Lecture #6 - Db

Question 1

Definition of complex diabetic patients?

+ Eg?

Answer 1

Definition: With related complications, with 1 or more risk factors that can potentially impede self-management and who is not reaching targets (A1c, BP, LDL).
Eg: Children, type 1, women who require pre-conception counselling, pregnancy and pt with db type 2 with related complications who are not reaching targets.

Question 2

Describe the elements of evidence-informed nursing care for Db pts?

Answer 2

HCP job is toward Self-management support.

Question 3

Describe the elements of optimal organization of care for complex Db pts?

Answer 3

Chronic care model and expanded chronic care model

Question 4

Self-Management Education vs Support?

Answer 4

Ed: Interventions to improve pt self-monitoring and decision making
Support: Motivational approach and help in problem-solving/goal-setting.

Question 5

Biggest issue in adherence to care?

Answer 5

Lack of perceived value of self-management.

Question 6

Polonski collaborative partnership 5 step approach?

Answer 6

1. Make non-visible visible
2. Power to pt
3. Reframe perceptions
4. Address negative self-blame issues
5. Provide info and address concerns.

Question 7

Discharge planning?

Answer 7

1. Start insuline one day before discharge
2. pt/caregivers receive oral/written instructions
3. Identify resources in the community

Question 8

Motivational interviewing principles?

Answer 8

Open questions
Ask/provide/ask approach
Affirm pt questions and progress
summarize

Question 9

SBN: Approach for developing strengths?

Answer 9

Turn potential into strengths
Turn deficit into strength
Minimize weakness