ely to perform self-care. Poor vision makes it hard to measure the correct amount of insulin. Those with multiple disorders may have to contend with additional dietary restrictions and medications. Poverty, a patient's literacy and health insurance can further complicate the situation."

The symposium, "State of the Science on Nursing Best Practices for Diabetes Self-Management," was held in Philadelphia. The planning committee included representatives from the American Journal of Nursing (AJN), American Association of Diabetes Educators, American Diabetes Association, Joslin Diabetes Center in Boston and University Of Pennsylvania School Of Nursing. The 50 participants were nurses and representatives from other health care disciplines including: nutrition, pharmacy, psychology, government health, research and regulatory agencies and the pharmaceutical industry. The following are some of the identified barriers to, and strategies for, diabetes self-care:

Barriers to Optimal Patient Care and Strategies to Overcome Them

• Difficulty navigating the health care system
  • Provide information and support to help patients and use a "patient navigator" to help patients and families work their way through the healthcare system.

• Diagnosis of diabetes does not automatically lead to self-management education
  • Make a referral for diabetes self-management education a standard component of care.
  • Develop a process for tracking it in the inpatient or outpatient setting.

• Time to see provider is limited; episodic versus comprehensive focus (acute versus chronic care)
  • Use time in the waiting or examination room for education, incorporating audiovisual and creative techniques (such as computer-assisted education).
  • Prioritize visit time on the basis of the patient's concerns and health care needs.

• Patient educ
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Contact: Cindy Gessell
clgessell@msn.com
201-652-4778
American Journal of Nursing
14-Jun-2007


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