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"The body of knowledge that serves as the rationale for nursing practice determines the areas of specialty to develop as well as the manner in which that knowledge is organized, tested and applied." -Carper, 1978
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Diabetes
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Risk Reduction
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| Best Practice:Homecare patients with diabetes should be taught to prevent, recognize and manage acute and chronic complications of diabetes. |
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Clinicians should teach patients about foot care and inspect feet on each visit.
Homecare patients with diabetes should receive annual screening for peripheral anesthesia or pain, erectile dysfunction and gastrointestinal disturbances. Comprehensive foot examinations to screen for peripheral neuropathy should be preformed at least annually and should include assessment of protective sensation, foot structure and biomechanics, vascular status, and skin integrity.
Homecare patients with diabetes should receive a dilated eye examination by an ophthalmologist or optometrist, and screening for renal function (e.g. urine microalbumin, serum creatinine level), and serum lipid levels at least annually.
Homecare patients with diabetes should have an assessment at the time of admission of their immunization status including influenza, pneumococcal pneumonia and tetanus. If vaccination need is identified, refer for consideration of immunization or obtain medical order and administer the appropriate vaccine.
Homecare patients with diabetes should receive education and encouragement to devise a plan for their medications and diabetes supplies in case of emergency, including accidents and natural disasters.
Homecare patients with diabetes who smoke should receive strong encouragement for smoking cessation at each visit.
Unless contraindicated, homecare patients with diabetes over age 30 should be taking an enteric-coated aspirin (80-325 mg per day) for cardiovascular risk reduction.
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| Assess
(4 documents) |
| This area is inclusive of not only all body functions but habits and lifestyle issues.
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| Plan
(2 documents) |
| The plan of care should include measurable specific patient goals that are realistic and attainable. Buy-in is imperative, also culture, ethnicity, tradition and individual preferences and economic circumstances need to be considered as part of the plan. |
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| Implement
(49 documents) |
| Lifestyle changes needed to manage the illness are exceedingly hard, and one needs to think about moving pebbles in order to move mountains, rather than trying to move mountains themselves. |
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| Evaluate
(2 documents) |
| As in all areas of care progress needs to be continually updated by assessing measurable outcomes. Goals and intervention may need to be revised to achieve desired health outcomes. |
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Risk Reduction
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