Managing diabetes awareness in long-term care: targeting the right resources is key to saving time while improving care.During the past three years, the Years, The the seven decades of Eleanor Pargiter’s life. [Br. Lit.: Benét, 1109] See : Time medical establishment has been flooded with information about diabetes. Healthcare professionals have been swamped with an array of Web sites, papers, reports, and seminars loaded with the latest facts on diabetes prevention, testing, diagnosis, and care. The problem for busy nursing staffs is how to determine what is valuable so that scarce time is spent wisely on issues that will most benefit patients. Information management has become a hot topic in long-term care long-term care (LTC), n the provision of medical, social, and personal care services on a recurring or continuing basis to persons with chronic physical or mental disorders. settings. Overburdened staffs are being challenged to stay up to date on the latest developments in diabetes treatment not only to improve long-term care but also to mitigate litigation An action brought in court to enforce a particular right. The act or process of bringing a lawsuit in and of itself; a judicial contest; any dispute. When a person begins a civil lawsuit, the person enters into a process called litigation. , negative publicity, and other factors that have adversely affected the nursing home industry in recent years. Many nurses and nursing assistants, however, are finding it nearly impossible to wade through the reams of material that come their way on a daily basis. Some rely on their education and training, which often do not take into account the most recent changes in diabetes care or constantly updated standards issued by the American Medical Directors Association (AMDA AMDA American Medical Directors Association AMDA Association of Medical Doctors of Asia (Nepal) AMDA Acid Maltase Deficiency Association AMDA American Musical Dramatic Academy AMDA Association of Medical Doctors for Asia ), American Diabetes Association The American Diabetes Association, or the ADA, is an American health organization providing diabetes research, information and advocacy. Founded in 1940, the American Diabetes Association conducts programs in all 50 states and the District of Columbia, reaching hundreds of (ADA Ada, city, United States Ada (ā`ə), city (1990 pop. 15,820), seat of Pontotoc co., S central Okla.; inc. 1904. It is a large cattle market and the center of a rich oil and ranch area. ), and other organizations. These standards cover virtually every aspect of the disease, from glycemic Glycemic The presence of glucose in the blood. Mentioned in: Cholesterol, High glycemic pertaining to the level of glucose in the blood. control and lifestyle modification to pharmacologic interventions and much more; understanding them is vital. [ILLUSTRATION OMITTED] This article is designed to help nurses and others cut through the clutter and locate relevant, credible, and reliable sources of information that they can access quickly and easily. Providing user-friendly online resources, newsletters, and continuing education continuing education: see adult education. continuing education or adult education Any form of learning provided for adults. In the U.S. the University of Wisconsin was the first academic institution to offer such programs (1904). programs should give these busy professionals a good starting point to help them manage diabetes information effectively. Meeting the Information Challenge Finding reliable information is essential, given the seriousness of managing diabetes, particularly in the long-term care environment. Long-term care has seen a dramatic rise in type 2 diabetes type 2 diabetes n. See diabetes mellitus. among the geriatric population as a result of the current obesity epidemic in the United States. Studies have found that 26% of nursing home patients have diabetes and 30% have glucose intolerance. (1) From blood glucose monitoring blood glucose monitoring Sugar monitoring Lab medicine The periodic testing of serum glucose in Pts known to have DM. See Bedside glucose monitoring, Beta cell implants, Diabetes, Glucometer, Glycosylated hemoglobin, Non-Invasive glucose monitoring. and calculated exercise regimens to diet and visual inspection of key body areas, nursing staffs are facing increased pressure to deliver quality care to these elderly and medically fragile individuals. Managing diabetes, along with residents' multiple coexisting medical conditions, is straining the resources of already overburdened nursing staffs. That said, nurses and nursing assistants can take several steps to obtain the latest information about diabetes management. Make Use of the Web One effective strategy is to make use of the numerous online diabetes resources. For example, the ADA's Web site (www.diabetes.org/cpr) not only provides diabetes care standards but also reports on research (i.e., clinical trials), a diabetes risk test, and diabetes expos, among other topics. In addition, the site offers a range of information on meetings and educational opportunities, research, clinical practice recommendations, journals, books, research papers, and more. Similarly, AMDA (www.amda.com) has issued a standard titled, "Managing Diabetes in the Long Term Care Setting," as well as other information on diabetes care. Other credible Web sites include: * The Centers for Disease Control and Prevention Centers for Disease Control and Prevention (CDC), agency of the U.S. Public Health Service since 1973, with headquarters in Atlanta; it was established in 1946 as the Communicable Disease Center. (www.cdc.gov/diabetes/faq/index.htm) * U.S. Food and Drug Administration (www.fda.gov/diabetes) * Joslin Diabetes Center Joslin Diabetes Center is the world’s largest and most respected diabetes research center, diabetes clinic, and provider of diabetes education. It is located in the Longwood Medical and Academic Area in Boston, Massachusetts. (www.joslindiabetescenter.com) * International Diabetes Center (www.parknicollet.com/diabetes) * National Institute of Diabetes and Digestive and Kidney Diseases About NIDDK The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), of the U.S. National Institutes of Health, conducts and supports research on many of the most serious diseases affecting public health. (www.niddk.nih.gov) * National Federation of the Blind The National Federation of the Blind (NFB) is an organization of blind people in the United States. It is the oldest and most likely largest national organization to be led by blind people. Its national headquarters are in Baltimore, Maryland. (www.nfb.org) A comprehensive site (www.mendosa.com) developed by a freelance medical writer who specializes in diabetes lists articles, columns, and online pieces about all aspects of diabetes--from symptoms to the latest treatments. The site also lists and links to all of the 800 or so substantive resources for diabetes, including charitable organizations, publications, universities, medicines, companies, agencies, and so on. Web sites for 178 equipment suppliers are listed along with sites for medication, software, and blood glucose blood glucose Diabetology The principal sugar produced by the body from food–especially carbohydrates, but also from proteins and fats; glucose is the body's major source of energy, is transported to cells via the circulation and used by cells in the presence meters and nearly two dozen diabetes-focused food companies. Another 146 general diabetes sites, as well as directories, studies, and other material, can be found on this site. Because its area of coverage is wide, it might be worthwhile to delegate a staff member to set aside some time to explore this site. Subscribe to Newsletters Another way nursing staffs can stay up to date is by subscribing to newsletters that pertain to diabetes management. ADA has a wonderful electronic newsletter--Diabetes E-News Now! Health Care Professional Edition--that is very helpful. A recent issue, for example, discussed topics such as new diabetes drugs, weight gain and diabetes, the use of exercise to combat a diabetes-related metabolic syndrome metabolic syndrome n. See syndrome X. Metabolic syndrome A group of risk factors for heart disease, diabetes, and stroke. among older adults, and news on various professional meetings. Other newsletter sources include: * Diabetes in Control (www.diabetesincontrol.com/index.php) * DiabetesLibrary.org (www.diabeteslibrary.org) * MEDLINEPlus (http://medlineplus.gov) * CMEonDiabetes.com (www.CMEonDiabetes.com) These newsletters and others look at a range of issues, including accelerated aging and diabetes, diabetic complications, eating healthy, controlling blood glucose, and other topics. Healthcare professionals can register for these newsletters on the Web sites. Use Manufacturer Resources Another key source of information comes from manufacturers, distributors, and medical equipment suppliers. Their Web sites offer a variety of materials--from fact sheets and flyers on products and services to studies and reports on various diabetes-related issues. Some firms have Frequently Asked Question (FAQ (Frequently Asked Questions) A group of commonly asked questions about a subject along with the answers. Vendors often display them on their Web sites for use as troubleshooting guidelines. ) sections on particular equipment, while others have established hot lines to respond to questions about specific devices, medicines, and treatments. Check with your specific vendors for information about their Web sites. Take Continuing Education Programs It is important that healthcare professionals keep current on diabetes management by participating in continuing education programs. MedCentrus, a healthcare communication and education company based in Minnesota and a division of Juntunen Group, has developed a program especially designed for nurses and nursing assistants working in long-term care facilities long-term care facility n. See skilled nursing facility. . The program, sponsored by Hypoguard, provides valuable information and insights into diabetes management to help nurses and other healthcare professionals understand the key areas of assessment, clinical goals, and variables involved in the evaluation and management of geriatric diabetes. The video-based training course describes diabetic testing equipment within the overall framework of the evaluation and treatment of diabetes among an elderly population. To develop the course, an outline was created based on feedback from nurses. The outline looked at a variety of desired outcomes, such as: * Key areas of assessment and the clinical goals for managing patients with diabetes in long-term care facilities * Impact of food, exercise, and medications on the blood glucose levels blood glucose level, n level of glu-cose in the bloodstream, normally about 70 to 115 mg/dL after fasting overnight. Higher levels may indicate diseases such as diabetes mellitus. of patients in long-term care facilities * Variables in performing a blood glucose test using a blood glucose meter * Symptoms of hyperglycemia hyperglycemia: see diabetes. and hypoglycemia hypoglycemia: see diabetes. hypoglycemia Below-normal levels of blood glucose, quickly reversed by administration of oral or intravenous glucose. Even brief episodes can produce severe brain dysfunction. * Changes in care that may improve glucose control An accredited accredited recognition by an appropriate authority that the performance of a particular institution has satisfied a prestated set of criteria. accredited herds cattle herds which have achieved a low level of reactors to, e.g. company and knowledgeable spokesperson were then sought out to help develop the program. MedCentrus was chosen based on the firm's knowledge, expertise, and convenient location. To date, more than 500 information kits have been distributed to various nursing homes and chains. For more information on this CE program, contact Hypoguard Customer Service at (800) 818-8877. Healthcare professionals may find a variety of additional CE programs at www.findthatce.com. This Web site lists CE programs on topics such as type 2 diabetes, internal medicine and diabetes, and geriatric medicine, as well as a course titled "Care & Concerns for Effective Management of Diabetes in the Elderly." The Web site www.criticalcareceu.com has a course that examines guidelines for diabetes care developed by the ADA and the American Association of Diabetes Educators. Keep Looking for Looking for In the context of general equities, this describing a buy interest in which a dealer is asked to offer stock, often involving a capital commitment. Antithesis of in touch with. Resources Clearly, a lot of information is available. The above-mentioned material should be considered as a starting point for continuing education about the latest developments in testing, diagnosing, and treating diabetes. By using information resources wisely, healthcare professionals in the long-term care environment can stay current on treatment trends and, in so doing, help them do their jobs more effectively and deliver the kind of care their vulnerable patients require. Michelle D. Dumonceaux is Manager of Long-Term Care Marketing for Hypoguard, a healthcare company specializing in diagnostic products and medical instruments at the point of care. To send comments to the author and editors, e-mail dumonceaux0905@nursinghomesmagazine.com. To order reprints in quantities of 100 or more, call (866) 377-6454. Reference 1. Pandya N. Diabetes Management in Long-Term Care. Caring for the Ages 2003;4(2):21-4. Available at: www.amda.com/caring/february2003/diabetes.htm. |
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