Nurse-sensitive indicators and outcomes
According to Myers et al. (2018), nurse-sensitive indicators are indicators that reflect the measures and dictate the structure, processes, and outcomes of quality nursing care. These guidelines are considered paramount in facilitating the quality of care and influence health. The nursing practice has evolved into one that focuses on improving standards of care that nurses offer their patients. Nurses need to master the guidelines and aspects of nurse-sensitive indicators as they give an insight for assessing quality patient care. Nurse-sensitive indicators are essential in healthcare and, importantly, when handling diabetes patients as they are utilized in reviewing patient outcomes to evaluate their care and satisfaction.
Diabetes
Diabetes mellitus, commonly referred to as diabetes, consists of a high public health problem associated with high morbidity and mortality in the United States. There are two types of the disease: type I and type II diabetes, although the latter is the most common. According to Wu et al. (2016), approximately ninety percent of diabetic disease cases are type II diabetes. The disease has been ranked among the top causes of death for several years and is also the leading cause of kidney failure and vision loss for individuals below age 65.
The incidence of diabetes rises dramatically with age. Diabetes is characterized by impaired metabolism of carbohydrates, proteins, and fats caused by inadequate or inefficient insulin action. Type II diabetes is signified by insulin resistance, where cells have a lower sensitivity to insulin, a relative insulin deficiency, or both. Type II diabetes generally develops in adulthood, and it leads to obesity in most patients.
The World Health Organization approximates that the global number of diabetes patients will escalate to 333 million in 2025 from 135 million in 1995. This substantial increase is expected to occur in the modernized and non-modernized countries. It is attributed to a shift in life, including a sedentary lifestyle, stress, and unhealthy dietary habits.
Diabetes requires long-term care, as it causes drastic changes in each patient’s physical and psychosocial factors. Management concentrates on keeping the escalating blood sugar levels as close to normal as possible without triggering hypoglycemia. Management could be through good nutrition, frequent exercise to maintain average body weight, and appropriate medication. Knowledge of the disease and active participation in the treatment process is crucial for persons with diabetes. The severity of diabetes complications is lesser for people with adequately managed sugar levels.
During recent years, diabetic
has been identified as a nurse-sensitive indicator for diabetes, which entails self-management of the disease. This indicator is a structural one as it represents the patient’s characteristics that influence the person’s ability to manage their health status. Interestingly, it has been identified that the management of the disease is more connected to lifestyle. Thus, education that necessitates the adaption of a healthy lifestyle and instills the belief that patients are the main managers of their condition has been important in clinical practice.
Moreover, educated patients are a contributing factor to the outcome of the disease. Patients will be able to improve metabolic control through knowledge, such as personal monitoring of blood or urine glucose content, observe the nutritional diet, and efficient medicine administration. Also, the patient can easily prevent manageable complications, including vascular complications, which will help develop a positive attitude towards the disease. Finally, diabetic education will help foster the clinical-patient relationship, a quality plan of care that comprises follow-ups.
The plan of care for diabetic education involves delivering educational interventions by a single educator. It should be conducted in less than ten months, with above 12 hours consisting of 6-10 sessions for better results. However, group-based approaches are encouraged as they translate to clinical improvement, changed lifestyles, and psychosocial outcomes.
An evaluation of educational outcomes should be conducted. The need for this evaluation is to enable professionals to identify sections where gaps in the education process hinder effective management of the disease, including the inability to detect signs and symptoms of vascular complication. Diabetes patients who conduct follow-ups and have discussions of treatment and management plans with clinical professionals tend to have healthier outcomes than those who do not. Consequently, diabetes exerts psychological distress that can pose as a hindrance to the personal management of diabetes. Therefore, psychological support and professional counseling should be included in the education program.
The effectiveness of education calls for regular follow-ups after completing the program because patients’ needs may change with time, and new ones may arise. Hence, regular attendance for educational reinforcement should be incorporated in the plan of care, including a review of self-management for emphasis. An introduction to new areas such as different diabetes complications and alternative ways of managing them is also vital.
Proper education and efficient drawing of the patient plan of care by well-experienced educators instill a sense of confidence in the patients on managing the disease and the hope of positive and healthy outcomes.
Conclusion
The huge impact of diabetes mellitus on a patient has contributed to why this disease is considered a major global concern. Nurse-sensitive indicators have helped healthcare facilities to understand the relationship between nursing care provided by professionals at the facility and the patient outcomes. Education, a structural indicator for diabetes care, has proven beneficial for both the patients and attending nurses. The indicator gives a comprehensive guide to nurses on making clinical judgments on the diseases and the self-management aspect to patients, leading to healthy outcomes.
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