Topics: Diabetes mellitus, Hypertension, Diabetes mellitus type 1 Pages: 5 (1384 words) Published: October 14, 2014

Diabetes Case Management
Plan: A Study on a
Hospital-Based Program

Diabetes Case Management Plan: A Study on a Hospital-Based Program

Case management is a program, which has set guidelines for a patient’s specific care in a disease process. Case management’s goals are to provide high-risk patients with a continuum of care, improving the quality of life, and lowering costs for the patients for their specific disease. To reach these goals case managers use different components which include; assessments and correct diagnosis, advocating for the patient, planning for specific services, identifying and linking services to the patient, monitoring and evaluating the specific services for the patient. Case management has been used in many disease processes, including cardiac, pulmonary, and renal disease. Recently however, case management is becoming a crucial part in the healthcare of diabetic patients in the outpatient setting. Diabetes is becoming a prominent disease process throughout the world’s population. In 2002 there were 18.2 million cases of diabetes in America (“National diabetes fact," 2005). In the world there are over 220 million cases of diabetes (“Diabetes fact sheet," 2009). Due to the high prevalence of diabetes, many countries are implementing case management plans to reduced the risk of medical complications from uncontrolled blood sugars. Taiwan is one of these countries. There are over 1 million ethnic Chinese affected by diabetes living in Taiwan in 2007 (Chang, Chang, Lee, Chen, & Huang, 2007). Due to this high prevalence, in Taiwan, a study was done to see if a Hospital-Based case management plan would be effective in reducing complications from diabetes type 2. This study was done in 2007 at the Northern Taiwan Regional Hospital in Taiwan. The purpose of the study was focused on the effectiveness of case management through a hospital setting. The researchers wanted to know if they could implement a case management program for the diabetic population to improve their quality of life and improve patient self-care. There were two phases to this study, the first phase was focused on the medical team providing the care and the second phase was focused on the patient’s outcomes. The first phase used a protocol that was established from evidence-based guidelines, consultations with experts, and peer feedback from the medical team. This team also created a self-care booklet that used pictures more than words. This booklet had six elements of self-care behavior, including taking medications, managing low blood sugar, monitoring blood sugars, exercise, diet management, and caring for feet (Chang, Chang, Lee, Chen, & Huang, 2007). The results from this part of the study showed a better understanding in self-care of diabetes type 2. The second phase used the protocol put into place during phase one into practice on the study’s population. The study’s population included 60 patients over 18 years of age, a diagnosis of type 2 diabetes, and was willing to participate in the program. However, there were patients that were not included due to, impaired vision, inadequate reading-skills, mental retardation, and mental disorders (Chang, Chang, Lee, Chen, & Huang, 2007). Once informed consent was given, the patients had a minimum of five doctor visits. The first visit was the enrollment assessment. This assessment included a physical exam and laboratory evaluation of HbA1C, fasting glucose, systolic and diastolic blood pressures, body weight, lipids (total cholesterol, LDL, HDL, and triglycerides), renal functions (creatinine, urine albumin, and BUN) and self-care knowledge (Chang, Chang, Lee, Chen, & Huang, 2007). The next four visits the laboratory evaluation and self-care knowledge was repeated to gather data (Chang, Chang, Lee, Chen, & Huang, 2007). The information gathered was then used in a multiple linear regression method...

References: Chang, H.C., Chang, Y.C., Lee, S.M., Chen, M.F., & Huang, M.C. (2007). The Effectiveness
of hospital-based case management: an example from a northern Taiwan regional hospital. Journal of Nursing Research, 15(4), Retrieved from http://web.ebscohost.com.proxybz.lib.montana.edu/ehost/detail?vid=3&hid=5&sid=5b255def-463f-486e-b6dc-d444d8abae7f%40sessionmgr12&bdata=JmxvZ2lucGFnZT1sb2dpbi5hc3Amc2l0ZT1laG9zdC1saXZl#db=c8h&AN=2009748868
National diabetes fact sheet. (2005, December 20). Retrieved from
Diabetes fact sheet. (2009, November). Retrieved from
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