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Diabetes Teaching Models

The Importance Of Interprofessional Practice And Education In The Era Of Accountable Care

The Importance Of Interprofessional Practice And Education In The Era Of Accountable Care

The Importance of Interprofessional Practice and Education in the Era of Accountable Care executive director and designated institutional official, Cone Health Medical Education and Greensboro Area Health Education Center, Greensboro, North Carolina; associate professor, Department of Family Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina Address correspondence to Dr. Jane Nester, Cone Health, 1200 N Elm St, Greensboro, NC 27401 (jane.nester{at}conehealth.com). In order to succeed in today's health care environment, interprofessional teams are essential. The terms multidisciplinary care and interdisciplinary care have been replaced by the more contemporary term interprofessional practice and education (IPE), which occurs when individuals from two or more professions learn about, from and with each other to enable effective collaboration and improve health outcomes. This commentary discusses new models of care, team members who contribute to IPE, and incentives and challenges. The landscape of health care delivery has changed considerably with the passage of the Patient Protection and Affordable Care Act (ACA). The federal government has moved to incentivize health care providers to improve quality and patient outcomes by tying reimbursement to cost savings, quality measures, service, and efficiency. With the patient at the center of health care, value-based care is now replacing volume-based care as we move towards a pay-for-performance structure. In addition, the Centers for Medicare & Medicaid Services (CMS) has implemented pilot programs to encourage providers to create interprofessional care teams. These teams are primarily designed for the purposes of coordinating care and education for their patients; improvi Continue reading >>

Forecast Models - Tropical Tidbits

Forecast Models - Tropical Tidbits

Numerical Model PredictionSupport this site: Hide analysis times / negative forecast hours (requires refresh) Move forward and backward through forecast times Show previous and future model runs at the same valid time CTRL + click + dragView vertical cross section CMD + click + dragView vertical cross section (Mac) ESCClose open popup windows, like this one Save or modify the link to this sounding . Save or modify the link to this cross section . This page supplies graphical forecasts from numerical weather models. Global models with imagery for the entire world include the ECMWF, GFS, ICON, CMC, NAVGEM, and their associated ensemble prediction systems. Mesoscale models for the United States include the NAM in various forms, the HRRR, several other WRF variants, and the Canadian RGEM and HRDPS. The mesoscale hurricane models HWRF and GFDL are run on tropical disturbances and storms. Climate models like the CFSv2, CanSIPS, and NMME provide monthly to seasonal forecasts. Products include map displays, model-derived soundings, and vertical cross sections. These products are generated using data from the NOAA Operational Model Archive Distribution System , the Meteorological Service of Canada , the Global Ocean Data Assimilation Experiment , the Climate Prediction Center , the European Center for Medium-Range Weather Forecasts , Deutsche Wetterdienst , and the Japan Meteorological Agency . Products for each model are generated and updated live as data becomes available. Social media: All images are free to share. If this content becomes a frequent centerpiece of your feed, please consider citing tropicaltidbits.com explicitly, at least periodically. Blogs, articles, and websites: Graphics may be used if tropicaltidbits.com is properly cited. However, you may not embed real Continue reading >>

What Is Diabetes Self-management Education?

What Is Diabetes Self-management Education?

Diabetes self-management education helps people to stay healthy and prevent costly complications, yet very few people with diabetes attend a course. Diabetes UK's Taking Control campaign aims to increase the provision and uptake of diabetes self-management education, so that everyone with diabetes has the skills and confidence to take control of their condition. This page gives healthcare professionals and local decision makers more information about patient education options. It includes resources to use with your patients and advice on improving uptake. People learn about their condition in different ways. A useful framework for understanding diabetes education, broadly based on a model used in Scotland, is in three levels: Level three: Structured education that meets nationally-agreed criteria (defined byNICE/SIGN), including an evidence-based curriculum, quality assurance of teaching standards and regular audit. Level two: Ongoing learning that may be quite informal, perhaps through a peer group. Level one: Information and one-to-one advice. Level three education: what is the evidence base? Diabetes education courses, often known as structured education, improve key outcomes, reduce the onset of complications and are cost effective or even cost saving. For a summary of the published evidence on structured education download Diabetes UK's reportDiabetes Education: the big missed opportunity in diabetes care (PDF, 285KB). Level three education: how to improve uptake and quality A short guide from Diabetes UK, including what your patients need to know about diabetes education and tips to improve attendance (see also key downloads).A short guide from Diabetes UK, including what your patients need to know about diabetes education and tips to improve attendance (see also Continue reading >>

Effectiveness Of Systematic Health Education Model For Type 2 Diabetes Patients

Effectiveness Of Systematic Health Education Model For Type 2 Diabetes Patients

Effectiveness of Systematic Health Education Model for Type 2 Diabetes Patients 1Department of Endocrinology, Nanjing Integrated Chinese and Western Medicine Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210014, China 2Department of Integrated Traditional Chinese and Western Medicine, Nanjing General Hospital of Nanjing Military Command, Nanjing 210012, China Correspondence should be addressed to Lanfang Chu ; [email protected] Received 12 April 2018; Accepted 27 June 2018; Published 25 July 2018 Copyright 2018 Yongwen Zhang and Lanfang Chu. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Health education is considered to be essential in the overall care of patients with type 2 diabetes mellitus (T2DM); systematic health education integrates individual education not only during hospitalization but also extended care outside of a hospital. To test effectiveness of the systematic health education model for T2DM, we conducted a randomized study with a control group among patients with T2DM living in Nanjing, China. Methods. 998 eligible patients completed the enrollment and were randomized to systematic health education model and conventional model groups (498 and 500 patients, resp.). The systematic health education model was based on the following aspects: image education, visitation of the exhibition hall, dissemination of educational materials, individualized medical nutrition therapy and exercise programs, WeChat group and regular health lectures, evaluation of complications, lifestyle modification, systematic treatment scheme, self-monitoring of glycemic control, mo Continue reading >>

The Clinical Effectiveness Of Diabetes Education Models For Type 2 Diabetes: A Systematic Review

The Clinical Effectiveness Of Diabetes Education Models For Type 2 Diabetes: A Systematic Review

PubMed Health. A service of the National Library of Medicine, National Institutes of Health. NIHR Health Technology Assessment programme: Executive Summaries. Southampton (UK): NIHR Journals Library; 2003-. NIHR Health Technology Assessment programme: ExecutiveSummaries. The clinical effectiveness of diabetes education models for Type 2 diabetes: a systematic review Southampton Health Technology Assessments Centre (SHTAC), Wessex Institute forHealth Research and Development (WIHRD), University of Southampton, UK Diabetes is a chronic and progressive disorder that has an impact on almost everyaspect of life. Type 2 diabetes is characterised by insulin resistance and relativeinsulin deficiency. It is commonly linked to being overweight or obese, and tophysical inactivity. Type 2 diabetes primarily affects people over the age of 40years and is becoming more common. The basic targets in the treatment of diabetes are the normalisation of blood glucose levels, blood pressure control and lipid management, and studies have shown thatgood diabetic control is associated with a significant reduction in the risk of anumber of complications. Control of diabetes is affected by both lifestyle factorsand by pharmacological treatments and the management of diabetes is largely theresponsibility of those affected. Supporting self-care is a crucial aspect of anydiabetes service, and national guidance recommends structured education asfundamental to this. The aim of patient education is to empower patients by improving knowledge, skillsand confidence, enabling them to take increasing control of their condition.Structured educational programmes for diabetes self-management are oftenmultifaceted interventions providing information and also management skills arounddiet, exercise , self-monito Continue reading >>

The Hba1c Teaching Model: Making Diabetes Education Tangible

The Hba1c Teaching Model: Making Diabetes Education Tangible

The HbA1c Teaching Model: Making Diabetes Education Tangible The HbA1c Teaching Model: Making Diabetes Education Tangible When I think about my hemoglobin A1c, my expression initially turns into a grimace as I think about a phlebotomist poking my arm with a needle to collect a blood sample. Then, anxiety becomes the prevalent emotion on my face as I worry about what my reading will be this time around. My mind wanders to the little color-coded chart tacked on the wall that explains healthy A1c levels in a very simplistic way. Anything above 9 is in the dangerous red zone, 7-8 is in the cautious yellow zone, and anything below 7 is considered in the healthy green zone. This chart certainly conveys what a good A1c level is, but it completely fails in explaining why a person with diabetes should work hard to maintain a healthy one. Thats why when I heard about Casey Steffens HbA1c teaching model, I was instantly intrigued. It is a scientific model of a HbA1c protein that is tangible so people with diabetes and health care professionals can see what protein glycation looks like. This description made me want to learn more, so I spoke with Steffen, who demonstrated a great deal of passion in launching this diabetes education crowdfunding initiative. First, I wanted to know what exactly the teaching model represents, and why it was created. Steffen explained to me that as a person who has lived with type one diabetes for the past 18 years, he has come to understand the importance of maintaining control over his blood sugars. His former endocrinologist, Dr.MaryVouyiouklis, played a central role in his learning process where his knowledge regarding HbA1c is concerned. As Steffen began to describe his campaign to me, I realized that despite living with diabetes for 16 years mys Continue reading >>

What Is Trulicity And How Can It Help?

What Is Trulicity And How Can It Help?

When your oral medicine is no longer giving you the control you need, Trulicity may help you get your blood sugar numbers where you and your doctor would like them to be. Once-weekly Trulicity is not insulin. It helps your body do what it is supposed to do naturally—release its own insulin, responding when your blood sugar rises. It’s used along with diet and exercise to help lower your blood sugar and A1C numbers. Trulicity is not insulin. It helps activate your body to release its own insulin. Once-weekly Trulicity is a type of medicine called a glucagon-like peptide-1 receptor agonist. Or GLP-1 RA, for short. It’s similar to the hormone GLP-1 that is already in your body and it’s thought to work the same way. The Lilly Answers Center If you have additional questions, call The Lilly Answers Center at 1‑844‑TRU‑INFO (1‑844‑878‑4636), Monday through Friday from 9 AM to 8 PM ET. Although we won't be able to replace the advice of your healthcare provider, we'll do our best to help you. Continue reading >>

Four Phases Of Intravenous Fluid Therapy: A Conceptual Model

Four Phases Of Intravenous Fluid Therapy: A Conceptual Model

Resuscitation: administration of fluid for immediate management of life-threatening conditions associated with impaired tissue perfusion Titration: adjustment of fluid type, rate and amount based upon context to achieve optimization of tissue perfusion De-escalation: minimization of fluid administration; mobilization of extra fluid to optimize fluid balance Fluid bolus: a rapid infusion to correct hypotensive shock. It typically includes the infusion of at least 500 ml over a maximum of 15 min Fluid challenge: 100200 ml over 510 min with reassessment to optimize tissue perfusion 17 Fluid infusion: continuous delivery of i.v. fluids to maintain homeostasis, replace losses, or prevent organ injury (e.g. prehydration before operation or for contrast nephropathy) Maintenance: fluid administration for the provision of fluids for patients who cannot meet their needs by oral route. This should be titrated to patient need and context and should include replacement of ongoing losses. In a patient without ongoing losses, this should probably be no more than 12 ml kg1 h1 Daily fluid balance: daily sum of all intakes and outputs Cumulative fluid balance: sum total of fluid accumulation over a set period of time 18 Fluid overload: cumulative fluid balance expressed as a proportion of baseline body weight. A value of 10% is associated with adverse outcomes 19 The workgroup elected not to consider fluid resuscitation/administration for children (<16 yr), pregnant women, burns patients, and patients with acute shock who have chronic conditions (chronic renal failure, hepatic failure, diabetic ketoacidosis, and hyperosmolar states). Even though we recognize its importance, we decided not to discuss the process of administration of fluids, for example, what route of administration, type Continue reading >>

Prepare A Patient For An Exam

Prepare A Patient For An Exam

Little preparation is needed for a CT scan.Patients, who do not have congestive heart failureor are not on dialysis, are asked to drink 64 ounces of water beforethe exam, especially if the exam is performed with oral or intravenous contrast.If possible, they should start drinking 12 hours before their scheduled appointment time. If patient is receiving IV or contrast, they should not eat or drink 4 hours prior to exam. Patients will be asked to remove jewelry and other metallic objects that might interfere with the scan. We ask patients to leave jewelry at home when possible. Patients who are breastfeedingshould be given an opportunity to make an informed decision about whether to continue breastfeeding after receiving intravascularly administered iodinated contrast media or to temporarily abstain. A very small percentage of iodinated contrast medium can be excreted into the breast milk and absorbed by the infants gut. We believe that the available data suggests that is safe for the mother and infant to continue breastfeeding after receiving such an agent. The patient can choose to temporarily abstain from breastfeeding for 24 hours with the active expression and discarding of breast milk from both breast during that period. If so, the patient may wish to use a breast pump to obtain milk beforehand to use during the 24 hour period following the administration of contrast media. Please inform the patient of this option when the exam is scheduled. Patient Screening Prior to Administration of Iodinated Contrast Prior to the administration of iodinated contrast, patients are screened for the following: Previous reactions to iodinated contrast media All severe allergies and reactions (both medications and food) History of diabetes, kidney disease,pheochromocytoma, solitary Continue reading >>

Diabetes Management In The School Setting

Diabetes Management In The School Setting

It is the position of the National Association of School Nurses (NASN) that the registered professional school nurse (hereinafter referred to as school nurse) is the school staff member who has the knowledge, skills, and statutory authority to fully meet the healthcare needs of students with diabetes in the school setting. Diabetes management in children and adolescents requires complex daily management skills (American Association of Diabetes Educators [AADE], 2016). Health services must be provided to students with diabetes to ensure their healthcare needs are met; requirements of relevant federal and state laws are met; and they can fully participate in school and school-sponsored events (AADE, 2016). Diabetes is the third most common chronic health disease affecting an estimated 2.22/1,000 children and adolescents according to The Search for Diabetes in Youth (SEARCH) Study (Pettitt et al., 2014). Children and adolescents are defined as youth under the age of 20 years. In 2009, approximately 191,986 or one in 433 youth with diabetes lived in the U.S. From these, 87% have type 1 diabetes and 11% have type 2 diabetes (Pettitt et al., 2014). In the year 2008 to 2009, 18,436 youth were newly diagnosed with type 1 diabetes and 5,089 youth were newly diagnosed with type 2 diabetes (Centers for Disease Control and Prevention [CDC], 2014). Advances in diabetes technology continue to enhance the students' ability to manage diabetes at school, thus improving their quality of life. Children and adolescents monitor blood glucose levels several times a day via blood glucose meters and continuous glucose monitors, conduct carbohydrate calculations, and inject insulin via syringe, pen and pump to attain blood glucose control (Brown, 2016). Intensive resources and consistent evide Continue reading >>

The Nurse Education And Transition (neat) Model: Educating The Hospitalized Patient With Diabetes

The Nurse Education And Transition (neat) Model: Educating The Hospitalized Patient With Diabetes

The number of patients with a diabetes mellitus (DM)-related diagnosis is increasing, yet the number of hospital-based diabetes educators is being reduced. Interest in determining effective ways for staff nurses to deliver diabetes education (DE) is mounting. The purpose of this multi-phase feasibility study was to develop and evaluate the Nurse Education and Transition (NEAT) inpatient DM education model. Exploratory focus groups were conducted with staff nurses from inpatient units at academic tertiary and community hospitals to gain insight into barriers, content, delivery and support mechanisms related to providing DE to hospitalized patients. Findings informed the development of the NEAT model, which included a delivery protocol and toolkit with brief educational videos on key diabetes topics uploaded onto iPads, patient assessments and teach back tools, a discharge survival skills summary sheet, and guidelines for electronic medical record documentation and scheduling outpatient DE visits. Trained staff nurses used NEAT to deliver DE to hospitalized patients with DM and then participated in follow-up focus groups to assess their experiences, with particular attention to the usefulness of NEAT in meeting the needs of nurses related to the delivery of diabetes survival skill education. Information generated was analyzed to identify emerging key themes. Exploratory focus groups revealed that staff nurses view teaching patients with DM as part of their job, but report barriers. Nurses agreed that inpatient DE should be designed to assure safety after discharge and advised that it be patient-centered, targeted, assessment-based and user friendly. Nurses who participated in the delivery of NEAT found that the process and tools met the majority of the basic DE needs of Continue reading >>

Teaching A Personal Support Worker

Teaching A Personal Support Worker

I am a nurse in a retirement home. One of my clients receives daily insulin injections.Today, the Director of Care asked me to assign this procedure to a personal support worker (PSW). Can I do that? The Regulated Health Professions Act, 1991 does provide an exception that allows someone who is not a member of a regulated profession, such as a PSW, to perform specific controlled acts, such as those that are a routine activity of living. A procedure would be considered a routine activity of living if, over time, the need, response and outcome of the procedure is known. This definition may apply to a client with diabetes who receives a regular (not sliding scale) dose of insulin to regulate his or her blood sugars. In this situation, the client’s condition should be predictable, and he or she should receive the same dose of insulin every day. The injection should be part of the client’s daily routine and put the client at minimal risk. If the insulin injection for this client meets the criteria of a routine activity of living, the PSW can be taught to administer the insulin. If the insulin injection for this client does not meet the criteria of a routine activity of living, the PSW requires delegation in order to perform it. If you choose to delegate, you must ensure that you do so according to the requirements for delegating which are listed in the Authorizing Mechanisms practice guideline. Before teaching this procedure, it is important to assess the degree of change in the client’s condition over time, the risks to the client of the PSW performing the procedure, and possible resources or supports available to the PSW should she/he need them. These client-specific factors will determine if it is appropriate for the PSW to provide the care. Before teaching, identif Continue reading >>

Models For Diabetes Education

Models For Diabetes Education

Part of the Contemporary Diabetes book series (CDI) Evidence-based models and frameworks have been introduced to support diabetes self-management education and support. This article presents various frameworks and models and describes their use in support of diabetes education at the patienteducator, the practice environment, and the systems/policy/environmental level. The text and tables present various models and specific recommendations and examples for educators to use at every level. Crosscutting concepts are that models that support diabetes education at all levels include an assessment, goal setting, problem solving, and systematic follow-up; an ongoing process; and community and primary care approaches that attempt to provide outreach and sustainable programs. Tested frameworks and models serve to support the provision of diabetes education at all levels and should be used in continued implementation and evaluation. Self-careDiabetes educationDiabetes self-management educationSelf-management supportPatienteducator interactionsPractice environmentsHealth systems This is a preview of subscription content, log in to check access Unable to display preview. Download preview PDF. Glasgow RE, Anderson RM. In diabetes care, moving from compliance to adherence is not enough: something entirely different is needed. Diabetes Care 22:20902097, 1999. PubMed CrossRef Google Scholar Mulcahy K, Maryniuk M, Peeples M, et al: Diabetes Self-Management Education Core Outcome Measures. Diabetes Educ 29:768803, 2003. PubMed CrossRef Google Scholar Barnett DM: Elliot P. Joslin, MD: A centennial portrait. Joslin Diabetes Center, 1998. Google Scholar Funnell MM, Tang TS, Anderson RM: From DSME to DSMS: Developing empowerment-based diabetes self-management support. Diabetes Spectr 20:22 Continue reading >>

The Impact Of Orems Self-care Model On The Quality Of Life In Patients With Type Ii Diabetes | Biomedical And Pharmacology Journal

The Impact Of Orems Self-care Model On The Quality Of Life In Patients With Type Ii Diabetes | Biomedical And Pharmacology Journal

The Impact of Orems Self-Care Model on the Quality of Life In Patients With Type II Diabetes Milad Borji1,2, Masoumeh Otaghi3and Shiva Kazembeigi4 1Young Researchers and Elite Club, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, Iran. 2Nurse, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran. 3Department, Ilam University of Medical Sciences, Ilam, Iran. 4Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran. Corresponding Author E-mail: [email protected] DOI : Diabetes mellitus is a chronic disease that reduces the quality of life in patients. Therefore, this research aimed to the effect of Orems self-care model on the quality of life(QOL) in patients with type II diabetes at Ilam, Iran. A quasi-experimental study was performed on 80 patients with type II diabetes in Ilam in the year 2015. The research tools used in this study were a demographic questionnaire and the SF-36 survey. The patients were divided randomly into control and experimental groups. Orems self-care programme was performed in six 60-90 minute sessions for six weeks in the experimental group. The data were analysed using SPSS software and descriptive and inferential statistics. The findings showed that the mean and standard deviation of the quality of life in the experimental group before and after the intervention were 47.1 9.21 and 67.91 12.87 respectively, which was statistically significant (P<0.001). However, in the control group it was 47.66 8.4 and 47.41 8.6 respectively, indicating that there was no statistically significant difference (P>0.05).Regarding the effectiveness of self-care programmes based on Orems theory on the quality of life in patients with diabetes, it is suggested that in nursing care this self-care pro Continue reading >>

Web Of Science Help

Web Of Science Help

JOHN KENNETH GALBRAITH AND THE FUTURE OF ECONOMICS JOHN OF THE CROSS: CONFERENCES AND ESSAYS BY MEMBERS OF THE INSTITUTE OF CARMELITE STUDIES AND OTHERS JOHNS HOPKINS SERIES IN CONTEMPORARY MEDICINE AND PUBLIC HEALTH JOHNS HOPKINS STUDIES IN EARTH AND SPACE SCIENCES JOHNS HOPKINS SYMPOSIA IN COMPARATIVE HISTORY JOINT COMMISSION JOURNAL ON QUALITY IMPROVEMENT JOINT CONFERENCE - 1996: IEEE INSTRUMENTATION AND MEASUREMENT TECHNOLOGY CONFERENCE & IMEKO TECHNICAL COMMITTEE 7, CONFERENCE PROCEEDINGS, VOLS I AND II JOINT CONFERENCE OF 96' AICDEI / 4T-JCCEID JOINT CONFERENCE ON THE SCIENCE AND TECHNOLOGY OF INTELLIGENT SYSTEMS JOINT EURO-ASIAN CONGRESS OF ENDOSCOPIC SURGERY JOINT EUROPEAN CONFERENCE AND EXHIBITION ON GEOGRAPHICAL INFORMATION - FROM RESEARCH TO APPLICATION THROUGH COOPERATION, PROCEEDINGS VOLS 1 AND 2 JOINT IMPLEMENTATION OF CLIMATE CHANGE COMMITMENTS JOINT INTERNATIONAL CONFERENCE IMEKO TC3/TC5/TC20 JOINT INTERNATIONAL CONFERENCE ON THEORY, DATA HANDLING AND MODELLING IN GEOSPATIAL INFORMATION SCIENCE JOINT INTERNATIONAL SYMPOSIUM ON OPTICAL MEMORY AND OPTICAL DATA STORAGE 1999 JOINT ITER-IAEA-ICTP ADVANCED WORKSHOP ON FUSION AND PLASMA PHYSICS JOINT MEETING OF THE SLOVAK PHYSIOLOGICAL SOCIETY, THE PHYSIOLOGICAL SOCIETY AND THE FEDERATION OF EUROPEAN PHYSIOLOGICAL SOCIETIES JOINT PROCEEDINGS OF THE WORKSHOPS: IWUC, MDEIS AND TCOB JOINT RESEARCH BY TRADE UNIONS AND UNIVERSITIES INTO THE TECHNOLOGICAL SOCIETY OF TOMORROW JOINT SOVIET-AMERICAN WORKSHOP ON THE PHYSICS OF SEMICONDUCTOR LASERS JOINT UWBST & IWUWBS 2004, CONFERENCE PROCEEDINGS JOINT VARENNA-LAUSANNE INTERNATIONAL WORKSHOP 2012 JOINT VARENNA-LAUSANNE INTERNATIONAL WORKSHOP 2014 JOURNAL FOR RESEARCH IN MATHEMATICS EDUCATION JOURNAL FOR SPECIALISTS IN PEDIATRIC NURSING JOURNAL FOR THE SCIENTIFIC STUDY O Continue reading >>

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