CPD reflective account
Blood glucose monitoring A CPD article enhanced Jackie Peck’s knowledge of testing the concentration of glucose in the blood as well as the role of patient education in managing diabetes whether blood glucose levels are stable. If the levels are higher or lower than recommended, the healthcare practitioner can work with the patient to establish the reason. Changes to diet or medication may be required.
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The incidence of diabetes is increasing. As a new practice nurse, I am aware that many patients require assistance to manage their diabetes, and I read this CPD article to improve my knowledge of blood glucose monitoring. Diabetes can be categorised as type 1 (complete insulin deficiency) or type 2 (resistance to insulin). Both can lead to hyperglycaemia, with increased mortality and morbidity. This can result in microvascular complications, such as retinopathy, neuropathy and nephropathy, and macrovascular complications, including heart disease, peripheral vascular disease and stroke. Blood glucose monitoring, combined with patient education and medication, can reduce the occurrence of these complications. The article described the different methods of blood glucose monitoring and how they can be used to maximum effect in diabetes management by the patient and healthcare practitioner. Glycated haemoglobin (HbA1c) testing provides the average blood glucose level over the previous two to three months. It is the gold standard in blood glucose monitoring because it is reliable, cannot be manipulated by the patient and can be used for long-term monitoring. A rise in the HbA1c level is a reliable indicator of increased risk of complications. The disadvantage of this method is that it cannot specify highs or lows in blood glucose levels. For ‘real-time’ measurement of blood glucose levels, patients self-monitor by obtaining a sample of capillary blood using a lancet, applying it to a reagent
Informed choices
strip and inserting this into a portable testing machine. They then use the results to titrate their insulin requirements. This is also a necessary safety measure for patients who are at risk of hypoglycaemia. Patients can take regular readings throughout the day, and the results indicate
This reflective account is based on NS733 Holt P (2014) Blood glucose monitoring in diabetes. Nursing Standard. 28, 27, 52-58.
After reading this article, I am more confident discussing monitoring methods with patients. They need to be able to make informed choices regarding their care, and I will try to ensure that patients with diabetes understand how and why testing is carried out, and the benefit of blood glucose monitoring. The article reinforced that patient education is essential to successful blood glucose monitoring, accurate recording of self-monitoring and attendance for quarterly HbA1c testing. To help educate patients, I intend to offer one-to-one discussions to them and their families, and access to Diabetes UK literature or websites, or primary care teaching groups, depending on their preference NS Jackie Peck is a practice nurse at Woodlands Medical Centre, Didcot, Oxfordshire
Write your own reflective account You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a reflective account. Turn to page 53 for this week’s article and on page 62 you can find out how to present and submit your reflective account.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php
NURSING STANDARD december :: vol 29without no 14 ::permission. 2014 61 Downloaded from RCNi.com by ${individualUser.displayName} on Jul 19, 2015. For personal use only. No 3 other uses Copyright © 2015 RCNi Ltd. All rights reserved.
Blood glucose monitoring A CPD article enhanced Jackie Peck’s knowledge of testing the concentration of glucose in the blood as well as the role of patient education in managing diabetes whether blood glucose levels are stable. If the levels are higher or lower than recommended, the healthcare practitioner can work with the patient to establish the reason. Changes to diet or medication may be required.
SCIENCE PHOTO LIBRARY
The incidence of diabetes is increasing. As a new practice nurse, I am aware that many patients require assistance to manage their diabetes, and I read this CPD article to improve my knowledge of blood glucose monitoring. Diabetes can be categorised as type 1 (complete insulin deficiency) or type 2 (resistance to insulin). Both can lead to hyperglycaemia, with increased mortality and morbidity. This can result in microvascular complications, such as retinopathy, neuropathy and nephropathy, and macrovascular complications, including heart disease, peripheral vascular disease and stroke. Blood glucose monitoring, combined with patient education and medication, can reduce the occurrence of these complications. The article described the different methods of blood glucose monitoring and how they can be used to maximum effect in diabetes management by the patient and healthcare practitioner. Glycated haemoglobin (HbA1c) testing provides the average blood glucose level over the previous two to three months. It is the gold standard in blood glucose monitoring because it is reliable, cannot be manipulated by the patient and can be used for long-term monitoring. A rise in the HbA1c level is a reliable indicator of increased risk of complications. The disadvantage of this method is that it cannot specify highs or lows in blood glucose levels. For ‘real-time’ measurement of blood glucose levels, patients self-monitor by obtaining a sample of capillary blood using a lancet, applying it to a reagent
Informed choices
strip and inserting this into a portable testing machine. They then use the results to titrate their insulin requirements. This is also a necessary safety measure for patients who are at risk of hypoglycaemia. Patients can take regular readings throughout the day, and the results indicate
This reflective account is based on NS733 Holt P (2014) Blood glucose monitoring in diabetes. Nursing Standard. 28, 27, 52-58.
After reading this article, I am more confident discussing monitoring methods with patients. They need to be able to make informed choices regarding their care, and I will try to ensure that patients with diabetes understand how and why testing is carried out, and the benefit of blood glucose monitoring. The article reinforced that patient education is essential to successful blood glucose monitoring, accurate recording of self-monitoring and attendance for quarterly HbA1c testing. To help educate patients, I intend to offer one-to-one discussions to them and their families, and access to Diabetes UK literature or websites, or primary care teaching groups, depending on their preference NS Jackie Peck is a practice nurse at Woodlands Medical Centre, Didcot, Oxfordshire
Write your own reflective account You can gain a certificate of learning by reading a Nursing Standard CPD article and writing a reflective account. Turn to page 53 for this week’s article and on page 62 you can find out how to present and submit your reflective account.
Visit the RCN Learning Zone The RCN Learning Zone is a FREE online service to help RCN members with their continuing professional development and professional portfolio management. The RCN Learning Zone can be found at www.rcn.org.uk/members/learningzone.php
NURSING STANDARD december :: vol 29without no 14 ::permission. 2014 61 Downloaded from RCNi.com by ${individualUser.displayName} on Jul 19, 2015. For personal use only. No 3 other uses Copyright © 2015 RCNi Ltd. All rights reserved.
