Hello and welcome my name is Holly tomosa I am a wound care certified registered nurse and I’ve worked in home care for 11 years today I’d like to share the findings from my RN BS 486 capstone project an individualized diabetes self-management intervention type 2 diabetes is an illness that requires long-term care strategies beyond medical and pharmacological interventions to.

Maintain good health and glycemic control the American Diabetes Association classifies diabetes as a chronic disease and suggests that health care providers align their approaches to diabetes management with the chronic care model this model encourages interactions between.

A collaborative care team and an informed patient however this model can vary from one organization or practitioner to another the purpose of this project is to focus on one of the six core elements of the chronic care model self-management support since the effectiveness of diabetes management ultimately depends on a patient’s adherence with recommended treatment the purpose of this analysis is to attempt to identify the best practice regarding teaching to help provide patients with self-management support I.

Conducted a single subject intervention study with the 67 year old Vietnam veteran which consisted of five in-home visits the patient has a history of diabetes neuropathy Charcot lower extremity amputations hypertension substance abuse post-traumatic stress disorder and major depressive disorder the patient is a Marine who served one year active duty as a skill as a result he was consistently exposed to Agent Orange despite being diagnosed with diabetes over 20 years ago as of late he has been.

Experiencing increased complications because of physical and psychological limitations the patient was unable to attend a group diabetes self-management program like the model created by Ford University with the assistance of my.

I prepared for the intervention following the American Association of diabetes educators protocol why did I pick this topic in my practice I’ve noticed an increased.

Incidence of diabetes related wounds especially in the aging veteran population however the true impetus for this intervention was actually the patient I had the privilege to work with a recent episode.

Of sharp CO and his left foot led to osteomyelitis which ultimately resulted in a below knee amputation his preoperative haemoglobin a1c was 12 after the amputation I provided daily wound care for the residual limb in the patient’s home and he shared a story that I could not help.

But react to I will now share this story but I want to preface it by explaining that the patient has no family.

Or support system I have cared for him off and on for the past five years for diabetic foot ulcers and amputations of three toes because of this we’ve built a.

Level of trust after enduring a guillotine amputation to remove the infected bone.
And a definitive below the knee amputation.

For prosthetic purposes the vascular surgeon who performed the second surgery issued a stern warning I give you five years before I take off your other leg you better do something with the pad on the.


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