Aspects of Proposal used at Clinical Site Order Instructions: It is important that the writer note that this is not a research paper, but an Evidence base project.
This is a proposal and not a research paper, it would be important to note that you are not proposing a research project. The writer will also take into consideration that the student is currently completing clinical in a clinical site (Dr. Office setting). And also note that the proposal is on Lack of proper education on the patient with type 2 diabetes. The writer must also talk about hemoglobin A1C when talking about this proposal as the writer in previous papers have not talked about this very important aspect of type 2 diabetes. I will upload the EBP again to help the writer, but he must also understand that it is a continuation of previous papers on this same topic.
Building on work done in the clinical practicum setting this week, and looking toward your ongoing work as an MSN, address the following questions:
1. What aspects of your proposal may be used at the site? (clinical site)
2. What aspects of your proposal may be used in your ongoing work as an MSN?
Aspects of Proposal used at Clinical Site Sample Answer
Aspects of my proposal that can be used at the clinical site
Research indicates that diabetes Type 2 incidences are increasing at alarming rates (LeClair, 2013). The current management standard for diabetes type 2 is the use of pharmacological therapy, which is balanced with diet and exercises to maintain effective glycaemic control and to avoid associated complications. This is important because higher glycaemic levels are linked directly to higher rates of health complications. The glycaemic control is monitored by the levels of glycosylated hemoglobin (HbA1c) (Stranieri, Yatsko, Jelinek & Venkatraman, 2015).
At the clinical site, the diabetes team should ensure that they have validated screening protocols for diabetes type 2. The evidence-based research recommended HbA1c levels is 7.5% as levels above this threshold are associated with risks for hyperglycemia (Tomar, 2016). It is recommended that HbA1c test is performed at least twice every year for patients who adhere to treatment goals and quarterly for patients not meeting glycaemic goals (Stranieri, Yatsko, Jelinek, & Venkatraman, 2015). However, Evidence-based practice (EBP) recommends the use of individualized insulin therapy.
Additionally, EBP indicates that healthcare provider should conduct a comprehensive assessment of the family functioning such as parental psychopathology, communication, parental support and involvement, and self-care behaviors and attitudes. This helps in designing the most effective patient education plan and implementation of EBP that improves coping strategies for diabetes Type 2 (LeClair, 2013).
Aspects of my proposal that can be used in the ongoing work as an MSN
Evidence-based research indicates that physical activity and diet are the most important aspect of controlling the ABCs of Type 2 diabetes. The ABCs includes (HbA1c, Blood pressure and Cholesterol). Effective management of the glycated hemoglobin (HbA1c) and to attain stable blood sugar control, it is very important for the patients to understand how to balance the food intake and physical activity. This involves patient education using the teach-back technique (Reinehr, 2013).
Anticipatory patient education and counseling of lifestyle modification are routine care are critical especially during the developmental transitions. Evidence-based studies indicate that successful management of diabetes type 2 will need heterogeneous interventions including cognitive behavioral therapy, general diabetes education, and skills training. This increases diabetes knowledge which correlates with significant improvements in emotional, physical and developmental outcomes (Stranieri, Yatsko, Jelinek & Venkatraman, 2015).
The healthcare provider in Doctor Office setting should interact with the other multidisciplinary healthcare professionals including dieticians, pharmacists, nurses, physical therapists, psychiatrists, laboratory technicians, and physicians. While an MSN can give an outline of the management of diabetes type 2, it is important to refer the patients to the experts for detailed patient education. This has been found to be effective in improving patient knowledge of diabetes, medication adherence, beneficial stress management attitude and self-care ability and glycaemic control (Fain, 2012).
The training topics that should be covered continuously include the action of insulin, its administration, dosage, blood glucose monitoring, ketone testing and diabetic ketoacidosis (DKA). Additionally, the patient should be educated on the detection and treatment of hypoglycemia (Stranieri, Yatsko, Jelinek & Venkatraman, 2015). Nutrition therapy training should cover what the patient should eat and the quantity. Exercises education includes outlining the effective exercise duration, what to do before and after exercises. It is important to initiate a discussion with the patient and their families on challenging factors associated with coping strategies. Examples of these factors include psychological issues, concerns on body shape or size, substance use, and general issues on patient life (Tomar, 2016).
Aspects of Proposal used at Clinical Site References
LeClair, E. (2013). Type 1 Diabetes and Physical Activity in Children and Adolescents. Journal Of Diabetes & Metabolism, 01(S10). http://dx.doi.org/10.4172/2155-6156.s10-004
Fain, J. (2012). National Standards for Diabetes Self-Management Education and Support: Updated and Revised 2012. The Diabetes Educator, 38(5), 595-595. http://dx.doi.org/10.1177/0145721712460840
Reinehr, T. (2013). Type 2 diabetes mellitus in children and adolescents. World Journal Of Diabetes, 4(6), 270. http://dx.doi.org/10.4239/wjd.v4.i6.270
Stranieri, A., Yatsko, A., Jelinek, H., & Venkatraman, S. (2015). Data-analytically derived flexible HbA1c thresholds for type 2 diabetes mellitus diagnostic. Artificial Intelligence Research, 5(1). http://dx.doi.org/10.5430/air.v5n1p111
Tomar, D. (2016). Detection of Diabetes Mellitus Using HbA1C as Diagnostic Criteria. Journal Of Medical Science And Clinical Research 4(3), http://dx.doi.org/10.18535/jmscr/v4i3.21
