Posts Tagged ‘diabetes’

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Diabetes Plus Marijuana Plus Medical Errors Minus Nursing Blogs

January 12, 2012

What’s new in health care news this week?

Diabetes everywhere. There’s an entire Health Affairs issue devoted to the topic of “Confronting the Growing Diabetes Crisis.” It looks at many interrelated issues, such as the personal financial burden of having diabetes over the course of a lifetime, whether it’s best to put scarce health care resources into focusing on prevention or treatment, models for community-based lifestyle programs for those with type 2 diabetes, the positive effects of the Affordable Care Act on giving those with diabetes access to affordable health insurance and crucial care, genetic factors related to type 2 diabetes, and a great deal more. Inevitably, many of the articles focus on type 2 diabetes, which is so closely linked to America’s obesity epidemic.

by Jorge Barrios, via Wikimedia

Joint studies. The New York Times reported this week on a large government study showing that, whatever one believes about marijuana’s psychological effects or the efficacy of its various medical uses, long-term marijuana smoking—at least one joint per day, every day of the year—does not impair lung function or contribute to the development of COPD. Will this change anyone’s mind about whether this drug is evil, a panacea for all ills, or somewhere in between? Probably not.

Unreported harm. The Office of the Inspector General (OIG) of the U.S. Department of Health and Human Services issued a report last week stating that only 14% of medical errors and other events that harm Medicare patients were reported by hospital employees. The report calls for improving reporting systems and the creation of a list of ”potentially reportable events.” According to the New York Times story on the topic, adverse events that have gone unreported include ”medication errors, severe bedsores, infections that patients acquire in hospitals, delirium resulting from overuse of painkillers and excessive bleeding linked to improper use of blood thinners.”

Which leads us (or does it?) into nursing blogs. Many of the ones in our blogroll have been pretty silent in the past few months, or longer, and it’s not clear why. Some bloggers are taking a break, some have burned out or decided to use their time for other things (like going back to school), some have simply decided to spend more time on Facebook or sharing their thoughts by ’microblogging’ on Twitter (or are simply playing lots of Words With Friends on their smartphones). There are almost certainly many interesting new nursing blogs we don’t yet know about that are taking their places. If you know about them, please let us know. We need to take some time and do some digging. And we plan on doing a serious revision of the blogroll in the next few weeks.—JM, senior editor  

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Diabetes, Hypertension, Obesity. . .The Case of the Missing School Nurse

August 11, 2010

By Peggy McDaniel, BSN, RN

I was amazed by a MarketWatch article this week about the overall lack of school nurses. According to the article, the National Association of School Nurses recommends that one nurse be available for every 750 well children. Many states operate with ratios greatly exceeding that number. For example, in 2009 Michigan had one nurse for every 4,836 children. To give credit where it is due, that same year Vermont provided one nurse for every 311 students. As a nurse, and a parent, I find this data frightening. Not only are there fewer trained professional nurses available to our children every year, but approximately 30% of American children suffer from chronic conditions such as type 1 or type 2 diabetes, asthma, and high blood pressure.

by woodley wonderworks, via Flickr.

Having more nurses available to patients in an inpatient setting has been proven to promote better patient outcomes. I’m going to go out on a limb and suggest that the same is probably true for school nurses.

Lousy timing. This acute shortage of school nurses could not come at a worse time. With more families than ever feeling the pinch of the recession, children are not immune to the oft-reported outcomes related to our current overall economic condition. Less money can translate into fewer visits to health care providers and dentists, greater family stress, and even hunger, among many other things. School nurses not only help kids with cuts and bruises but also make referrals to dentists and other needed services. The article I mentioned above didn’t discuss the number of children with mental health issues in our public school system, but this factor adds another level of complexity to the care of our nation’s children, one that nurses are prepared to assist with.

As a parent of healthy kids, I didn’t worry too much about the availability of a school nurse. My daughters actually regretted the fact that I was not only a pediatric nurse, but also owned a medical grade thermometer—needless to say, you didn’t stay home at our house unless you were truly sick! My good friend has a daughter who was diagnosed with type 1 diabetes just prior to entering first grade. Read the rest of this entry ?

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ADA 70th Scientific Sessions: Reform Implications for Diabetes Care; Fighting Obesity in Middle School; Harnessing New Technology for Better Self-Management

June 29, 2010

By Jane Seley, NP, BC-ADM, CDE. Seley coordinates the Diabetes Under Control column in AJN and is a diabetes nurse practitioner at New York Presbyterian/Weill Cornell.

By Mel B./via Flickr

I’m at the American Diabetes Association (ADA) 70th Scientific Sessions, which takes place from June 25-June 29th in Orlando. The ADA Scientific Sessions is an important forum for diabetes researchers and clinicians from all over the world to present research findings, network, and share ideas.

There are over  17,000 health care professionals registered from all over the world, 700 speakers, 2000 research posters, and 175 device and pharmaceutical company exhibitors. Every year, new diabetes treatments and technologies are discussed and displayed. Some highlights of sessions so far:

1) Implications of U.S. health care reform on the care and prevention of diabetes: Health care reform has the potential to have a huge impact on the millions of people with prediabetes and diabetes who have inadequate or no insurance coverage. Many of our patients have to make difficult decisions around checking blood glucose and taking insulin because of the high cost of medications and supplies and poor reimbursement. People with diabetes can spend hundreds of dollars every month for medication and self-management supplies. Nurses need to be proactive in assisting patients in accessing all available resources and lobbying for better reimbursement for diabetes care.

2) Pancreas not to blame in gastric bypass–related hypoglycemia: Hypoglycemia that may occur post gastric bypass surgery was thought to be a result of abnormal pancreatic islet cells. A recent study found that the beta cells in the pancreas function properly postoperatively. The mechanism of post gastric bypass hypoglycemia remains a mystery. As nurses, we have to monitor our patients carefully postoperatively and make sure that diabetes medications are appropriately reduced if the insulin requirements dramatically decline.

Mega Hamburger/Marshall Astor, via Flickr

3) The symposium on “What influences what we eat?” by Amy Ozier, PhD, RD, an expert in eating disorders and obesity at Northern Illinois University, was well received. Dr Ozier is creator of the EADES (Eating & Appraisal Due to Emotions and Stress) Questionnaire. She discussed the psychological and physical factors that modulate how much we eat. Ozier uses the questionnaire to assess whether eating is a response to stress and emotions and examines coping mechanisms. When caring for a patient with hyperglycemia or a high A1c indicating poor glycemic control, we need to look at contributing factors such as overeating as well as what may be triggering the behavior. Read the rest of this entry ?

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Online Social Networks for Chronic Illness – Time for Providers to Take Them Seriously

March 25, 2010

For many people, social networks are a place for idle chatter about what they made for dinner or sharing cute pictures of their pets. But for people living with chronic diseases or disabilities, they play a more vital role.

“It’s really literally saved my life, just to be able to connect with other people,” said Sean Fogerty, 50, who has multiple sclerosis, is recovering from brain cancer and spends an hour and a half each night talking with other patients online.

That’s from an article in the technology section of today’s NY Times, which draws upon a report from the Pew Internet and American Life Foundation about how people with chronic illnesses are finding connection, support, and information in online social networks like DiabetesConnect.

Chronic illness can be isolating for many reasons: you often can’t explain a condition’s relentlessness and complexity to those around you; at the same time, you may be homebound or to some degree limited in the types of activities you can engage in.

Providers should be aware of such online networks and the role they play for patients. Patients get useful information about self-care, and they feel less alone—though some who study online social networks do caution against any sites where the mood is focused entirely on the negative. Good feelings and bad (like good information and bad) can both be infectious on the Web, as we’ve learned during recent political debates.

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Nurse Organizations Oppose Move to Allow Non-Licensed Personnel to Give Insulin to Students (Despite ADA Testimony Supporting the Practice)

August 25, 2009

By Shawn Kennedy, MA, RN, editorial director and interim editor-in-chief

By Mel B./via Flickr

By Mel B./via Flickr

A scenario is playing out in California that may have far-reaching consequences for nursing and for school children with diabetes. At issue is a move by the California Department of Education to allow non-nurse, unlicensed school personnel—teachers, aides, administrators, and others—to administer insulin to children while at school or at school functions if licensed personnel are unavailable. Read the rest of this entry ?

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