Sy Virginia
Pediatr Nurs. 2016 Sep-Oct;42(5):247-51.
Patient and family education is a critical element of diabetes management. Manychildren with new onset type 1 diabetes present with symptoms of diabeticketoacidosis (DKA) and are hospitalized at diagnosis. These children and theirfamilies receive their initial education in the hospital setting. As soon as bloodglucose levels are stabilized and the acidosis is corrected, the patient is dischargedhome, usually within three days (Nettles, 2005). There is little time toprovide the skills and education, as well as emotional support, for a smooth transitionto home. It is a challenge to achieve these goals if the only resource personfor diabetes education is the clinical nurse specialist (CNS). The CNS for a 14-bed pediatric unit sought to expand the role of the bedside nurse to being the primaryeducator of patients with diabetes through education and support. All nursesattended an eight-hour workshop on diabetes. A DKA protocol was developedthrough multidisciplinary collaboration, and nurses were educated on this protocol.Additionally, the CNS organized a diabetes resource cart that contains thetools for diabetes education. The protocol and education materials wereuploaded in the Pediatric SharePoint site to make them accessible to nurses. Most importantly, the CNS developed a structured patient education plan that isoutcome-oriented, and based on review of current literature and practices in theunit. This initiative resulted in an increase in nursing confidence and expertiserelated to diabetes care as demonstrated by competencies met by nurses andanecdotal evidence from nurses and patients’ caregivers.
患者及家属教育是糖尿病管理的关键要素。许多新诊断为1型糖尿病的儿童在发病时伴有糖尿病酮症酸中毒(DKA)症状,确诊时需住院治疗。这些儿童及其家属在医院环境中接受初始教育。一旦血糖水平稳定且酸中毒得到纠正,患者通常会在三天内出院回家(内特尔斯,2005年)。几乎没有时间为患者提供技能培训、教育以及情感支持,以使其顺利过渡到居家状态。如果糖尿病教育的唯一资源人员是临床护理专家(CNS),那么要实现这些目标将是一项挑战。一家拥有14张床位的儿科病房的CNS试图通过教育和支持,将床边护士的角色扩展为糖尿病患者的主要教育者。所有护士都参加了一个为期八小时的糖尿病研讨会。通过多学科合作制定了DKA治疗方案,并对护士进行了该方案的培训。此外,CNS还组织了一个糖尿病资源推车,里面装有糖尿病教育工具。该方案和教育材料已上传至儿科SharePoint网站,以便护士们能够获取。最重要的是,CNS制定了一个以结果为导向的结构化患者教育计划,该计划基于对该病房当前文献和实践的审查。这项举措提高了护士在糖尿病护理方面的信心和专业技能,这从护士达到的能力标准以及护士和患者护理人员的轶事证据中得到了证明。