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The Ten Gold Standards in Educating Your Patients with Diabetes

Jan 2, 2014
 

The National Standards ensure diabetes care is given properly…. 

The National Standards for Diabetes Self-Management Education is designed to define the quality of education and support for diabetics and pre-diabetics. A diverse group of health care providers review and revise the standards every five years. There are ten standards that diabetes educators and programs should follow in order to provide optimal care. While these are tools given to the patient to achieve control, the patient needs to use the tools to keep control.

 

The first standard defines internal structure and states that providers are to "document an organizational structure, mission statement, and goals." A documented "handbook" helps to define clear goals/objectives, define relationships, and roles for everyone, and also provides managerial support.

The second standard defines external input and states that providers should "seek ongoing input from external stakeholders and experts in order to promote program quality." Diabetes care needs to be up-to-date and constantly improving as more options become available. It’s important for providers to build relationships with other entities in diabetes care in order to better serve their patients.

The third standard defines access to diabetes self-management education. "Providers will determine who to serve, how to best deliver diabetes education to that population, and what resources can provide ongoing support for that population." A crucial issue for diabetes care is access. A number of people do not get the care they need because of socioeconomic factors, cultural issues, health insurance shortfalls, and lack of encouragement from other health care providers. Understanding the demographics of an area can help providers determine the type of outreach needed.

The fourth standard defines program coordination. "A coordinator will be designated to oversee the education program and will have oversight responsibility for planning, implementation, and evaluation of education services." Basically someone needs to be in charge and keep things running smoothly while constantly evaluating performance and finding ways to improve. A coordinator keeps the program organized and functional.

The fifth standard defines instructional staff. "At least one of the instructors for designing and planning will be a registered nurse, registered dietitian, or pharmacist with training and experience pertinent to diabetes self-management education, or another professional with certification in diabetes care and education." Pharmacists have the background necessary and are perfect for providing diabetes education and being a part of the health care team needed to combat diabetes.

The sixth standard defines the curriculum. "Written curriculum reflecting current evidence and practice guidelines, with criteria for evaluating outcomes, will serve as the framework for the provision of diabetes education." Curriculum should accommodate a variety of learning styles. It is also important for educators to recognize the need for content to be tailored to match individual needs. Content should include problem-solving, collaborative care, psychosocial issues, behavior changes, and ways to encourage constant self management efforts. Possible topics include but are not limited to diabetes the disease, nutrition, physical activity, medication usage, monitoring blood glucose, preventing complication, support and coping mechanisms, and personal strategies in accomplishing goals.

The seventh standard defines the need for individualization. "The diabetes self-management education, and support needs of each participant will be assessed by one or more instructors. The participant and instructor(s) will then together develop an individualized education and support plan focused on behavior change." There are numerous pieces to a patient’s own case, it is necessary to gather as much information about a patient and ensure that care is favorable for their needs.

The eighth standard defines ongoing support. "The participant and instructor(s) will together develop a personalized follow-up plan for ongoing self-management support." Ongoing education will probably be necessary to effectively manage diabetes and prediabetes. In addition to continual care, a patient needs to be able to hold up their end of the relationship and follow through with everything taught.

The ninth standard defines patient progress. "Providers will monitor whether participants are achieving their personal diabetes self-management goals and other outcomes as a way to evaluate the effectiveness of educational intervention(s), using appropriate measurement techniques." The key outcome for patients is making a behavior change. Assessments of patient outcomes need to be completed at appropriate intervals.

The tenth and final standard defines quality improvement. There is always room to make a program better. Educators need to measure how effective their work is for patients and continue to look for ways to improve. "Diabetes education must be responsive to advances in knowledge, treatment, education strategies, and psychosocial interventions, as well as consumer trends and the ever changing health care environment." Following these standards can help to develop a successful diabetes self-management education program.

Practice Pearls
  • The first standard defines internal structure and states that providers are to "document an organizational structure, mission statement, and goals."
  • The second standard defines external input and states that providers should "seek ongoing input from external stakeholders and experts in order to promote program quality."
  • The third standard defines access to diabetes self-management education.
  • The fourth standard defines program coordination.
  • The fifth standard defines instructional staff.
  • The sixth standard defines the curriculum.
  • The seventh standard defines the need for individualization.
  • The eighth standard defines ongoing support.
  • The ninth standard defines patient progress.
  • The tenth standard defines quality improvement.

Haas, L. et al. National Standards for Diabetes Self-Management Education and Support. Diabetes Care;37(S1):s1444-s155. January 2014.