and their interventions integrate well with DM and effectively support providers' care delivery. A literature review was conducted for papers published within the past 3 years and identified using the search terms "diabetes educator" and "disease management." Those that primarily addressed community health workers or the primary care/community setting were excluded. Two case studies were conducted to augment the literature. Ten of 30 manuscripts identified in the literature review were applicable and indicate that techniques and interventions based on cognitive theories and behavioral change can be effective when coupled with diabetes DM. Better diabetes self-management through diabetes education encourages participation in DM programs and adherence to recommended care in programs offered by DM organizations or those that are provider based. Improved health outcomes and reduced cost can be achieved by blending diabetes education and DM. Diabetes educators are a critical part of the management team and, with their arsenal of goal setting and behavior change techniques, are an essential component for the success of diabetes DM programs. Additional research needs to be undertaken to identify effective ways to integrate diabetes educators and education into DM and to assess clinical, behavioral, and economic outcomes arising from such programs.
This tenth best practice review examines four series of common primary care questions in laboratory medicine: (i) antenatal testing in pregnant women; (ii) estimated glomerular filtration rate calculation; (iii) safety testing for methotrexate; and (iv) blood glucose measurement in diabetes. The review is presented in question-answer format, referenced for each question series. The recommendations represent a précis of guidance found using a standardised literature search of national and international guidance notes, consensus statements, health policy documents and evidence-based medicine reviews, supplemented by Medline Embase searches to identify relevant primary research documents. They are not standards but form a guide to be set in the clinical context. Most are consensus rather than evidence-based. They will be updated periodically to take account of new information.
As we progress into the second decade of the 21st century, the healthcare needs of an increasingly diverse population are changing. Children's nurses must respond to these challenges by creating clear and effective plans of care in collaboration with children and their families. Legally and professionally, children's nurses are required to accurately record plans of care given to individual patients to provide a legal document demonstrating that care has been delivered (Nursing and Midwifery Council (NMC), 2008). Within this article, an overview of the nursing process and its components will be discussed, considering how this process assists in organizing and prioritizing care delivery to the child or young person and family. In addition, the support offered by a framework such as the Roper, Logan and Tierney model of nursing , in systematically assessing, planning and documenting care to meet individuals' needs, must be reinforced and its application practiced. Subsequently, the use and contribution of such processes and frameworks to the organization and delivery of care will be examined within the context of a clinically-based scenario, which has helped to explore students' knowledge and skills in the second year of a 3-year undergraduate programme. The authors firmly believe that care planning skills are fundamental to safeguarding vulnerable children, their families and, indeed, the nursing profession in this current challenging socioeconomic environment.
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