Background
Type 2 diabetes is a dangerous but treatable disease that manifests as high blood sugar, low insulin, and general insulin resistance. It results from living habits rather than any form of a pathogen, and people can develop it spontaneously as long as they are in a risk group. It generally does not require hospitalization unless the issue is severe, and most patients continue their daily lives. However, its symptoms are not immediately apparent to an untrained observer and can come on slowly, preventing the person from noticing. People can be trained in noticing and measuring their symptoms, but they remain fallible and can fail to see a potential cause for alarm. As such, medical workers are trying to develop more reliable and efficient methods of monitoring patients with the condition.
Problem Statement
Most patients with diabetes live their lives with some specific accommodations that manage the condition, such as lifestyle and diet changes alongside specific medications. However, their symptoms require monitoring, and professionals are preferable to the patients for the purpose. Currently, this matter is being resolved through regular clinic visits, with specialists receiving the patients and assessing their condition. However, the procedure takes considerable time and effort on the part of both medical workers and patients. The former have to take time away from their other patients, and the latter have to travel to the clinic and wait to be assessed. With the recent advancements in technology, such an inefficient approach may be outdated and require a replacement.
Purpose of the Change Proposal
Telemedicine is emerging as an alternative approach to the monitoring of remote patients whose issues do not warrant hospitalization. It can take a variety of forms, from regular videoconferences that confirm the patient’s condition to specialized medical tools that link with a smartphone app and submit data to the hospital automatically. Its primary advantage is that the patient no longer needs to come to the clinic physically, which is particularly relevant for seniors. The patients can also be more independent, with the medical workers supporting their judgment with their expertise. Telemedicine has already been successfully applied to various aspects of type 2 diabetes management. As such, it may be prudent to adopt it as a standard and outfit care institutions with telemedicine facilities to improve outcomes.
PICOT
Geriatric patients who have type 2 diabetes are the population for this proposal. The use of telemedicine to monitor symptoms is the intervention, and it is compared to the standard practice of regular clinic visits. The expected outcome is a decrease in the concomitant effects of the condition as a result of continuous monitoring. The time is 12 months, which should be sufficient to see a significant change without taking overly long. With these aspects outlined, it is possible to create the following PICOT question:
In geriatric patients who have type 2 diabetes (P), will the implementation of telemedicine to communicate cares and concerns and conduct continuous symptom monitoring (I) instead of traditional regular clinic visits (C) reveal a reduction in the concomitant effects of the condition (O) over a 12-month period (T)?
Literature Search Strategy Employed
The author searched several platforms that host peer-reviewed scholarly nursing literature: Google Scholar, JSTOR, and NCBI PubMed. The process focused on the keywords ‘type 2 diabetes,’ ‘symptoms,’ and ‘telemedicine.’ Only articles that had been published in the last five years were eligible due to the requirement for relevance. Overall, the search yielded approximately 3,000 articles, not all of which applied to the purpose of this proposal. Some were rejected because they did not discuss the relevant topic but mentioned it. Most were omitted due to time concerns, as this proposal only needed several supporting works and was not intended as a literature review. Ultimately, three articles that discuss the advantages of telemedicine and its applicability to various symptom categories passed the inspection.
Evaluation of the Literature
The three articles selected for this paper discuss various aspects of telemedicine and their relevance to the ultimate choice of one approach or the other. Rasmussen, Lauszus, Lokke, and Jensen (2017) claim that the new method is more cost-effective than clinic visits and yields better results, particularly with regards to blood glucose. Fox, Kronenberg, and Weiskopf (2019) highlight the relationship between diabetes and preventable blindness and propose a telemedicine strategy to screen patients for the issue. Finally, Huang, Tao, Meng, and Jing (2015) show a significant improvement in patient glycemic control as a result of telemedicine usage. Overall, the literature appears to promote the view that the new method can improve the quality of current diabetes care and create opportunities for new treatments that enhance patient quality of life further.
Applicable Nursing Theory Utilized
Martha E. Rogers’s Theory of Unitary Human Beings is the most applicable for this proposal, as it discusses both scientific progress and the application of the findings in ways that help patients. Past findings have demonstrated that telemedicine is appropriate to nursing as a whole, helping medical workers manage various conditions. Now, nurses should use the art of nursing to find creative applications of the approach that help diabetes patients improve their well-being. As the literature review demonstrates, it is possible to use telemedicine to address various aspects of the condition and prevent side complications. Medical workers should work on ways to further enhance health by using the new tool at their disposal for various purposes and choosing the best ideas for implementation.
Proposed Implementation Plan
The implementation will consist of three separate parts: planning, purchase and installation, and training. First, the nursing staff will determine the specific devices and software they will use for telemedicine and outline the requirements. Second, the facility will purchase the necessary equipment, construct a telemedicine room, and configure it so that it becomes operable. Third, the staff will be trained in the operation of the telemedicine equipment and in teaching seniors how to use the tools to communicate. The three steps will have to happen successively because a plan is necessary before purchase and because the room will be required for practical staff training.
Potential Barriers and Answers
Some seniors may not be able to afford the equipment required for successful telemedicine usage. The nursing staff should find inexpensive devices that have the required functions and are easy to use. They can then suggest these options to the people in question as cheaper alternatives that still have the benefits. Additionally, seniors may not be receptive to the new technology and its usage, especially if the method chosen requires their active participation. They will require extensive explanations and reminders before they get used to the regular communication or other monitoring methods used.
References
Fox, C. R., Kronenberg, K., & Weiskopf, E. S. (2019). Using telemedicine to increasing eye care screening & referral for people with diabetes.Journal of Public Health Issues and Practices, 3. Web.
Huang, Z., Tao, H., Meng, Q., & Jing, L. (2015). Effects of telecare intervention on glycemic control in type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. European Journal of Endocrinology, 172(3), R93-R101.
Rasmussen, O. W., Lauszus, F. F., Lokke, M., & Jensen, M. S. (2017). Telemedicine is cost effective compared with standard care in type 2 diabetes mellitus – A randomized trial with an economic analysis in an outpatient clinic.Biotechnology Health Science, 4(2). Web.