This document provides a summary of a dissertation presentation on the effectiveness of nursing interventions on treatment compliance and clinical outcomes among clients with type 2 diabetes mellitus. The presentation covers the introduction, need for the study, statement of the problem, objectives, hypotheses, operational definitions, conceptual framework, review of literature, research methodology, intervention description, data collection, data analysis, results and discussion. Key findings from the results include that nursing interventions like an informative education program and resistance exercise were effective in improving knowledge, treatment compliance and clinical outcomes like fasting blood sugar among the experimental group compared to the control group. Statistical analysis found significant differences between the groups, supporting the effectiveness of the nursing interventions.
This document outlines a prospective study on the effect of pandemic restrictions on quality of life and medication adherence in diabetes patients. It discusses the introduction, aims and objectives, methodology, results and conclusion of the study. The study aims to assess the impact of COVID-19 pandemic restrictions on quality of life and medication adherence in 110 diabetes patients in Bangalore, India over 6 months. Preliminary results show that quality of life was reduced for most patients due to restrictions, while medication adherence decreased initially but increased after counselling. New diabetes cases and complications were also observed due to reduced activity and increased weight during the pandemic. The study concludes that the prevalence of diabetes has increased overall due to pandemic restrictions.
Knowledge, attitude, practice and associated factorsBeka Aberra
This document outlines a research proposal on assessing the knowledge, attitude, and practices of diabetes patients in Ethiopia. It discusses diabetes as a growing health problem worldwide and in Ethiopia. The study will use a cross-sectional design to survey 326 diabetes patients at a hospital in Addis Ababa regarding their knowledge, attitude, and self-management practices, and factors influencing these. It describes the methodology, including developing a scoring system and statistical analysis plan. The proposal discusses obtaining ethics approval and plans to disseminate results to stakeholders and through publication.
The document summarizes the RENEWING HEALTH project which aims to test telemedicine services to improve care for patients with diabetes, COPD, or cardiovascular diseases across 9 regions in Europe. The project involves 7,800 patients from 2010-2012 and evaluates telemedicine interventions on patients' quality of life, health outcomes, costs of care, and organizational impacts. Specifically, the project in Norrbotten, Sweden involves a randomized trial providing 200 diabetes patients tablet computers to self-manage their condition and transmit health data to providers to improve HbA1c and quality of life compared to routine care.
This document describes a study that used action research to develop a feasible lifestyle intervention for patients with prediabetes in primary care settings. The study had two main goals: (1) determine the resources and competencies needed, and (2) identify effective intervention components. It involved two cycles with general practices. The first cycle explored various intervention options, and the second tested the intervention developed in cycle one. In total, 64 patients, 8 GPs, and 10 nurses participated. The study found an intervention involving six consultations over one year was feasible for practices. Nurses had the skills to deliver the core intervention. It led to clinical reductions in patients' BMI and HbA1c. The developed intervention showed potential for diabetes prevention
This document provides an introduction and background for a prospective study on the effect of pandemic restrictions on quality of life and medication adherence in diabetes patients. The study will be conducted over 6 months at a medical college hospital in Bangalore, India, surveying 124 diabetes patients using the WHOQOL-BREF questionnaire to assess quality of life and the Morisky 8-item scale to evaluate medication adherence. The objectives are to compare quality of life and adherence scores between pre-pandemic and pandemic periods, and to examine changes in lifestyle and diet among patients during the pandemic restrictions.
The document discusses emerging blood glucose monitoring technologies. It notes that the growing diabetes epidemic poses diagnostic and management challenges. There is an immediate need for new approaches to support patient self-management and treatment adherence. The document summarizes various emerging monitoring technologies like continuous glucose monitors, closed loop insulin delivery systems, mobile apps, and alternatives to glucose monitoring. It emphasizes that technology must be tailored to individual patient needs and that self-monitoring of blood glucose remains an important management tool when used properly.
This study examined the nutritional practices of type 2 diabetes patients at Sikanze Hospital in Lusaka, Zambia. The researcher surveyed 41 diabetes patients and analyzed their dietary habits, lifestyle behaviors, and nutrition education levels. The results showed relationships between better nutrition status and higher nutrition education, adherence to dietary methods, and engagement in physical exercise. Over half of patients had poor nutrition status based on their BMI. The study concluded that improving nutrition education, access to dieticians, and health promotion could help diabetes patients better manage their condition through diet and lifestyle. It recommended strengthening community education, healthcare worker training, and national diabetes treatment guidelines.
This article summarizes the results of establishing care pathways and an expert patient program for chronic conditions like diabetes, heart failure, and COPD in Barcelona, Spain. Key results include:
- Increased detection and monitoring of the conditions through improved protocols between primary and specialized care.
- Reduced hospital admissions and length of stay for heart failure patients.
- Increased patient knowledge and self-care through the expert patient program, which may have contributed to reduced heart failure admissions.
- High satisfaction among patients in the expert patient program.
This document outlines a prospective study on the effect of pandemic restrictions on quality of life and medication adherence in diabetes patients. It discusses the introduction, aims and objectives, methodology, results and conclusion of the study. The study aims to assess the impact of COVID-19 pandemic restrictions on quality of life and medication adherence in 110 diabetes patients in Bangalore, India over 6 months. Preliminary results show that quality of life was reduced for most patients due to restrictions, while medication adherence decreased initially but increased after counselling. New diabetes cases and complications were also observed due to reduced activity and increased weight during the pandemic. The study concludes that the prevalence of diabetes has increased overall due to pandemic restrictions.
Knowledge, attitude, practice and associated factorsBeka Aberra
This document outlines a research proposal on assessing the knowledge, attitude, and practices of diabetes patients in Ethiopia. It discusses diabetes as a growing health problem worldwide and in Ethiopia. The study will use a cross-sectional design to survey 326 diabetes patients at a hospital in Addis Ababa regarding their knowledge, attitude, and self-management practices, and factors influencing these. It describes the methodology, including developing a scoring system and statistical analysis plan. The proposal discusses obtaining ethics approval and plans to disseminate results to stakeholders and through publication.
The document summarizes the RENEWING HEALTH project which aims to test telemedicine services to improve care for patients with diabetes, COPD, or cardiovascular diseases across 9 regions in Europe. The project involves 7,800 patients from 2010-2012 and evaluates telemedicine interventions on patients' quality of life, health outcomes, costs of care, and organizational impacts. Specifically, the project in Norrbotten, Sweden involves a randomized trial providing 200 diabetes patients tablet computers to self-manage their condition and transmit health data to providers to improve HbA1c and quality of life compared to routine care.
This document describes a study that used action research to develop a feasible lifestyle intervention for patients with prediabetes in primary care settings. The study had two main goals: (1) determine the resources and competencies needed, and (2) identify effective intervention components. It involved two cycles with general practices. The first cycle explored various intervention options, and the second tested the intervention developed in cycle one. In total, 64 patients, 8 GPs, and 10 nurses participated. The study found an intervention involving six consultations over one year was feasible for practices. Nurses had the skills to deliver the core intervention. It led to clinical reductions in patients' BMI and HbA1c. The developed intervention showed potential for diabetes prevention
This document provides an introduction and background for a prospective study on the effect of pandemic restrictions on quality of life and medication adherence in diabetes patients. The study will be conducted over 6 months at a medical college hospital in Bangalore, India, surveying 124 diabetes patients using the WHOQOL-BREF questionnaire to assess quality of life and the Morisky 8-item scale to evaluate medication adherence. The objectives are to compare quality of life and adherence scores between pre-pandemic and pandemic periods, and to examine changes in lifestyle and diet among patients during the pandemic restrictions.
The document discusses emerging blood glucose monitoring technologies. It notes that the growing diabetes epidemic poses diagnostic and management challenges. There is an immediate need for new approaches to support patient self-management and treatment adherence. The document summarizes various emerging monitoring technologies like continuous glucose monitors, closed loop insulin delivery systems, mobile apps, and alternatives to glucose monitoring. It emphasizes that technology must be tailored to individual patient needs and that self-monitoring of blood glucose remains an important management tool when used properly.
This study examined the nutritional practices of type 2 diabetes patients at Sikanze Hospital in Lusaka, Zambia. The researcher surveyed 41 diabetes patients and analyzed their dietary habits, lifestyle behaviors, and nutrition education levels. The results showed relationships between better nutrition status and higher nutrition education, adherence to dietary methods, and engagement in physical exercise. Over half of patients had poor nutrition status based on their BMI. The study concluded that improving nutrition education, access to dieticians, and health promotion could help diabetes patients better manage their condition through diet and lifestyle. It recommended strengthening community education, healthcare worker training, and national diabetes treatment guidelines.
This article summarizes the results of establishing care pathways and an expert patient program for chronic conditions like diabetes, heart failure, and COPD in Barcelona, Spain. Key results include:
- Increased detection and monitoring of the conditions through improved protocols between primary and specialized care.
- Reduced hospital admissions and length of stay for heart failure patients.
- Increased patient knowledge and self-care through the expert patient program, which may have contributed to reduced heart failure admissions.
- High satisfaction among patients in the expert patient program.
A DIRECT MEDICAL COST ANALYSIS OF PATIENTS WITH T2DM AND ITS MACROVASCULAR CO...Abith Baburaj
A DIRECT MEDICAL COST ANALYSIS OF PATIENTS WITH T2DM AND ITS MACROVASCULAR COMPLICATIONS
-A PHARMACOECONOMIC STUDY
-assessment of cost of treatment of diabetis with its macrovascular complication patients
Diabetic nursing visits for better A1C control in patients Discussion.pdfsdfghj21
Diabetic nursing visits can help improve A1C control in patients through education on lifestyle changes, diet, medications, and monitoring. Studies have found uncontrolled diabetes leads to complications like eye, kidney and cardiovascular issues. Nurses play an important role in helping patients manage their diabetes tighter through regular visits focused on glycemic control.
Early treatment revisions by addition or switch for type 2 diabetes patients with HbA1c ≥9.0% were associated with:
1) Greater reduction in HbA1c levels 6-12 months after treatment revision compared to delayed treatment revisions.
2) No significant impact on diabetic complication severity over 12-36 months.
3) Higher total healthcare costs, medical costs, and pharmacy costs at 12, 24, and 36 months compared to delayed treatment revisions, despite better glycemic control. The study suggests that while early treatment revision improves blood sugar control in the short term, longer follow-up is needed to assess impact on complications and the higher costs of early treatment may not be justified given the lack of benefit
This study assessed the effectiveness of a health education program for type 2 diabetes patients in Egypt. It found that most patients had low baseline knowledge about diabetes. After the education program, patients had significant improvements in their knowledge, attitudes, blood sugar levels, and HbA1c. The program involved 3 sessions over 3 months that provided information on diabetes symptoms, treatment, complications, diet, exercise, and self-management. The study demonstrated that health education can positively impact diabetes outcomes and is an important part of diabetes care.
This document summarizes a study that evaluated the impact of a remotely delivered behavioral health intervention program on medical outcomes and costs for individuals with cardiovascular disease. The study found that participants who completed the 8-week behavioral health program had significantly fewer hospital admissions and total hospital days during the following 6 months compared to a control group. This resulted in lower overall healthcare costs despite the costs of the behavioral health program. The study demonstrates that addressing behavioral health issues through a remote behavioral health intervention can successfully improve medical outcomes and reduce healthcare expenditures for high-risk patients.
The Camden Coalition of Healthcare Providers aims to reduce healthcare costs through improved care coordination for high-utilizing patients, especially those with diabetes. The Care Transitions program identifies these patients using a health information exchange and provides intensive 30-90 day care coordination post-hospitalization. Preliminary analysis found that among 21 enrolled patients with diabetes, there was a 57% reduction in emergency room and hospital utilization, decreasing average monthly charges from over $900 and $22,000, respectively, to $0 after enrollment. The program's success in reducing utilization is attributed to strong team coordination, standardized discharge planning, and quick post-discharge follow-up.
Artificial intelligence (AI) is a fast-growing field and its applications to diabetes, a global pandemic, can reform the approach to diagnosis and management of this chronic condition. Principles of machine learning have been used to build algorithms to support predictive models for the risk of developing diabetes or its consequent complications. Digital therapeutics have proven to be an established intervention for lifestyle therapy in the management of diabetes. Patients are increasingly being empowered for self-management of diabetes, and both patients and health care professionals are benefitting from clinical decision support. AI allows a continuous and burden-free remote monitoring of the patient's symptoms and biomarkers. Further, social media and online communities enhance patient engagement in diabetes care. Technical advances have helped to optimize resource use in diabetes. Together, these intelligent technical reforms have produced better glycemic control with reductions in fasting and postprandial glucose levels, glucose excursions, and glycosylated hemoglobin. AI will introduce a paradigm shift in diabetes care from conventional management strategies to building targeted data-driven precision care.
Poster: eCOA Best Practices in Diabetes Clinical TrialsCRF Health
1) Managing diabetes involves regular blood glucose monitoring, tracking meals and insulin usage, which clinical trials seek to capture along with other patient-reported outcomes. This complexity can increase patient burden and lower compliance.
2) CRF Health created an electronic diabetes diary designed to limit additional burden on patients while accurately collecting needed clinical data. Usability testing found it less burdensome than paper methods.
3) Feedback from patients and sponsors identified challenges in diabetes data capture. CRF Health addressed these through design iterations informed by patient input, resulting in an intuitive interface that integrated glucose readings into event-based reporting.
ueda2011 remote area diabetes clinic model-d.mesbahueda2015
1. This document describes the establishment of a remote area diabetes clinic in Minia, Egypt to provide care to diabetic patients in underserved rural areas.
2. Key goals of the clinic were to establish a patient registry, provide multidisciplinary care through a healthcare team, and decrease complications through good glycemic control.
3. Evaluation of the clinic over 4 years showed improvements in glycemic control, blood pressure control, and reductions in diabetes-related complications like retinopathy and nephropathy.
DASHBOARD BENCHMARK
Miatta Teasley
Capella University
Running Head: DASHBOARD BENCHMARK
DASHBOARD BENCHMARK
April 19,2022
DASHBOARD BENCHMARK
Second Quarter Hypertension Intervention Compliance at Med for adults presenting with Diabetes
Intervention
Needed
Completed
Compliance Percentage
Initial Lactate within 3 hours
30
30
100%
Blood cultures were drawn before antibiotics
22
17
77%
Antibiotics administered within 3 hours
22
20
91%
Fluid resuscitation if in septic shock within 2hours
19
12
63%
Vasopressors if hypertension persists after fluid or lactate >4mmoL/L within 6 hours
12
7
58%
Overall
105
86
82%
Second Quarter Dialysis Intervention
Compliance and Inpatient Mortality
Patient ID
Number of Interventions needed
Number of Interventions completed
Inpatient Mortality
2000
4
2
0
2014
3
3
1
2098
2
1
0
2134
5
4
0
2156
3
4
1
2245
4
2
0
2345
3
3
1
2567
5
4
1
2676
4
1
1
2935
3
2
0
Note: The Staffing benchmark for the nurse staffing unit is 3 patients per nurse. The average monthly staffing for the unit is 3 nurse workloads. The average number of patients in the unit per month in the third quarter was 5.75.
The data above is a review regarding the compliance of Dialysis measures and interventions compliance and the sample of the second quarter inpatient mortality. The information below entails evaluating the data, which indicates that various departments need to be improved, and a proposal for a specific area and target for improvement.
Evaluation of Dashboard Metrics
There are several inefficiencies in regards to dialysis measures at Med. From the dashboard concerning the compliance of executing the arranged measures and procedures, the two stand out at the 77% compliance rate on drawing blood cultures before running antibiotics and 58% compliance rate on administering vasopressors for those patients that require them. As per Medicare.Gov (n.d), the national average for meeting dialysis guidelines is 72%, and the state of Minnesota is 60% which indicates that Med is performing at 82% overall testing. Higher percentages are required to ensure the advanced quality of life for residents of the healthcare institution (Morfín et al., 2018).
Failure to complete blood draws for cultures before running broad-spectrum antibiotics; there will be an incapability to authorize contamination and the responsible pathogen. This can result in an inefficient or ineffective intervention for aiding a patient. Moreover, by failing to confirm infection from the start, unnecessary and wasteful care interventions could be performed or ordered for patients (Morfín et al., 2018). As per the failure to administer vasopressors, the institution is gambling with the patient's life. As the reinforcement for the dialysis unit states, vasopressor therapy is needed to sustain and uphold perfusion in the wake of life-threatening hypertension. The needed nature of compliance concerning administering this intervention can be seen in the samp.
Continuous Glucose Monitoring and Its Use Beyond Type 1 DiabetesAaron Neinstein
This document discusses the potential for continuous glucose monitor (CGM) use beyond just type 1 diabetes. It begins by predicting that by 2025, everyone with diabetes will be using CGMs and many without diabetes will also be tracking their blood sugar. It then reviews the evidence that CGMs improve outcomes for those with type 2 diabetes compared to fingerstick monitoring alone. Several studies show CGMs lower A1c and time spent in hypoglycemia. The document also discusses emerging data on using CGMs in those without known diabetes to identify patterns of glucose dysregulation. It concludes that while interest in broader CGM use is growing, many questions remain around defining optimal populations, dosing, and care models to support non-diabetic
Research Comparing Gastric Bypass Surgery and Intensive Medical Therapy in Ty...Yunji Kim
Gastric bypass surgery results in better glycemic control and diabetes remission compared to intensive medical therapy alone in obese patients with type 2 diabetes according to several randomized controlled trials and cohort studies. Studies found greater reductions in HbA1c and BMI levels in patients who underwent gastric bypass surgery versus those receiving intensive medical therapy. Remission rates of type 2 diabetes were higher, ranging from 40-75%, in patients undergoing gastric bypass surgery compared to 0% of those receiving intensive medical therapy alone. However, larger and longer term studies are still needed to further evaluate safety and long term outcomes of gastric bypass surgery.
The annual report summarizes the National TB Program in Swaziland for 2012. Key highlights include: ART uptake among HIV+ TB patients increased to 66%; TB treatment success rate improved to 73% but remains below the 85% WHO target; MDR-TB cases increased from 332 to 613 from 2011 to 2012; and MDR-TB treatment success rate improved from 18% to 57%. The report outlines the program structure, services provided, epidemiological trends showing declining TB burden, and challenges around drug supply and MDR-TB recording and reporting. Recommendations focus on strengthening MDR-TB surveillance, drug supply chain management, research activities, and laboratory collaboration.
1601Rev Bras Enferm. 2019;72(6)1601-8. httpdx.doi.org10.1.docxaulasnilda
1601Rev Bras Enferm. 2019;72(6):1601-8. http://dx.doi.org/10.1590/0034-7167-2018-0731
ABSTRACT
Objective: to evaluate the contributions of an educational program for capillary blood
glucose self-monitoring. Method: a quasi-experimental study performed in an outpatient
unit of a tertiary health care service in a sample of 25 people with Type 2 Diabetes Mellitus,
from July 2016 to December 2017, developed through interactive tools for care with
capillary blood glucose self-monitoring. Results: among the items of capillary blood
glucose self-monitoring that showed improvement after participation in the educational
program, the most noteworthy are the “postprandial blood glucose values” (p=0.0039),
“Interpretation of capillary blood glucose results with meals and medications” (p=0.0156),
“recognition of the ‘weakness’ symptom for hyperglycemia” (p=0.0386) and “administration
of medications correctly” for hyperglycemia prevention (p=0.0063). Conclusion: the study
made it possible to recognize the main characteristics of blood glucose self-monitoring that
may contribute to the care for the person with diabetes.
Descriptors: Diabetes Mellitus; Health Education; Blood Glucose Self-Monitoring; Self-
Care; Nursing Care.
RESUMO
Objetivo: avaliar as contribuições de um programa educativo para a automonitorização da
glicemia capilar. Método: estudo quase-experimental, realizado em unidade ambulatorial de
um serviço de atenção terciária à saúde, em amostra de 25 pessoas com Diabetes Mellitus tipo
2, no período de julho de 2016 a dezembro de 2017, desenvolvido por meio de ferramentas
interativas para o cuidado com a automonitorização da glicemia capilar. Resultados: entre os
itens da automonitorização da glicemia capilar que apresentaram melhora após a participação
no programa educativo, destacam-se os “valores da glicemia pós-prandial” (p=0,0039),
“interpretação dos resultados de glicemia capilar com as refeições e medicamentos” (p=0,0156),
“reconhecimento do sintoma ‘fraqueza’ para a hiperglicemia” (p=0,0386) e “administração de
medicamentos corretamente” para prevenção da hiperglicemia (p=0,0063). Conclusão: o
estudo possibilitou reconhecer as principais características da automonitorização da glicemia
que poderão contribuir para o cuidado à pessoa portadora da doença.
Descritores: Diabetes Mellitus; Educação em Saúde; Automonitorização da Glicemia;
Autocuidado; Cuidados de Enfermagem.
RESUMEN
Objetivo: evaluar las contribuciones de un programa educativo para la automonitorización de
la glucemia capilar. Método: el estudio cuasi-experimental, realizado en unidad ambulatoria
de un servicio de atención terciaria a la salud, en muestra de 25 personas con Diabetes
Mellitus tipo 2, en el período de julio de 2016 a diciembre de 2017, desarrollado por medio de
herramientas interactivas para el cuidado con la automonitorización de la glucemia capilar.
Resultados: entre los ítems de la automonitorización de la glucemia capilar que ...
Abstract Quality improvement methods are vital in treati.docxrobert345678
Abstract
Quality improvement methods are vital in treating biopsychosocial conditions. Diabetes is a chronic disease that requires follow-
up care to prevent comorbidities. With an increased population suffering from diabetes, mainly type 2 diabetes, traditional
treatments are ineffective, and a new treatment approach should be adopted. While this is deemed a plausible solution to curb the
increase of diabetes, research indicates that 70% of quality improvement initiatives fail within twelve months of implementation
(O'Donoghue et al., 2021). Therefore, stakeholders must follow proposed improvements methods closely to achieve meaningful
and sustainable change. To combat widespread chronic diseases such as diabetes, strategies such as self-management support,
intensified treatment, encouraged physical activity, and patient education plays a crucial role in managing a patient's condition.
The disease heavily relies on one self-management abilities. The proposed strategies aim to achieve patient adherence to prevent
other health effects that can be otherwise be contained and ensure that mental distress often experienced by diabetes patients is
adequately dealt with.
This study source was downloaded by 100000855641916 from CourseHero.com on 01-03-2023 03:05:19 GMT -06:00
https://www.coursehero.com/file/137101090/NURS-FPX6021-Assessment-3-Yudelca-Collado-Quality-Improvement-Presentation-Poster-1-2pptx/
https://www.coursehero.com/file/137101090/NURS-FPX6021-Assessment-3-Yudelca-Collado-Quality-Improvement-Presentation-Poster-1-2pptx/
Quality Improvement Presentation Poster
Yudelca Collado
Capella University
Biopsychosocial Concepts for Advanced Nursing Practice I
Quality Improvement Presentation Poster
1/27/2022
Quality Improvement Methods
• The word "quality improvement" refers to the practice of enhancing
the intended outputs of an existing process. Typically, this would need
previous knowledge of the process and the areas that may be
improved.
• Once a problem has been identified, it is critical to develop a plan of
action to improve the outcomes in that area. Recent studies have
indicated the sufficient evidence-to-clinical practice gap in diabetes
care (Mukerji et al., 2019). Upon discovering this, several plans of
action are required to improve the gaps in care delivery towards
diabetes patients.
• While most providers concentrate on the physical aspect of the
patient's health, research indicates that diabetes patients are often
affected by depression and diabetes distress ( Gary et al., 2019). This
results in underdiagnosis and undertreatment of diabetes patients,
which impedes patients' chances of managing their health condition.
• With the identification of this, challenges within primary care must be
addressed to ensure that there is sufficient screening for both
depression and diabetes distress.
• Several strategies must be applied to sufficiently monitor the patient:
self-management support, intensi.
Welch 2015 Telemedicine and eHealth (1)Garry Welch
This study evaluated a 3-month diabetes telehealth program in an urban community health center that integrated remote home monitoring devices, including a cellular pillbox, with nurse telehealth support. The program aimed to improve blood glucose control for patients with poorly controlled type 2 diabetes. Results showed high usage of the monitoring devices, high patient satisfaction, and a clinically significant 0.6% reduction in hemoglobin A1c levels from baseline to the 3-month follow-up. The findings provide support for the usability and clinical benefits of integrating an easy-to-use cellular pillbox into a telehealth program for managing type 2 diabetes in an underserved population.
Richard Mendelsohn- Beyond 2010: SMART Living Paneleventwithme
The document discusses a digitally enabled citizen program called Birmingham OwnHealth that aims to improve health outcomes for those with chronic diseases. The program provides personalized care plans, information prescriptions, and support for self-management through telehealth and care managers. Initial outcomes include reductions in avoidable hospitalizations and emergency visits, as well as improvements in clinical metrics like HbA1c and blood pressure. An independent university study found participants in the program experienced greater reductions in these measures compared to controls.
NRS433V Relationship Between Obesity Diabetes PICOT.docxstirlingvwriters
This document provides instructions for a 1,500-1,750 word paper on the relationship between obesity and diabetes. It involves revising a PICOT statement from a previous assignment, finalizing qualitative and quantitative research critiques based on instructor feedback, and proposing evidence-based practice changes by linking the research to the identified nursing problem. The paper must follow APA guidelines and include an abstract. Sample sections of qualitative and quantitative research critiques on studies examining the relationship between obesity and diabetes are also provided.
Implantation,conception, development of placenta.pptNithuNithu7
1. Implantation begins 6 days after fertilization when the blastocyst attaches to the endometrial epithelium. By day 7, it is implanted in the endometrium and derives nourishment from the eroded endometrium.
2. By day 10, the blastocyst is completely buried within the functional layer of the endometrium. The endometrium is now called the decidua.
3. The decidua supports the development of the placenta and fetus through fetomaternal circulation until birth.
Aplastic anemia is a condition where the bone marrow fails to produce sufficient new blood cells, causing pancytopenia. It can be inherited or acquired due to radiation, chemicals, drugs, viruses or immune disorders. Symptoms include easy bruising, bleeding gums, and fatigue. Diagnosis involves blood and bone marrow tests showing low blood cell counts and a fatty, cellular bone marrow. Treatment options include hematopoietic growth factors, immunosuppression with antithymocyte globulin and cyclosporine, stem cell transplantation, and blood product support. Younger patients with a matched sibling donor usually receive stem cell transplantation, while older patients typically receive immunosuppression.
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A DIRECT MEDICAL COST ANALYSIS OF PATIENTS WITH T2DM AND ITS MACROVASCULAR CO...Abith Baburaj
A DIRECT MEDICAL COST ANALYSIS OF PATIENTS WITH T2DM AND ITS MACROVASCULAR COMPLICATIONS
-A PHARMACOECONOMIC STUDY
-assessment of cost of treatment of diabetis with its macrovascular complication patients
Diabetic nursing visits for better A1C control in patients Discussion.pdfsdfghj21
Diabetic nursing visits can help improve A1C control in patients through education on lifestyle changes, diet, medications, and monitoring. Studies have found uncontrolled diabetes leads to complications like eye, kidney and cardiovascular issues. Nurses play an important role in helping patients manage their diabetes tighter through regular visits focused on glycemic control.
Early treatment revisions by addition or switch for type 2 diabetes patients with HbA1c ≥9.0% were associated with:
1) Greater reduction in HbA1c levels 6-12 months after treatment revision compared to delayed treatment revisions.
2) No significant impact on diabetic complication severity over 12-36 months.
3) Higher total healthcare costs, medical costs, and pharmacy costs at 12, 24, and 36 months compared to delayed treatment revisions, despite better glycemic control. The study suggests that while early treatment revision improves blood sugar control in the short term, longer follow-up is needed to assess impact on complications and the higher costs of early treatment may not be justified given the lack of benefit
This study assessed the effectiveness of a health education program for type 2 diabetes patients in Egypt. It found that most patients had low baseline knowledge about diabetes. After the education program, patients had significant improvements in their knowledge, attitudes, blood sugar levels, and HbA1c. The program involved 3 sessions over 3 months that provided information on diabetes symptoms, treatment, complications, diet, exercise, and self-management. The study demonstrated that health education can positively impact diabetes outcomes and is an important part of diabetes care.
This document summarizes a study that evaluated the impact of a remotely delivered behavioral health intervention program on medical outcomes and costs for individuals with cardiovascular disease. The study found that participants who completed the 8-week behavioral health program had significantly fewer hospital admissions and total hospital days during the following 6 months compared to a control group. This resulted in lower overall healthcare costs despite the costs of the behavioral health program. The study demonstrates that addressing behavioral health issues through a remote behavioral health intervention can successfully improve medical outcomes and reduce healthcare expenditures for high-risk patients.
The Camden Coalition of Healthcare Providers aims to reduce healthcare costs through improved care coordination for high-utilizing patients, especially those with diabetes. The Care Transitions program identifies these patients using a health information exchange and provides intensive 30-90 day care coordination post-hospitalization. Preliminary analysis found that among 21 enrolled patients with diabetes, there was a 57% reduction in emergency room and hospital utilization, decreasing average monthly charges from over $900 and $22,000, respectively, to $0 after enrollment. The program's success in reducing utilization is attributed to strong team coordination, standardized discharge planning, and quick post-discharge follow-up.
Artificial intelligence (AI) is a fast-growing field and its applications to diabetes, a global pandemic, can reform the approach to diagnosis and management of this chronic condition. Principles of machine learning have been used to build algorithms to support predictive models for the risk of developing diabetes or its consequent complications. Digital therapeutics have proven to be an established intervention for lifestyle therapy in the management of diabetes. Patients are increasingly being empowered for self-management of diabetes, and both patients and health care professionals are benefitting from clinical decision support. AI allows a continuous and burden-free remote monitoring of the patient's symptoms and biomarkers. Further, social media and online communities enhance patient engagement in diabetes care. Technical advances have helped to optimize resource use in diabetes. Together, these intelligent technical reforms have produced better glycemic control with reductions in fasting and postprandial glucose levels, glucose excursions, and glycosylated hemoglobin. AI will introduce a paradigm shift in diabetes care from conventional management strategies to building targeted data-driven precision care.
Poster: eCOA Best Practices in Diabetes Clinical TrialsCRF Health
1) Managing diabetes involves regular blood glucose monitoring, tracking meals and insulin usage, which clinical trials seek to capture along with other patient-reported outcomes. This complexity can increase patient burden and lower compliance.
2) CRF Health created an electronic diabetes diary designed to limit additional burden on patients while accurately collecting needed clinical data. Usability testing found it less burdensome than paper methods.
3) Feedback from patients and sponsors identified challenges in diabetes data capture. CRF Health addressed these through design iterations informed by patient input, resulting in an intuitive interface that integrated glucose readings into event-based reporting.
ueda2011 remote area diabetes clinic model-d.mesbahueda2015
1. This document describes the establishment of a remote area diabetes clinic in Minia, Egypt to provide care to diabetic patients in underserved rural areas.
2. Key goals of the clinic were to establish a patient registry, provide multidisciplinary care through a healthcare team, and decrease complications through good glycemic control.
3. Evaluation of the clinic over 4 years showed improvements in glycemic control, blood pressure control, and reductions in diabetes-related complications like retinopathy and nephropathy.
DASHBOARD BENCHMARK
Miatta Teasley
Capella University
Running Head: DASHBOARD BENCHMARK
DASHBOARD BENCHMARK
April 19,2022
DASHBOARD BENCHMARK
Second Quarter Hypertension Intervention Compliance at Med for adults presenting with Diabetes
Intervention
Needed
Completed
Compliance Percentage
Initial Lactate within 3 hours
30
30
100%
Blood cultures were drawn before antibiotics
22
17
77%
Antibiotics administered within 3 hours
22
20
91%
Fluid resuscitation if in septic shock within 2hours
19
12
63%
Vasopressors if hypertension persists after fluid or lactate >4mmoL/L within 6 hours
12
7
58%
Overall
105
86
82%
Second Quarter Dialysis Intervention
Compliance and Inpatient Mortality
Patient ID
Number of Interventions needed
Number of Interventions completed
Inpatient Mortality
2000
4
2
0
2014
3
3
1
2098
2
1
0
2134
5
4
0
2156
3
4
1
2245
4
2
0
2345
3
3
1
2567
5
4
1
2676
4
1
1
2935
3
2
0
Note: The Staffing benchmark for the nurse staffing unit is 3 patients per nurse. The average monthly staffing for the unit is 3 nurse workloads. The average number of patients in the unit per month in the third quarter was 5.75.
The data above is a review regarding the compliance of Dialysis measures and interventions compliance and the sample of the second quarter inpatient mortality. The information below entails evaluating the data, which indicates that various departments need to be improved, and a proposal for a specific area and target for improvement.
Evaluation of Dashboard Metrics
There are several inefficiencies in regards to dialysis measures at Med. From the dashboard concerning the compliance of executing the arranged measures and procedures, the two stand out at the 77% compliance rate on drawing blood cultures before running antibiotics and 58% compliance rate on administering vasopressors for those patients that require them. As per Medicare.Gov (n.d), the national average for meeting dialysis guidelines is 72%, and the state of Minnesota is 60% which indicates that Med is performing at 82% overall testing. Higher percentages are required to ensure the advanced quality of life for residents of the healthcare institution (Morfín et al., 2018).
Failure to complete blood draws for cultures before running broad-spectrum antibiotics; there will be an incapability to authorize contamination and the responsible pathogen. This can result in an inefficient or ineffective intervention for aiding a patient. Moreover, by failing to confirm infection from the start, unnecessary and wasteful care interventions could be performed or ordered for patients (Morfín et al., 2018). As per the failure to administer vasopressors, the institution is gambling with the patient's life. As the reinforcement for the dialysis unit states, vasopressor therapy is needed to sustain and uphold perfusion in the wake of life-threatening hypertension. The needed nature of compliance concerning administering this intervention can be seen in the samp.
Continuous Glucose Monitoring and Its Use Beyond Type 1 DiabetesAaron Neinstein
This document discusses the potential for continuous glucose monitor (CGM) use beyond just type 1 diabetes. It begins by predicting that by 2025, everyone with diabetes will be using CGMs and many without diabetes will also be tracking their blood sugar. It then reviews the evidence that CGMs improve outcomes for those with type 2 diabetes compared to fingerstick monitoring alone. Several studies show CGMs lower A1c and time spent in hypoglycemia. The document also discusses emerging data on using CGMs in those without known diabetes to identify patterns of glucose dysregulation. It concludes that while interest in broader CGM use is growing, many questions remain around defining optimal populations, dosing, and care models to support non-diabetic
Research Comparing Gastric Bypass Surgery and Intensive Medical Therapy in Ty...Yunji Kim
Gastric bypass surgery results in better glycemic control and diabetes remission compared to intensive medical therapy alone in obese patients with type 2 diabetes according to several randomized controlled trials and cohort studies. Studies found greater reductions in HbA1c and BMI levels in patients who underwent gastric bypass surgery versus those receiving intensive medical therapy. Remission rates of type 2 diabetes were higher, ranging from 40-75%, in patients undergoing gastric bypass surgery compared to 0% of those receiving intensive medical therapy alone. However, larger and longer term studies are still needed to further evaluate safety and long term outcomes of gastric bypass surgery.
The annual report summarizes the National TB Program in Swaziland for 2012. Key highlights include: ART uptake among HIV+ TB patients increased to 66%; TB treatment success rate improved to 73% but remains below the 85% WHO target; MDR-TB cases increased from 332 to 613 from 2011 to 2012; and MDR-TB treatment success rate improved from 18% to 57%. The report outlines the program structure, services provided, epidemiological trends showing declining TB burden, and challenges around drug supply and MDR-TB recording and reporting. Recommendations focus on strengthening MDR-TB surveillance, drug supply chain management, research activities, and laboratory collaboration.
1601Rev Bras Enferm. 2019;72(6)1601-8. httpdx.doi.org10.1.docxaulasnilda
1601Rev Bras Enferm. 2019;72(6):1601-8. http://dx.doi.org/10.1590/0034-7167-2018-0731
ABSTRACT
Objective: to evaluate the contributions of an educational program for capillary blood
glucose self-monitoring. Method: a quasi-experimental study performed in an outpatient
unit of a tertiary health care service in a sample of 25 people with Type 2 Diabetes Mellitus,
from July 2016 to December 2017, developed through interactive tools for care with
capillary blood glucose self-monitoring. Results: among the items of capillary blood
glucose self-monitoring that showed improvement after participation in the educational
program, the most noteworthy are the “postprandial blood glucose values” (p=0.0039),
“Interpretation of capillary blood glucose results with meals and medications” (p=0.0156),
“recognition of the ‘weakness’ symptom for hyperglycemia” (p=0.0386) and “administration
of medications correctly” for hyperglycemia prevention (p=0.0063). Conclusion: the study
made it possible to recognize the main characteristics of blood glucose self-monitoring that
may contribute to the care for the person with diabetes.
Descriptors: Diabetes Mellitus; Health Education; Blood Glucose Self-Monitoring; Self-
Care; Nursing Care.
RESUMO
Objetivo: avaliar as contribuições de um programa educativo para a automonitorização da
glicemia capilar. Método: estudo quase-experimental, realizado em unidade ambulatorial de
um serviço de atenção terciária à saúde, em amostra de 25 pessoas com Diabetes Mellitus tipo
2, no período de julho de 2016 a dezembro de 2017, desenvolvido por meio de ferramentas
interativas para o cuidado com a automonitorização da glicemia capilar. Resultados: entre os
itens da automonitorização da glicemia capilar que apresentaram melhora após a participação
no programa educativo, destacam-se os “valores da glicemia pós-prandial” (p=0,0039),
“interpretação dos resultados de glicemia capilar com as refeições e medicamentos” (p=0,0156),
“reconhecimento do sintoma ‘fraqueza’ para a hiperglicemia” (p=0,0386) e “administração de
medicamentos corretamente” para prevenção da hiperglicemia (p=0,0063). Conclusão: o
estudo possibilitou reconhecer as principais características da automonitorização da glicemia
que poderão contribuir para o cuidado à pessoa portadora da doença.
Descritores: Diabetes Mellitus; Educação em Saúde; Automonitorização da Glicemia;
Autocuidado; Cuidados de Enfermagem.
RESUMEN
Objetivo: evaluar las contribuciones de un programa educativo para la automonitorización de
la glucemia capilar. Método: el estudio cuasi-experimental, realizado en unidad ambulatoria
de un servicio de atención terciaria a la salud, en muestra de 25 personas con Diabetes
Mellitus tipo 2, en el período de julio de 2016 a diciembre de 2017, desarrollado por medio de
herramientas interactivas para el cuidado con la automonitorización de la glucemia capilar.
Resultados: entre los ítems de la automonitorización de la glucemia capilar que ...
Abstract Quality improvement methods are vital in treati.docxrobert345678
Abstract
Quality improvement methods are vital in treating biopsychosocial conditions. Diabetes is a chronic disease that requires follow-
up care to prevent comorbidities. With an increased population suffering from diabetes, mainly type 2 diabetes, traditional
treatments are ineffective, and a new treatment approach should be adopted. While this is deemed a plausible solution to curb the
increase of diabetes, research indicates that 70% of quality improvement initiatives fail within twelve months of implementation
(O'Donoghue et al., 2021). Therefore, stakeholders must follow proposed improvements methods closely to achieve meaningful
and sustainable change. To combat widespread chronic diseases such as diabetes, strategies such as self-management support,
intensified treatment, encouraged physical activity, and patient education plays a crucial role in managing a patient's condition.
The disease heavily relies on one self-management abilities. The proposed strategies aim to achieve patient adherence to prevent
other health effects that can be otherwise be contained and ensure that mental distress often experienced by diabetes patients is
adequately dealt with.
This study source was downloaded by 100000855641916 from CourseHero.com on 01-03-2023 03:05:19 GMT -06:00
https://www.coursehero.com/file/137101090/NURS-FPX6021-Assessment-3-Yudelca-Collado-Quality-Improvement-Presentation-Poster-1-2pptx/
https://www.coursehero.com/file/137101090/NURS-FPX6021-Assessment-3-Yudelca-Collado-Quality-Improvement-Presentation-Poster-1-2pptx/
Quality Improvement Presentation Poster
Yudelca Collado
Capella University
Biopsychosocial Concepts for Advanced Nursing Practice I
Quality Improvement Presentation Poster
1/27/2022
Quality Improvement Methods
• The word "quality improvement" refers to the practice of enhancing
the intended outputs of an existing process. Typically, this would need
previous knowledge of the process and the areas that may be
improved.
• Once a problem has been identified, it is critical to develop a plan of
action to improve the outcomes in that area. Recent studies have
indicated the sufficient evidence-to-clinical practice gap in diabetes
care (Mukerji et al., 2019). Upon discovering this, several plans of
action are required to improve the gaps in care delivery towards
diabetes patients.
• While most providers concentrate on the physical aspect of the
patient's health, research indicates that diabetes patients are often
affected by depression and diabetes distress ( Gary et al., 2019). This
results in underdiagnosis and undertreatment of diabetes patients,
which impedes patients' chances of managing their health condition.
• With the identification of this, challenges within primary care must be
addressed to ensure that there is sufficient screening for both
depression and diabetes distress.
• Several strategies must be applied to sufficiently monitor the patient:
self-management support, intensi.
Welch 2015 Telemedicine and eHealth (1)Garry Welch
This study evaluated a 3-month diabetes telehealth program in an urban community health center that integrated remote home monitoring devices, including a cellular pillbox, with nurse telehealth support. The program aimed to improve blood glucose control for patients with poorly controlled type 2 diabetes. Results showed high usage of the monitoring devices, high patient satisfaction, and a clinically significant 0.6% reduction in hemoglobin A1c levels from baseline to the 3-month follow-up. The findings provide support for the usability and clinical benefits of integrating an easy-to-use cellular pillbox into a telehealth program for managing type 2 diabetes in an underserved population.
Richard Mendelsohn- Beyond 2010: SMART Living Paneleventwithme
The document discusses a digitally enabled citizen program called Birmingham OwnHealth that aims to improve health outcomes for those with chronic diseases. The program provides personalized care plans, information prescriptions, and support for self-management through telehealth and care managers. Initial outcomes include reductions in avoidable hospitalizations and emergency visits, as well as improvements in clinical metrics like HbA1c and blood pressure. An independent university study found participants in the program experienced greater reductions in these measures compared to controls.
NRS433V Relationship Between Obesity Diabetes PICOT.docxstirlingvwriters
This document provides instructions for a 1,500-1,750 word paper on the relationship between obesity and diabetes. It involves revising a PICOT statement from a previous assignment, finalizing qualitative and quantitative research critiques based on instructor feedback, and proposing evidence-based practice changes by linking the research to the identified nursing problem. The paper must follow APA guidelines and include an abstract. Sample sections of qualitative and quantitative research critiques on studies examining the relationship between obesity and diabetes are also provided.
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Implantation,conception, development of placenta.pptNithuNithu7
1. Implantation begins 6 days after fertilization when the blastocyst attaches to the endometrial epithelium. By day 7, it is implanted in the endometrium and derives nourishment from the eroded endometrium.
2. By day 10, the blastocyst is completely buried within the functional layer of the endometrium. The endometrium is now called the decidua.
3. The decidua supports the development of the placenta and fetus through fetomaternal circulation until birth.
Aplastic anemia is a condition where the bone marrow fails to produce sufficient new blood cells, causing pancytopenia. It can be inherited or acquired due to radiation, chemicals, drugs, viruses or immune disorders. Symptoms include easy bruising, bleeding gums, and fatigue. Diagnosis involves blood and bone marrow tests showing low blood cell counts and a fatty, cellular bone marrow. Treatment options include hematopoietic growth factors, immunosuppression with antithymocyte globulin and cyclosporine, stem cell transplantation, and blood product support. Younger patients with a matched sibling donor usually receive stem cell transplantation, while older patients typically receive immunosuppression.
This document provides an overview of different organizational theories, including classical, neo-classical, and modern theories. Classical theory views the organization as a machine and aims to increase efficiency. Neo-classical theory recognizes human and social factors. Modern theory uses a systems approach and views the organization as comprising technical, managerial, and social subsystems that interact with the external environment. Key aspects of organizational theories include division of labor, scalar processes, organizational structure, and span of control. [/SUMMARY]
Essential newborn care (ENC) involves basic care provided to newborns during the first hours, days, and weeks of life to support survival and wellbeing. It includes immediate care at birth, care during the first day, and up to 28 days. Ventilation must be initiated within 1 minute of birth, and breastfeeding should be initiated within the first hour. ENC aims to prevent infection, hypothermia, and identify neonates needing special care. It also involves counseling mothers on danger signs, immunization, and follow-up care.
This document discusses Indian childhood cirrhosis (ICC), a progressive liver disease seen in Indian infants and children between 6 months and 4 years of age. ICC is characterized by abdominal distension, irritability, fever, enlarged liver and spleen, ascites, and jaundice. While the exact causes are unknown, factors like exposure to toxins from fungi or copper cookware, early weaning, genetic susceptibility, and previous malnutrition may play a role. The disease progresses from early symptoms to later stages of liver failure and eventual death if left untreated. Diagnosis involves liver biopsy and urine copper tests. Treatment focuses on chelating excess copper, managing complications, and supportive care.
Uses of computer in hospitals and community.pptNithuNithu7
Computers are used widely in hospitals and the community for healthcare. In hospitals, computers are used for physician order entry, clinical information systems, wireless devices, electronic medical records, telehealth, and other applications. They are also used for registration, reports, transcription and other administrative tasks. In the community, computers are used for point of care systems, telemedicine, teleconferencing, monitoring, and other public health applications like in rural healthcare. Computers help improve access to healthcare for rural communities.
This document provides information about constructing and administering objective tests. It discusses terminology related to testing such as test, marks, item, analysis, scoring, and reports. It also covers administering a test, scoring methods, types of scores like raw scores, percentile ranks, and standard scores. The document discusses grading systems, methods of grading tests, and item analysis to select appropriate test items. Finally, it describes different types of objective tests including true/false, matching, multiple choice, identification, and completion tests and provides guidelines for constructing each type of objective test.
The document discusses patient record systems and nursing documentation. It defines key terms like records, reports and kardex. It describes different types of patient record systems including narrative documentation, problem-oriented medical records, focus charting and source records. It outlines principles of record writing, different documentation methods, advantages of proper record keeping and common record keeping forms used. The document also discusses records management mechanisms, issues related to patient records and role of records in nursing education and public health.
1. Diabetes insipidus is a disorder caused by a deficiency of anti-diuretic hormone (ADH) or a failure of the kidneys to respond to ADH, resulting in the excessive production of dilute urine.
2. Central diabetes insipidus is caused by a failure of the pituitary gland to secrete adequate ADH, while nephrogenic diabetes insipidus results from the kidneys' failure to respond to circulating ADH.
3. The standard treatment is desmopressin (DDAVP), a synthetic analog of ADH, which is given intranasally and has a longer duration of action than natural ADH.
CANDLE syndrome is a rare auto inflammatory disease characterized by recurrent fever in the first month of life along with skin lesions, lipodystrophy, and multi-system inflammation. It is caused by a loss of function mutation that results in a malfunction of the immuno-proteasome complex. Clinical manifestations include recurrent fever, acral perniotic lesions, loss of facial fat, aseptic meningitis, and myositis. Treatment involves oral corticosteroids, NSAIDs, cyclosporine, IV immunoglobulin, and supportive measures like physical and parental therapies. The prognosis for CANDLE syndrome is unclear as it is a new rare condition.
Gender and Mental Health - Counselling and Family Therapy Applications and In...PsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Leveraging Generative AI to Drive Nonprofit InnovationTechSoup
In this webinar, participants learned how to utilize Generative AI to streamline operations and elevate member engagement. Amazon Web Service experts provided a customer specific use cases and dived into low/no-code tools that are quick and easy to deploy through Amazon Web Service (AWS.)
This presentation was provided by Racquel Jemison, Ph.D., Christina MacLaughlin, Ph.D., and Paulomi Majumder. Ph.D., all of the American Chemical Society, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
Beyond Degrees - Empowering the Workforce in the Context of Skills-First.pptxEduSkills OECD
Iván Bornacelly, Policy Analyst at the OECD Centre for Skills, OECD, presents at the webinar 'Tackling job market gaps with a skills-first approach' on 12 June 2024
The chapter Lifelines of National Economy in Class 10 Geography focuses on the various modes of transportation and communication that play a vital role in the economic development of a country. These lifelines are crucial for the movement of goods, services, and people, thereby connecting different regions and promoting economic activities.
How Barcodes Can Be Leveraged Within Odoo 17Celine George
In this presentation, we will explore how barcodes can be leveraged within Odoo 17 to streamline our manufacturing processes. We will cover the configuration steps, how to utilize barcodes in different manufacturing scenarios, and the overall benefits of implementing this technology.
Chapter wise All Notes of First year Basic Civil Engineering.pptxDenish Jangid
Chapter wise All Notes of First year Basic Civil Engineering
Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
Linear Measurements: Instruments used. Linear Measurement by Tape, Ranging out Survey Lines and overcoming Obstructions; Measurements on sloping ground; Tape corrections, conventional symbols. Angular Measurements: Instruments used; Introduction to Compass Surveying, Bearings and Longitude & Latitude of a Line, Introduction to total station.
Levelling: Instrument used Object of levelling, Methods of levelling in brief, and Contour maps.
Chapter 4
Buildings: Selection of site for Buildings, Layout of Building Plan, Types of buildings, Plinth area, carpet area, floor space index, Introduction to building byelaws, concept of sun light & ventilation. Components of Buildings & their functions, Basic concept of R.C.C., Introduction to types of foundation
Chapter 5
Transportation: Introduction to Transportation Engineering; Traffic and Road Safety: Types and Characteristics of Various Modes of Transportation; Various Road Traffic Signs, Causes of Accidents and Road Safety Measures.
Chapter 6
Environmental Engineering: Environmental Pollution, Environmental Acts and Regulations, Functional Concepts of Ecology, Basics of Species, Biodiversity, Ecosystem, Hydrological Cycle; Chemical Cycles: Carbon, Nitrogen & Phosphorus; Energy Flow in Ecosystems.
Water Pollution: Water Quality standards, Introduction to Treatment & Disposal of Waste Water. Reuse and Saving of Water, Rain Water Harvesting. Solid Waste Management: Classification of Solid Waste, Collection, Transportation and Disposal of Solid. Recycling of Solid Waste: Energy Recovery, Sanitary Landfill, On-Site Sanitation. Air & Noise Pollution: Primary and Secondary air pollutants, Harmful effects of Air Pollution, Control of Air Pollution. . Noise Pollution Harmful Effects of noise pollution, control of noise pollution, Global warming & Climate Change, Ozone depletion, Greenhouse effect
Text Books:
1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
4. BCP, Surveying volume 1
This presentation was provided by Rebecca Benner, Ph.D., of the American Society of Anesthesiologists, for the second session of NISO's 2024 Training Series "DEIA in the Scholarly Landscape." Session Two: 'Expanding Pathways to Publishing Careers,' was held June 13, 2024.
2. Presented by,
Registration no: 2521910201
Effectiveness of nursing intervention on treatment compliance
and clinical outcomes among clients with type 2 diabetes
mellitus in selected hospital at Puducherry
31 August 2021 VMCON, PDY. Registration No: 2521910201 2
3. INTRODUCTION
• Diabetes Mellitus (DM) is a chronic incurable disease of the metabolic
process when the pancreas is unable to produce insufficient insulin or
when the body doesn’t use the insulin produced which is characterized
by a high level of blood sugar which in a long run will damage the many-
body system’s if not controlled properly.
• The most common type among the three is Type 2 Diabetes Mellitus
(T2DM) which is caused by obesity and a sedentary lifestyle mainly.
• WHO has taken up certain measures globally to prevent and control DM
particularly in middle and low-income countries such as the
development of norms and standards, awareness program, conducting
surveillance, and guidelines to prevent major non-communicable
diseases such as DM.
31 August 2021 3
VMCON, PDY. Registration No: 2521910201
4. NEED FOR THE STUDY
• Every year the World Diabetes Day is observed on 12th November
focusing on a particular theme with an aim to spread the awareness of
diabetes among people due to the enormous increase of prevalence
rate globally.
• World Diabetes Day 2020 theme was “Nurse and Diabetes”. With the
world facing the global pandemic COVID-19, DM patients have a higher
risk of getting affected by the disease with an increased mortality rate
as well as having difficulty in accessing the health care facilities.
• A global survey report explained that 49% of all the countries have
experienced disruptions in carrying out DM services and it is also
estimated that 6% of the world population is affected by diabetes.
• With world diabetes statistics more than 420 million adults, 96 million
are from South-East Asia Region. (WHO, 2020).
31 August 2021 4
VMCON, PDY. Registration No: 2521910201
5. STATEMENT OF THE PROBLEM
A study to assess the effectiveness of nursing interventions on treatment
compliance and clinical outcomes among clients with type 2 diabetes
mellitus in selected hospital at Puducherry.
31 August 2021 5
VMCON, PDY. Registration No: 2521910201
6. OBJECTIVES
To assess the knowledge, treatment compliance, and clinical outcomes
of clients with T2DM.
To evaluate the effectiveness of IEP and RE on treatment compliance
and clinical outcomes among clients with T2DM between the EG and
CG.
To find out the association between pretest levels of knowledge,
treatment compliance, and clinical outcomes and their selected
demographic variables of clients with T2DM in the EG and CG.
31 August 2021
6
VMCON, PDY. Registration No: 2521910201
7. HYPOTHESES
• Hypothesis 1 (H1) - There is a significant difference in the level of
knowledge, treatment compliance, and clinical outcomes before and
after nursing interventions among clients with T2DM.
• Hypothesis 2 (H2) - There is a significant association between pretest
level of knowledge, treatment compliance, and clinical outcomes and
their selected demographic variables & health profile among clients
with T2DM.
31 August 2021 7
VMCON, PDY. Registration No: 2521910201
8. OPERATIONAL DEFINITIONS
• Assess: In this study, it refers to determine the level of knowledge, treatment
compliance, and clinical outcomes regarding DM among clients with T2DM.
• Effectiveness: In this study, it refers to the ability of the nursing interventions to
produce an intended result.
• Nursing interventions: Nursing Interventions is a systematically planned lecture cum
demonstration program for patients with T2DM, which is shown below:
Informative Education Programme (IEP): It is a planned teaching program for
imparting knowledge regarding DM for about 20-30 minutes using the power
Point Presentation (PPT) for clients with T2DM in the EG.
Resistance exercise (RE): It is a planned lecture cum demonstration program
using a laptop that included wall push-ups, side raises, bicep curls, triceps
extensions, and chair raise of RE for the clients with T2DM in the EG.
31 August 2021 8
VMCON, PDY. Registration No: 2521910201
9. contd:-
• Treatment compliance: In this study, it refers to determine treatment compliance
among the clients with T2DM by using nine modified items of the WHO adherence
scale for long-term therapies and eight modified items Morisky Medication
Adherence Scale (MMAS).
• Clinical outcomes: In this study, it refers to the find out the anthropometric
measurements: height, weight, and BMI-normal:18.5-25 kg/m2, Physiological
measurement: BP-normal: <120/80 mmHg and Bio- physiological measurement FBS-
normal: <100 mg/dl, among the clients with T2DM.
• Clients with type 2 diabetes mellitus: In this study, it refers to patients who are
diagnosed to have T2DM by a qualified physician and admitted for further
management in the wards of AVMC&H, Puducherry.
• Selected Hospital: In this study, the hospital refers to AVMC&H, Puducherry providing
medical, surgical treatment, and nursing care for clients with T2DM.
31 August 2021 9
VMCON, PDY. Registration No: 2521910201
11. REVIEW OF LITERATURE
• Section I: Knowledge among clients with T2DM
• Section II: Treatment compliance among clients with T2DM
• Section III: Clinical outcomes among clients with T2DM
• Section IV: Effectiveness of IEP on treatment compliance and clinical
outcomes among clients with T2DM
• Section V: Effectiveness of exercise on treatment compliance and
clinical outcomes among clients with T2DM
Total-27
31 August 2021
11
VMCON, PDY. Registration No: 2521910201
12. RESEARCH METHODOLOGY
31 August 2021 12
VMCON, PDY. Registration No: 2521910201
Methodology Description
Research approach Quantitative approach
Research design Quasi experimental research design with pre test and
post test
EG: O-X-O1O2O3 CG: O-O1O2O3
Setting of the study All wards of AVMC&H, Puducherry
Independent
variables
Nursing interventions: IEP and demonstration of RE
Dependent
variables
Levels of knowledge, levels of treatment compliance and
levels of clinical outcomes such as BMI, BP and FBS.
Target population T2DM who were admitted to AVMC&H, Puducherry.
13. 31 August 2021 13
VMCON, PDY. Registration No: 2521910201
Methodology Description
Accessible
population
Clients aged between 40 and 70 years with T2DM who
were admitted to AVMC&H, Puducherry.
Sample Clients aged between 40 and 70 years with T2DM who
fulfilled the inclusion criteria.
Sampling
technique
Convenient sampling technique, which is a type of non-
probability sampling technique.
Sample size 60 clients (30-EG and 30-CG)
Content validity Seven experts
Reliability (r) Knowledge questionnaires-0.839, Treatment compliance-
0.791, Height-0.95, Weight-0.97, BP-0.94
14. 31 August 2021 14
VMCON, PDY. Registration No: 2521910201
CRITERIA FOR SELECTION OF SAMPLES
Inclusion Criteria: Clients with T2DM
• who were willing to participate.
• of both gender.
• who were able to understand and
communicate Tamil and/or English.
• aged between 40 and 70 years.
• who were being admitted to
AVMC&H, Puducherry for treatment.
• who were willing to follow the nursing
interventions.
Exclusion Criteria: Clients with T2DM
• who were mentally, visually, and
physically challenged.
• who was critically ill.
• who already had diabetic foot ulcers.
• who had joint pain.
• who had a hearing impairment.
• who were already practising resistant
exercise.
15. DESCRIPTION OF TOOL
Section – A
• Part 1: Demographic variables (9)
• Part 2: Health profile variables (8)
Section – B
• Part 1: A structured questionnaire on
knowledge regarding DM (20)
• Part 2: Treatment compliance statements-
modified WHO adherence to long-term.
therapies and eight items from MMAS (15)
• Part 3: Clinical outcomes-
- Anthropometric measurements: height,
weight, and BMI
- Physiological measurement: BP
- Bio-physiological measurement: FBS
31 August 2021 15
VMCON, PDY. Registration No: 2521910201
18. DATA ANALYSIS
31 August 2021 VMCON, PDY. Registration No: 2521910201
18
Section A Section B Section C
• Numbers,
percentage,
mean and
standard
deviation used to
assess the level
of knowledge,
treatment
compliance, and
clinical
outcomes.
• Paired ‘t’ test was used to determine effectiveness of
nursing interventions on the knowledge, treatment
compliance, BMI, BP, FBS among clients with T2DM in the
EG.
• Repeated ANOVA F test was used to determine the
comparison of the effectiveness of nursing interventions
on the knowledge, treatment compliance, BMI, BP, FBS
among clients with T2DM in the EG between pretest and
posttests.
• Student independent ‘t’ test was used to determine the
comparison of the effectiveness of nursing interventions
on the knowledge, treatment compliance, BMI, BP, FBS
among clients with T2DM in both EG and CG.
• Chi-square test was
applied to ascertain
an association
between the
pretest level of
knowledge,
treatment
compliance, BMI,
BP and FBS among
clients with T2DM
with their
demographic and
health profile in
both EG and CG.
19. RESULTS AND DISCUSSION
Section A: Assess the knowledge, treatment compliance, and clinical outcome of
clients with T2DM.
Table 1: Levels of knowledge among EG and CG in the pretest
N=30+30
31 August 2021 19
VMCON, PDY. Registration No: 2521910201
Knowledge levels EG CG
Adequate knowledge (15-20) 20% 13.3%
Moderately adequate knowledge (8-14) 63.3% 53.4%
Inadequate knowledge (0-7) 16.67% 33.3%
20. Table2: Levels of treatment compliance among EG and CG in the pretest
N=30+30
31 August 2021 VMCON, PDY. Registration No: 2521910201 20
TREATMENT COMPLIANCE LEVEL EG CG
High (11-15) 10% 23.3%
Medium (6-10) 66.7% 63.4%
Low (0-5) 23.3% 13.3%
Hashimoto et al. (2019) conducted a cross-sectional study and found that a medium
level of adherence to medications was associated with high BMI with OR 1.159; 95%
CI 1.034–1.300 and poor diabetes knowledge with OR 0.844; 95% CI 0.741–0.961
(p=0.031).
21. Table 3: Levels of clinical outcomes among EG and CG in the pretest
N=30+30
31 August 2021 VMCON, PDY. Registration No: 2521910201 21
Clinical outcomes EG CG Clinical outcomes EG CG
BMI Under weight 3.3% 6.7% DBP Normal 10% 20%
Normal 70% 66.7% Pre HTN 56.7% 50%
Overweight 26.7% 23.3% Stage I HTN 33.3% 30%
Obese class 1 3.3% 3.3% Stage II HTN - -
SBP Normal 16.7% 23.3% FBS Normal - -
Pre HTN 76.7% 63.4% Pre- diabetes 3.3% 3.3%
Stage I HTN 6.7% 13.3% Diabetes 96.7% 96.7%
Muliyil et al. (2017) investigated compliance to treatment among T2DM receiving care at
peripheral mobile clinics in a rural block of Vellore District, Southern India, and study results
yielded that was a decrease by 0.09% for every 10% greater in compliance.
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TESTS KNOWLEDGE LEVEL TREATMENT COMPLIANCE
EG CG EG CG
Pretest 11.93±3.16 9.87±3.16 7.50±2.45 7.50±2.45
Posttest 2 14.20±1.83 11.33±3.08 9.87±1.55 8.33±1.83
Posttest 3 15.13±1.81 11.97±3.32 11.07±1.05 8.07±1.84
Mamta et al. (2016) conducted a pre-experimental study found that the knowledge
score was high in post-test (13±5.01) in comparison to the score with pre-test
(23.6±4.5). At the level of CI (95%), the difference was found statistically significant.
Section B: Evaluate the effectiveness of IEP and RE on knowledge, treatment compliance,
and clinical outcomes among clients with T2DM between EG and CG.
Table 4: Effectiveness of IEP and RE on knowledge, treatment compliance in the post-test
N=30+30
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TESTS BMI SBP DBP FBS
EG CG EG CG EG CG EG CG
Pretest 23.60±
2.48
23.19±
3.01
124.33±
8.58
122.33±
9.71
82.33±
6.26
81.00±
7.12
217.20±
63.93
214.07±
78.14
Posttest 1
-
123.60±
6.63
121.67±
9.49
81.67±
4.61
81±
4.81
185.67±
62.19
217.47±
76.30
Posttest 2 123.67±
7.18
122.63±
6.83
80.33±
4.90
80.67±
5.21
139.83±
30.63
158.47±
40.62
Posttest 3 23.52±
2.38
23.18±
2.97
122.33±
5.04
123±
6.51
80.33±
3.19
81.33±
6.29
117.30±
14
140.70±
31.46
Mookambika et al. (2016) study results observed that 54% had exercise can control
the disease (p=0.007) and 35.8% had exercise daily, 60% had the management of DM
includes diet, exercise, and drugs.
Table 5: Effectiveness of IEP and RE on clinical outcomes in the posttest
N=30+30
24. Table 6: Effectiveness of IEP and RE with different inferential statistics in the posttest
Repeated
ANOVA-F value
(N=30)
Knowledge-27.799: ***p<0.001
Treatment compliance-50.400,: ***p<0.001
FBS- 38.835: ***p<0.001
Paired ‘t’ test
values
(N=30)
Knowledge- 4.682, 4.157, 5.845, p<0.001
Treatment compliance-6.814, 4.539, 7.944: ***p<0.001
FBS-2.579: *p<0.05, 4.326:***p<0.001, 4.359: ***p<0.001, 8.752:
***p<0.001
Student
independent ‘t’
test
(N=30+30)
Knowledge-2.279:*p<0.05, 4.387: ***p<0.00, 4.588: ***p<0.001
Treatment compliance- 1.039: p=0.303, 3.509: ***p≤0.001, 7.769:
***p≤0.001
FBS- 0.170: p= 0.866, 1.769:p=0.082, 2.006: *p<0.05, 3.722:
***p<0.001
The stated research hypothesis (H1) was accepted.
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25. Section C: Association between pre-test knowledge, treatment compliance, and clinical
outcomes and their selected demographic variables of T2DM between EG and CG.
EG
• There was an association between Pretest Knowledge Level with selected
Demographic Variable such as gender: female, marital status: married, type of
family: nuclear family, source of getting health information: family members
• There was an association b/w pretest Knowledge Level with selected Health Profile
such as no harmful habits
• There was an association b/w pretest Treatment Compliance with selected
Demographic Variables such as age
• There was an association b/w BMI and family monthly income, DBP and marital
status & type of family and FBS and family monthly income
• There was an association b/w BMI and food habits and FBS and food habits, any
harmful habits & any regular medication
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26. Contd…
CG
• There was an association b/w Pretest Treatment Compliance with
selected Health Profile such as use of any complementary and
alternative medicine
• There was an association b/w SBP and age & religion and DBP and
gender
• There was an association b/w BMI and any complementary and
alternative medicine SBP and any co-morbid conditions
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DISCUSSION: Mokabel et al (2017) concluded that there was corroboration of
ameliorated knowledge of routine blood sugar checkups, dietary charts, exercise, and
lifestyle characteristics.
The stated research hypothesis (H2) was accepted.
27. CONCLUSION
• The prevalence of DM is high and it majorly affects the quality of life. Timely diagnosis
using clinical criteria and effective intervention is of utmost importance.
• The purpose of this study was to assess the effectiveness of nursing interventions on
treatment compliance and clinical outcomes among clients with T2DM in a selected
hospital at Puducherry.
• The data revealed that the nursing interventions- IEP and demonstration of RE had
produced positive impact and found to be effective in improving the level of
knowledge and treatment compliance and clinical outcomes such as control blood
sugar and normal BP and BMI in the EG and less effectiveness was seen in BMI and BP.
• The study concluded that providing educative program will improve the knowledge of
both caregiver and the clients and also following a routine RE regularly at home also
will help in controlling the blood sugar levels, BP and ideal body weight and increase
the muscle strength as well.
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VMCON, PDY. Registration No: 2521910201
28. RECOMMENDATIONS
• Diabetic education should be given periodically and a diary can
be maintained for ensuring client participations in health
education programme related to diabetes mellitus.
• Diabetes mellitus self-management education material tailored
to the educational level of clients should be available in the
clinics.
• Diabetes mellitus self-management education should be made
mandatory in hospitals.
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VMCON, PDY. Registration No: 2521910201
29. IMPLICATIONS OF THE STUDY
Nursing Education
• Nursing education need to be strengthened to enable nursing students to know
about current knowledge on diabetes mellitus and utilize evidence based findings
(RE enhance good clinical outcomes), to promote treatment compliance among
clients with T2DM.
• Nursing curriculum should provide clinical experience regarding conduction of IEP in
various settings.
Nursing Practice
• Nurses play an important role in promotive, curative and preventive aspects of
health care system. Nurses should render IEP for T2DM clients in the hospital and
community.
• The nurses working in the hospital can provide health education and they can
conduct planned teaching apart from incidental teaching.
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VMCON, PDY. Registration No: 2521910201
30. IMPLICATIONS OF THE STUDY contd:-
Nursing Administration
• The nurse administrators in the hospital can develop guidelines for conducting IEP for type 2 diabetes
mellitus clients and encourage practice of the guidelines by nurses in the hospital to improve the
compliance among clients with T2DM.
• Continuous quality assessment can be done by the hospital on the quality of health education
provided to the patients.
Nursing Research
• The findings of the study serve as a basis for the nursing professional and the students to conduct
further studies in different aspects of T2DM treatment like compliance, diet, exercise, foot-care, eye
care and self-administration of insulin.
• Knowledge, attitude and practice study on prevention of diabetes mellitus complications can be
done.
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VMCON, PDY. Registration No: 2521910201
31. LIMITATIONS
The study was limited to 60 clients-30 in the CG and 30 in the EG with
T2DM aged between 40 and 70 years admitted in AVMC&H, Puducherry.
The period of study was limited to 6 weeks of study duration.
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32. REFERENCE
Book references-11
• Black, J.M., & Hawks, J.H. (2012). Medical-Surgical Nursing: clinical management for
positive outcomes. (8th ed., vol 1., pp.1063-65). Elsevier.
• Hinkle, J.L., & Cheever, K.H. (2017). Brunner & Suddarth’s textbook of medical surgical
nursing. (13th ed., vol 2., pp.1417-60). Wolters Kluwer.
• Park, K. (2017). Park’s textbook of preventive and social medicine. (24th ed., pp. 417).
Bhanot.
• Polit., & Beck. (2018). Nursing Research. (10th ed., pp. 120-121). Wolters Kluwer.
Journal articles- 36
Web references-12
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