Evidence-Based Healthcare Assessment Sample

Introduction Of Evidence-Based Healthcare Assessment

Diabetes is a significant problem in the healthcare sector worldwide, which can generate adverse comorbid symptoms in individuals and can deteriorate the health conditions of those individuals. Type 2 diabetes is a factor of concern on a global aspect. In the United Kingdom, 7% of the entire population suffers from diabetes, among which nearly one million individuals have undiagnosed type 2 diabetes. More than 3000 children in the United Kingdom are diagnosed with type 2 diabetes every year. Nearly about 4.7 million individuals in the United Kingdom have diabetes. Among them, every one in ten individuals over 40 years is diagnosed with type 2 diabetes (Diabetes.org, 2022). As per statistical analysis, the number of diabetic patients will reach 5.5 million by the end of 2030 in the UK (Centers for Disease Control and Prevention, 2022). Thus, diabetes has turned into a concerning problem in the United Kingdom. In terms of diminishing the frequency of diabetes in the United Kingdom, nurses play an important role in generating awareness to ensure prompt treatment and diagnosis. Nursing practices dedicated to diabetes in the healthcare sector of the United Kingdom can ensure healthy lifestyle patterns for the entire population with proper lifestyle advice and dietary advice. Thus, effective nursing practice in the healthcare sector has the potential to downgrade the exponential rate of diabetic patients in the United Kingdom.

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In this research a specific study has been selected named “A digital lifestyle behaviour change

intervention for the prevention of type 2 diabetes: a qualitative study exploring intuitive engagement with real-time glucose and physical activity feedback” (Whelan et al. 2021). This research has conducted with the help of semi-structured interview of 26 participants (61.5% female, 56.6 years) who are at the moderate or high risk of type 2 diabetes mellitus. After participants participated in an intervention involving the use of a fitness tracker (Fitbit Charge 2) and a flash glucose monitor (Freestyle Libre), interviews were conducted (Whelan et al. 2021). Purposive inspecting guaranteed portrayal of ages, sexual orientations and gathering designations.

The essay is effective in understanding the importance of nursing care in type 2 diabetes mellitus and the primary research is beneficial to gather knowledge about the healthcare issues properly. The interview of participants is helpful to collect information about the diseases and the process of nursing care can be known to improve treatment factors. Importance of nursing care for different age group is required for treatment process maintenance and this detailed knowledge is effective for understanding the impact of nursing care on young adult, adult, or old age people.

Severity of diabetes in UK

Diabetes mellitus is a global concern in the healthcare sector due to its exponential growth rate in children, young adults and adults. Nearly about 4.7 million individuals in the United Kingdom have diabetes. Among those individuals, 90% of individuals suffer from type 2 diabetes, whereas 8% of them suffer from type 1 diabetes. Again, 2% of the entire population, suffering from diabetes, suffers from rarer types of diabetes. As per the statistical analysis, approximately 850,000 individuals in the United Kingdom are suffering from type 2 diabetes, but have not been diagnosed yet (Diabetes.org, 2022).

Lack of physical activities and an unhealthy diet leads to enhanced levels of diabetes among individuals in the United Kingdom. In the United Kingdom, 7% of the entire population suffers from diabetes, among which nearly one million individuals have undiagnosed type 2 diabetes. As per statistical analysis, the number of diabetic patients will reach approximately 5.5 million by the end of 2030 in the UK (Diabetes.org, 2022). According to Sinclair et al. (2020), The severity of diabetes is in such a condition that one out of ten residents of the UK, over 40 years, suffers from type 2 diabetes. In 2021, approximately 140,775 individuals died due to type 2 diabetes, which indicates a 1.7% of the mortality rate in the entire population of the UK below 60 years.

Nursing care in UK

Nursing care is the fundamental pillar of the Healthcare sector. In terms of diminishing the frequency of diabetic patients in the healthcare sector of the United Kingdom, potential nursing care has been implemented that can be easily aligned with daily routine. Nursing care has been designed in such a manner that it can promote healthy lifestyle patterns with a healthy diet plan. Type 2 diabetes can lead to potential adverse complications, such as kidney diseases, limb amputation, stroke, heart attack, etc. Thus, according to Li et al. (2018), nurses act as vital support to diabetic patients. The National Health Service (NHS) has spent over 10 billion euros in 2021 for diabetes management in the United Kingdom. Thus, nursing care has been strengthened for supporting diabetic patients.

Optimal care and skills are provided by trained nurses in the healthcare sector of the UK to manage adversities related to type 2 diabetes. Nursing care acts as a mitigation strategy to overcome diabetes. Nursing care dedicated to diabetes in the United Kingdom is certified by the European Accreditation Council for Continuing Medical Education (EACMME). Nursing care acts as the key component for recognising and mitigating the growing impact of diabetes. Besides, proper medication and management of diet and lifestyle are required for type 1 diabetes, which can be incorporated into the nursing care for diabetic patients.

Main Body

Factors Affecting the Quality of evidence informing decision-making in healthcare practice

Nursing practice is the fundamental pillar associated with generating awareness against diseases in a population. Diabetes is a burning problem in the entire population in the United Kingdom. Currently, nearly 7% of the entire population in the United Kingdom suffers from diabetes. Besides, the number of diabetic patients only in the United Kingdom can reach 5.5 million by 2030. According to Alhaik et al. (2019), Implementation of proper and effective nursing practice can cure diabetes, which effectively can diminish the frequency of diabetic patients in the United Kingdom. Nursing practices associated with diabetes has a major responsibility to ensure healthy lifestyle pattern and dietary practice among individuals.

The prime nursing practice is associated with generating awareness in diabetic patients regarding risk factors associated with diabetes. As the risk factors are elaborated to the patients, there is a high probability of adopting healthy lifestyle patterns and healthy dietary practices in the first place. Thus, generating awareness is one of the major nursing practices in terms of curing diabetes. Besides, a vast knowledge regarding diabetes and its clinical significance has to be provided to the patients for generating awareness related to the disease.

The patients can be involved in regular exercise in terms of keeping up healthy practices. There is a direct connection between obesity and type 2 diabetes. Thus, according to Whelan et al. (2021), shifting from a sedentary lifestyle can be effective for curing adverse effects associated with type 2 diabetes. Besides, nursing practice can implement healthy food habits in diabetic patients for reducing blood sugar levels. Nurses encourage individuals to consume food with low carbohydrates and low lipid content in terms of ensuring healthy dietary patterns. Trained nurses push diabetic patients towards a healthy lifestyle pattern while restricting junk foods and incorporating exercise.

As the number of diabetic patients is increasing day by day, there is a huge number of borderline patients, who will turn eventually into diabetic patients, and a massive number of individuals have not been diagnosed yet. Thus, according to Sinclair et al. (2020), nursing care in the UK targets to provide counselling and education to those individuals at the borderline to generate awareness among them (Whelan et al. 2021). Besides, smoking has a direct relationship with the emergence of diabetes. Thus, nursing care forces the diabetic patients and individuals on the borderline to quit smoking. Strategies regarding smoking cessation can be developed by the nurses and can be implemented in the care plan to generate awareness among individuals.

Nursing care is directly involved with the management of adverse medical conditions of the patients at critical stages of diabetes. Proper management strategies can eventually diminish the severity of diabetes in an individual. Besides, blood glucose monitoring at regular intervals is an essential strategy to keep diabetes under control. People suffering from type 1 diabetes suffer from a lack of insulin for metabolising carbohydrates in the body. Thus, proper insulin administration and proper diet chart design can be implemented in nursing practices in terms of curing type 1 diabetes. In general, trained nurses act as front liners in terms of curing diabetes in the population of the United Kingdom.

Evidence-based to nursing care across the lifespan

Diabetes in the UK has increased in the past few years, and the government is concerned about the increased rate of Diabetes in the country. The government has provided guidelines for the management and treatment of Diabetic patients. The nursing guidelines provided by the government of the UK are followed in every hospital and clinical care setting. Nursing care for diabetic patients revolves around the incorporation of healthy lifestyle patterns for diabetic patients. The nursing guidelines are provided for both types of diabetes, such as type I and type II. There are nursing courses and special programmes for nurses to become Diabetes specialists. Almost all hospitals in the UK have at least two Diabetes specialist nurses.

Diabetes Specialist Nurses (DSN) are specialists in providing efficient patient care and self-management plans. Generally, a DSN is the first person assigned to a patient with Diabetes and high risks of associated symptoms. A programme of nursing called “TREND-UK” provides knowledge and training to the nurses for the special management of patients with Diabetes (Awuchi et al. 2020). Competencies related to the nursing of diabetic patients, diabetic guidelines and podiatry are taught in this course. The training is provided for care in the clinical, hospital and home settings.

The roles and responsibilities according to the Diabetic healthcare guidelines of the UK for the nurses and nursing team include- “prevention and control advice with the help of behavioural changes and health coaching techniques, screening, prevention and early detection of type 2 diabetes, promotion of self-care, promotion of mental health care, urine and blood glucose monitoring, oral and injectable therapies and identification of cases of hyperglycemia and hypoglycaemia”. Type I diabetes cannot be prevented, but nursing guidelines can effectively prevent the development of complications by the continuous and regular monitoring and assessment of blood glucose levels (Whelan et al. 2021). NICE guidelines provide a plan for the care and health management of Type I Diabetic people. This includes “advice on diagnosis, education and support, blood glucose management, cardiovascular risk, and identifying and managing long-term complications” (Whelan et al. 2021).

The NICE guidelines involve recommendations on the “diagnosis and early plan care provided by the nurses, dietary plans and management, blood glucose management, insulin delivery and therapy, awareness for hypoglycemia, knowledge about diabetic ketoacidosis, management of complications and cardiovascular risks” (Eizirik et al. 2020).

Diabetes is also prevalent in Adults, and medical conditions that are increasingly common in middle age population are “diabetes and cardiac disease”. According to a study, between “0.2–2% of Adults in the UK have pre-existing diabetes”. In the UK, “National Institute for Health and Care Excellence (NICE)” produced guidelines that recommend “women with pre-existing diabetes to be referred immediately once pregnant to joint diabetes and antenatal clinic”. A “National Enquiry into diabetes in pregnancy” recommended “the minimum team composition (obstetrician, diabetes physician, diabetes specialist nurse, diabetes midwife and dietician)” (Whelan et al. 2021). Along with that, multidisciplinary team management (MDT) methods were also recommended for adults with Diabetes.

Collected data analysis

In group 1, participants had access to the glucose sensor's feedback for the entire six weeks, as well as the activity monitor's feedback for the final two weeks (Whelan et al. 2021). To prevent data loss, participants were required to scan the glucose sensor by temporarily hovering their smartphone over it at least once every eight hours to transfer data to the application. Additionally, the activity monitor provided feedback on a wrist-worn device in addition to communicating with an application for smartphones. Bluetooth was used to transfer the data to the application. The heart rate, distance travelled, calories burned, and number of steps taken were all displayed on the activity monitor (Whelan et al. 2021). The wrist-worn device sent brief haptic vibrations to remind the wearer to move frequently.

In group 2, participants had access to the glucose sensor's feedback for the final two weeks as well as the activity monitor's feedback for the entire six weeks. For the duration of the six weeks, group 3 members had access to both the glucose sensor and the activity monitor's feedback. The glucose sensor showed information about the glucose level, the direction of the trend, the time in range, and daily patterns through communication with an app for smartphones. Moreover, answers of the CASP tool has provided in the appendices.

Article name	Q1	Q2	Q3	Q4	Q5	Q6	Q7	Q8	Q9	Q10
Y	Y	Y	N	Y	Y	Y	Y	Y	N

Table 1: CASP Result of the selected article

(Source: Created by researcher)

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Conclusion

Nursing care is critical and advised for patients with Diabetes. Diabetes is a critical disease which involves a high risk of cardiovascular diseases and cardiac arrest. Along with that, it produces multiple comorbidities that damage the vital organs like kidneys and the retina of the eyes of the body. Hence, it is very vital to carefully examine and identify the conditions prevalent with the onset of diabetes in patients. The government of the UK has allowed special finances for the monitoring and vigilance of the cases of existing Diabetes and provided guidelines for the better management of the future cases. The nurses play a special part in the diagnosis, treatment and care of diabetic patients. Present research has helped in the development of a critical health care plan, along with the continuous assessment of body vitals and blood glucose levels, is one of the prime tasks of the nurses. Proper management strategies can eventually diminish the severity of diabetes in an individual. It has also helped in the nursing interventions also include the development of a self-care management plan for the patients. The self-care management plan includes the provision of a healthcare routine which monitors the intake of sugars in the diet and ensures a sufficient amount of exercise. Self-care management plans and programmes are also available under the guidelines of the government. Special nurses are also trained for the assessment of diabetes in clinical settings.

The health of Adults with diabetes is also the focus of the government. A multidisciplinary team is assigned the preparation of diet charts, exercises, lifestyles and medication for Adults. The health of the developing baby and the chances of developing diabetes in the foetus are also kept under consideration. Diabetes is a global problem and is prevalent among the majority of people, irrespective of their age. Although it cannot be totally eradicated, its complexity and threat can be reduced by adopting a proper self-management plan, and nursing practice by nurses and doctors for the correct identification and diagnosis.

References

Selected article

• Whelan, M.E., Denton, F., Bourne, C.L., Kingsnorth, A.P., Sherar, L.B., Orme, M.W. and Esliger, D.W., 2021. A digital lifestyle behaviour change intervention for the prevention of type 2 diabetes: a qualitative study exploring intuitive engagement with real-time glucose and physical activity feedback.BMC Public Health,21, pp.1-11, Retrieved from: https://link.springer.com/article/10.1186/s12889-020-09740-z

Others

• Alhaik, S., Anshasi, H. A., Alkhawaldeh, J. F., Soh, K. L., & Naji, A. M. (2019). An assessment of self-care knowledge among patients with diabetes mellitus. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 13(1), 390-394. Retrieved on: 3rd January 2023, from: https://www.sciencedirect.com/science/article/pii/S1871402118304077
• Awuchi, C. G., Echeta, C. K., & Igwe, V. S. (2020). Diabetes and the nutrition and diets for its prevention and treatment: a systematic review and dietetic perspective. Health Sciences Research, 6(1), 5-19.Retrieved on: 3rd January 2023, from: https://www.academia.edu/download/61997637/908084520200205-42671-lab2o8.pdf
• Centers for Disease Control and Prevention (2022). Gestational Diabetes. Retrieved on: 3rd January 2023, from: https://www.cdc.gov/diabetes/basics/gestational.html
• Diabetes.org (2022). Diabetes Can Affect Your Heart . Retrieved on: 3rd January 2023, from: https://diabetes.org/diabetes/type-2/diabetes-and-your-heart/diabetes-affect-your-heart
• Eizirik, D. L., Pasquali, L., & Cnop, M. (2020). Pancreatic β-cells in type 1 and type 2 diabetes mellitus: different pathways to failure. Nature Reviews Endocrinology, 16(7), 349-362. Retrieved on: 3rd January 2023, from: https://www.nature.com/articles/s41574-020-0355-7
• Hamdy. O. (2021). Diabetic Ketoacidosis (DKA) Workup. Retrieved on: 3rd January 2023, from: https://emedicine.medscape.com/article/118361-workup
• Holman, N., Knighton, P., Kar, P., O'Keefe, J., Curley, M., Weaver, A., ... & Valabhji, J. (2020). Risk factors for COVID-19-related mortality in people with type 1 and type 2 diabetes in England: a population-based cohort study. The lancet Diabetes & endocrinology, 8(10), 823-833. Retrieved on: 3rd January 2023, from: https://www.sciencedirect.com/science/article/pii/S2213858720302710