Collaborative Practice
The concept of collaborative practice stems from theories of quality management. The founders of quality management in industry emphasized the need for quality improvement as an integral part of the "fabric" of any "organization" (G. Sierchio, 2003, ¶6). The writings and teachings of quality management are being translated to apply to the healthcare industry. Studies have shown that the multidisciplinary team approach positively affects patient welfare and reduces healthcare costs (G. Sierchio, 2003, ¶7).Insulin pump therapy is a form of intensive diabetes therapy that aims to improve blood sugar control. It is referred to as "wearing your pancreas on your belt." Pump therapy is a personal choice and for it to be effective the client must be provided with the education and be willing to learn what is required to make it safe and effective. Starting pump therapy essentially means learning about diabetes all over again (Lawson, ¶7). Pump therapy is most successful when there is collaboration between the diabetes team that at the minimum consists of a physician, nurse, and dietitian knowledgeable in pump therapy.Mr. J. is a 57 year old diagnosed with Type 2 diabetes at the age of 34. Initial treatm
asp?ID=45561Registered Nurses Association of Ontario. J's history, it soon became apparent that he had not received the education needed for successful insulin pump therapy. His glucose monitor was quite outdated. Counting carbohydrates takes time and effort to learn and the dietitian is indispensable in instructing the client how to accurately estimate the amount of carbohydrates in food. He was given an emergent dietitian referral. A back up meter was given to him in the event he was to lose or have a malfunction of his meter. Canadian Journal of diabetes, 27, S21. He did not have a glucose diary or monitoring program and no idea of carbohydrate counting nor did he know what his glucose goals should be. On further questioning he assured me, he was knowledgeable in carbohydrate counting which is what mealtime bolus are based on. His foot abscess was unroofed and culture was taken. Nursing diagnoses such as "Skin Integrity, Impaired", and "Knowledge Deficit" would less likely have occurred if there had been referrals made and collaboration between services that are required for insulin pump therapy. This was the extent of his education.
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