The role of nurses in diabetes care can be an expert or a part of ordinary care-primary or secondary care. No matter where nursing is carried out, the focus is always on the patient's self-management.
Nurses can not only play the role of experts in diabetes care, but also undertake only part of the nursing work. No matter what kind of nursing place, patients' self-care should be emphasized.
Self-care is the key to diabetes management. Self-care should be resumed as soon as possible. However, when diabetics do need help, it needs to come from knowledgeable health professionals.
Self-care is the key to deal with diabetes, and the earlier you start, the better. However, when diabetics really need help, it must be provided by knowledgeable professional health experts.
Traditionally, diabetes education in Britain has been undertaken by diabetes specialist nurses, who also assume other clinical, management and research roles. Some teaching is conducted on a one-to-one basis, but health professionals have realized that diabetics can learn a lot from each other, so it has become normal to invite partners and family members to participate in group education. It is important to invite people who buy and cook family food to attend educational courses. This may be a family member, but it may also be a domestic helper or a nursing staff in a nursing home.
Traditionally, diabetes education in Britain is undertaken by nursing practitioners, who are diabetes experts and also undertake other clinical, therapeutic and research work. Some education is conducted in a one-on-one way, but health professionals gradually realize that diabetics can also learn a lot from each other. Therefore, group education has become a standard, and peers or family members can also be invited to participate. It is also important to invite home food buyers and chefs to join the education. He may be a family member, a domestic worker or a nursing home attendant.
With the increasing number of people suffering from diabetes in the community, nurse interns and district nurses have taken on the tasks of former diabetes care experts. Therefore, they will participate in planning and providing diabetes education for patients. Today, many diabetics, especially type 2 diabetics, have never seen a diabetes care expert, because these nurses are often from hospitals.
With the increase in the number of diabetic patients in the community, nurses in practice nursing and other areas have taken on many tasks that were done by diabetes nursing experts in the past. Therefore, they will also participate in the planning and implementation of diabetes education. Today, many diabetic patients, especially type 2 diabetic patients, can't see these nursing experts because they all work in hospitals.
Today's technology has led to many changes in the way people get health advice. Using telephone or internet is a common way to get health information now. Therefore, more and more people come to health experts with useful (and sometimes confusing) information, which they obtained from these sources, or may be obtained from radio, television and friends. Birmingham is trying to provide interactive health consultation through digital TV, and some health promotion organizations have touch screen programs and interactive cd-rom.
With the development of science and technology, great changes have taken place in people's health consultation methods. Telephone or Internet has become a common means to obtain health information. Therefore, more and more people turn to health professionals who have useful (and sometimes confusing) information, which comes from the above channels or from radio, television and friends. Birmingham is trying to hold digital TV interactive health consultation programs, and some health promotion organizations have been exposed to these screen programs and interactive CDs.
This increase in patient choice should be welcomed. This may mean that the role of nurses will change. They are no longer the first information providers, but other important roles will develop. These will include explaining what this information means to individuals and their friends and relatives, and creating a forum to discuss how to put the suggestions into action.
This provides patients with more choices and should be welcomed. This may mean that the role of nurses will change, they are no longer the first to provide information, and new important roles will appear, including explaining the meaning of information to individuals and their relatives and friends, and establishing forums to discuss how to implement suggestions.
Nurses who care for diabetic patients need to work towards the same goal, so setting goals and determining the priority of managing their illness are important aspects of nursing. From the experiment of diabetes control and complications (DCCT, 1993) and united kingdom prospective diabetes study group (UKPDS, 1998), it is possible to prevent complications of diabetes, and if complications occur, it can slow down the deterioration process. Therefore, it is very important to maintain good blood sugar control.
Nurses who care for diabetic patients must have the same work goals. Therefore, setting goals and determining the priority of diseases have become important factors in nursing. Studies have shown that complications of diabetes can be prevented. If complications occur, the deterioration process can also be slowed down. The key is to control blood sugar.
The target of glycosylated hemoglobin (HBA 1 c) in patients with1type diabetes is 7.5%( 1 type), and it is lower than 7% in patients with type 2 diabetes. As we all know, blood pressure is a factor of diabetic complications. For 1 type and type 2 diabetes, blood pressure should be lower than 140/ 80mmHg, and the lower the better, but you will not feel the symptoms of hypotension, such as dizziness. Total cholesterol should be less than 5 mmol/L, HDL should be greater than 1.0, and LDL should be less than 3. If complications occur, these goals may be set more tightly to prevent them from worsening. Patients need to know the recommended level of these tests so that they can ask about the survey results and understand the information given to them. In this way, they will be able to see whether they need more treatment and whether they need to change their lifestyle and food choices.
The target of glycosylated hemoglobin is 7.5% for patients with type I diabetes, and less than 7% for patients with type II diabetes. Blood pressure is a factor leading to diabetic complications. The blood pressure of both types of diabetes should be lower than 140/80mmHg, and the lower the better. Of course, it is best not to have symptoms of hypotension, such as dizziness. Total cholesterol should be lower than 5mmol/L, HDL should be higher than 1.0 and LDL should be lower than 3. If there are complications, we should set goals more carefully to prevent deterioration. Patients should know the recommended values of these tests in order to ask about the test results and understand the meaning of the information. In this way, they can know for themselves whether they need more treatment and whether they need to change their lifestyle and diet.
Complication screening
Routine screening of diabetic complications is usually the responsibility of nurses. This will include urine protein test, as an examination of renal function, blood drawing for blood lipid evaluation, blood pressure measurement, and eye and foot examination.
The routine screening of diabetes is usually the responsibility of nurses, including proteinuria examination of renal function, blood lipid examination, blood pressure examination and eye and foot examination.
Screening for retinopathy: This is done through ophthalmoscope or retinography when pupils are dilated. The nurse's role is to explain what will happen during the operation and what the test results mean. Nurses can also measure their eyesight. Some patients may need laser photocoagulation. Similarly, nurses should be able to provide information and comfort.
Screening for retinopathy: ophthalmoscopy or retinoscopy to dilate pupils. The nurse's role is to explain what will happen during the operation and the significance of the test results. Nurses can also check their eyesight. Some patients may need laser coagulation, so nurses should be able to provide information and comfort patients.
Neuropathy screening: Patients with normal circulation, gait and vision have a lower risk of neuropathy. These patients should be given advice on foot hygiene and wearing suitable shoes. When patients can't feel their feet and their circulation is damaged by peripheral vascular diseases, the risk of neuropathy will increase greatly. It is necessary to advise these patients not to rely on the feeling of their feet, but to observe them every day to check whether there is any injury and seek help immediately if there is a problem. If you have vision problems, it may need someone else to do it. Putting a mirror on the floor is helpful for self-examination.
Neuropathy screening: Patients with normal circulation, gait and vision have low risk of neuropathy. Suggestions on foot hygiene should be made to patients and suitable shoes should be provided. When patients have no sensation in their feet and peripheral vascular diseases lead to circulatory disorders, the risk of neuropathy is greatly increased. It is necessary to advise these patients not to rely on foot sensation, but to check whether their feet are damaged every day and seek help immediately if there is any problem. If you have poor eyesight, you need help from others. Putting a mirror on the floor is also helpful for self-examination.
Temperature sense of patients with neuropathy will be weakened, so they must be advised not to use hot water bottles, and be careful when walking into the bathroom or sitting near a heat source.
The temperature perception of patients with neuropathy has decreased, so they must be advised not to use hot water bottles and to be careful when stepping into the bathtub or sitting next to a heat source.
Neuropathy was evaluated by examining the foot pulse (dorsum of foot and posterior tibia). If it cannot be reached, it may need to be referred for vascular evaluation and treatment. Using hand-held Doppler to evaluate is helpful to detect whether there is peripheral vascular insufficiency. Patients with decreased or disappeared foot pulse should be informed that this puts their feet in danger and they should take extra precautions to protect their feet. This may mean seeking the care of a podiatrist, wearing special shoes with suitable insoles, checking their feet every day, and taking action on any abnormalities found.
Neuropathy can be evaluated by examining the pulse of the arteries of the foot (instep and posterior tibia). If the pulse is not felt, vascular evaluation and treatment should be arranged. Portable Doppler instrument is helpful to find out whether the peripheral blood vessels are short of blood supply. If the pulse of the foot artery is reduced or inaccessible, inform him that his foot is in danger, and he should pay extra attention to protecting his foot. This may mean seeking the care of a podiatrist, choosing suitable insole shoes, checking your feet every day, and taking measures against any abnormalities found.
Loss or weakening of vibration sensation is the first sign of neuropathy. This is measured with a tuning fork. If the sense of vibration is missing or weakened, there is a risk of foot injury.
The disappearance or weakening of vibration sensation is the first sign of neuropathy. You can check it with a tuning fork. If the vibration is missing or weakened, there is a risk of foot injury.
In order to prevent amputation of patients with peripheral diseases, it is very important to ensure early referral to vascular surgeons. Early recommendation of special shoes to orthopedic surgeons can prevent amputation of neuropathy foot.
In order to prevent amputation of patients with peripheral diseases, it is important to ensure that vascular surgeons are arranged as soon as possible. Arranging orthopedic braces to make specific shoes as soon as possible can prevent the amputation of neurotic feet.
Nutritional advice: For anyone, the usual advice for a healthy diet is to eat at least five kinds of fruits and vegetables every day; Limit alcohol intake to less than three units per day for women and less than four units per day for men, and limit salt intake. If an individual is overweight, calorie restriction is very important, and suggestions should be given to reduce fat in general and increase monosaturated fat and polyunsaturated fat accordingly. If the cholesterol level is higher than the target, it should be referred to a general practitioner, and may be treated with statins.
Nutritional advice: For anyone, the usual healthy eating advice is: at least five pieces of fruit and vegetables a day; Reduce alcohol by less than three units per day for women and four units for men; Salt restriction; If patients are obese, they should limit their calorie intake and eat less salt and fat, but increase monosaturated fat and polyunsaturated fat in an appropriate proportion. If cholesterol is higher than this index, general practitioners should be arranged to treat it with inhibin.
Patients who have difficulty in achieving their nutritional goals should have the opportunity to see a dietitian (preferably a diabetes specialist dietitian).
Patients who are difficult to meet the nutritional indicators should have the opportunity to see a dietitian (preferably a diabetes specialist dietitian).
conclusion
When screening complications and running diabetes clinics, nurses need to be aware that psychological and social problems will affect how patients view their diabetes and whether they may change their lifestyle.
When conducting diabetes screening and diabetes clinic, nurses should know that mental and social factors have great influence on patients' views on their own diabetes and how to change their lifestyle.
The role of diabetics is to be active decision makers, and the role of nurses is to provide information, guidance and support. The nurse will assess the risk so as to take appropriate intervention measures at the right time. In addition, nurses should regard each annual review or screening as an opportunity to understand the information held by patients and fill in any gaps through educational materials. Exploring why patients may feel unable to change their lifestyle and receive suggested treatment may help nurses suggest actions that these patients may follow.
Diabetic patients should be active decision makers, while nurses are providers of information, guidance and support. Nurses can take appropriate measures at the right time by evaluating risks. Moreover, nurses should take each annual examination or screening as a good opportunity to find out what information patients have and make up for the deficiencies. Exploring why patients feel unable to change their lifestyle and understand the suggested treatment will help nurses to provide such patients with action suggestions they are willing to accept.