Critically evaluate evidence-base relating to the assessment, treatment and management of persons with a diagnosis of diabetes

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Diabetes: A Contemporary Approach 6NU521

Jan 2022

(T2, 21.22AY)

 Assessment Brief

Diabetes: A Contemporary Approach 6NU521

Introduction

The medium- and long-term impact of diabetes on the individual, public health, and primary and secondary care services, financially, physically and practically, is of international concern. Type 1 and Type 2 Diabetes are the most common forms of diabetes. Other types of diabetes may be rarer, but when working in health and social care it is likely that you will come across a person with gestational- or surgical-related diabetes.

This module aims to discuss diabetes in relation to public health, but also the care cycle: assessment, diagnosis, treatment and management. You will relate this to a specific area of your experience and there will be use of real-life case studies to illustrate key points throughout the module. This module assumes that you have a basic knowledge of the anatomy and physiology of the endocrine and digestive system.

Due to the rapidly changing nature of the health and social care landscape, much of this module relies upon guided, self-directed study. This intends to facilitate the development of skills to enhance your ability to source high quality sources of evidence, and apply them in practice with specific reference to diabetes care. You will be provided with case studies and examples for you to propose evidence-based care.

You should be prepared to spend time researching, reading and digesting a wide range of information on the topic of diabetes, but also engaging in the online discussions.

You should spend an hour or so becoming used to the learning materials and layout of blackboard. The learning activities in all units help facilitate the background knowledge and basis of your module assessment.

Module Learning Outcomes

On successful completion of this module, you will be able to:

1. Critically evaluate evidence-base relating to the assessment, treatment and management of persons with a diagnosis of diabetes

2. Interpret data, evidence and the role of public health in the prevention and management of diabetes

Assessment Title

Diabetes Mellitus Case Study

Assessment Description

A written report of 3000 words that applies current, evidence based principles to an area relevant to practice.  The case study may be local, national or international e.g. prevention strategies. The report needs to explore anatomy & physiology, concepts of public health and characteristics of diabetes. The case study could also relate to a specific patient or more overarching situations e.g. the role of policy in your location, the role of new technologies/advances in application to a type of diabetes or specific patient.

Key dates and details

Assessment Type:

Case Report CW1

Assessment weighting:

100%

Word count/Length

3000

Learning Outcome/s:

1 & 2

Submission Method:

Turnitin.

Submission Date:

 

Provisional Feedback Release Date:

 

Check module timetable for sessions.

Guidelines

Background

A report is written for a clear purpose and to a particular audience. Specific information and evidence are presented, analysed and applied. Reports are presented in a clearly structured format making use of sections and headings so that the information is easy to locate and follow. Reports are used as forms of written assessment to identify what you have learned from your reading, research and experience and giving you an experience of a skill that is used in practice and research (e.g., incident, development, progress and scientific reports). Report writing skills may be increasingly useful as your career progresses.

Case reports allow episodes of care to inform the delivery of high-quality healthcare. A case report is a narrative that describes, for practice, research, or educational purposes, a health problem. Case reports written without guidance from reporting standards are insufficiently rigorous to guide clinical practice and research needs.

Diabetes Case Report

  • No individuals (including patients and staff) should be contacted.
  • No medical, health or any other records should be used.
  • Confidentiality needs to be maintained including the explicit use of pseudonyms and, as appropriate, removal or modification of personal identifiers.

Episode of Care

  • Only one episode of care should be discussed – the episode of care that is discussed needs to be identified in the timeline (see the end of p. 7 and top of p. 8 for examples).
  • The episode explored should be on diabetes primary diabetes prevention (e.g., delaying the development of type 2 diabetes in a population) OR secondary diabetes prevention (e.g., preventing persons with prediabetes from developing diabetes) OR tertiary diabetes prevention (i.e., preventing the complications of diabetes).
  • The current diabetes condition should be assessed. This includes glycaemic control (management of blood glucose levels) and risk assessment for potential complications that may develop (assessment of signs and symptoms of complications). Thus, depending on the focus, discussions should include - meeting or not meeting diabetes therapeutic objectives (HbA1c goal/s) if set, self-management including adherence to therapy, psychological aspects of diabetes (e.g., self-efficacy) and a quality diabetes care plan (developing a plan or modifying the current one) including check-ups (e.g., yearly).
  • Therefore the episode can be in a diabetes or primary care setting but cannot be at an emergency setting (e.g., A+E).

Focus

  • The focus should be the patient.
  • Therefore, each point should start with the patient e.g., related literature should come afterwards.

Case

Can be a:

  • Patient recently or previously encountered by you or colleagues.
  • Patient in your current or previous health settings.
  • Patient you have professionally and anonymously discussed with other professionals.
  • Patient encountered during student placement (during your nursing training).
  • National case study e.g., health strategy.
  • International case study e.g., global diabetes plan.
  • Case related to a location e.g., role of policy.
  • Case on technologies/advances for diabetes or a specific patient.
  • Made-up case study, accommodating diabetes issues you would like to explore, within the confinements of the Learning Outcomes.

Cannot be from:

  • Journals.
  • The internet.
  • Books.
  • Published sources.
  • Similar sources to the above.

Type of Diabetes

ONE of the following types of diabetes should be discussed in relation to the case study:

Type 1 Diabetes Mellitus (T1DM).

Type 2 Diabetes Mellitus (T2DM).

Gestational Diabetes Mellitus (GDM).

Diabetes Mellitus as a result of pancreatitis or pancreatectomy.

Headings needed for the report

Introduction

Patient Information

Clinical Findings

Timeline

Diagnostic Assessment

Therapeutic Intervention

Follow-up and Outcomes

Discussion

References

Minor part of the report

(presenting the context) (guidance 300-500 words)

what is relevant from the following should be considered:

Introduction: brief, key background information (e.g., patient attended their yearly diabetes review appointment, is on a medical ward due to.. OR similar), relevant literature including explaining the type of diabetes and its pathophysiology and what this case report will explore.

Patient information: demographic of the patient, the patient’s main compliant/s, relevant medical, family, and psychosocial history (e.g., diet, lifestyle and family history information, relevant comorbidities and past interventions and the outcomes of the relevant comorbidities and past interventions).

Clinical findings: presentation including signs, symptoms and relevant vital signs and observations, physical examination findings, clinical findings.

Timeline: Most relevant dates for interventions and outcomes (text; not a table or figure).

E.g., 1.

  • 2012 – Obesity diagnosis.
  • Episode of care being reported (2020) – T2DM diagnosis.

E.g., 2.

  • 2014 – T2DM diagnosis in primary care.
  • 2014 – Lifestyle advice.
  • 2015 – Poor glycaemic control.
  • 2016 – Started on an OHA in primary care.
  • 2016-2022 – Poor glycaemic control.
  • Episode of care being reported (2022) – E.g., Yearly diabetes appointment, admitted to a health setting OR similar.

E.g., 3.

  • 2016 – Prediabetes diagnosis during an acute hospital admission, lifestyle advice.
  • Episode of care being reported (2018) – Elevated blood glucose, referred to a diabetes clinic in primary care. T2DM diagnosis, diabetes care plan developed, referred to a diabetes lifestyle programme.
  • 2020 – Diabetes clinic review, started on an OHA.
  • 2022 – Diabetes clinic review, started on another OHA.

Major part of the report

(main part) (guidance 2500 words)

what is relevant from the following should be considered:

Diagnostic Assessment: Diagnostic methods (patient assessment, laboratory testing, imaging, surveys), diagnostic challenges, diagnosis, differential diagnoses and how these were ruled out, prognosis,

Therapeutic Intervention: therapeutic intervention (pharmacologic, surgical, preventive), administration of therapeutic intervention (dosage, strength, duration), changes in therapeutic interventions with explanations, effectiveness of therapeutic relationship, self-care, self-efficacy,

Follow-up and Outcomes: clinician- and patient-assessed outcomes, follow-up results (e.g., patient assessment, or test results), intervention adherence and tolerability, adverse and unanticipated events, biopsychosocial impact,

Discussion: discussion of the relevant literature, arguments with rationale, inferences explained, lessons learnt or what we can take from the discussions, considerations for practice and/or research going forward, strengths and/or limitations of the report.

Sources for the presentation of case reports

Gagnier, J.J., Kienle, G., Altman, D.G., Moher, D., Sox, H., Riley, D. and CARE group, 2014. The CARE guidelines: consensus‐based clinical case reporting guideline development. Journal of Clinical Epidemiology, 67 (1). Available at: https://ezproxy.derby.ac.uk/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S089543561300317X&site=eds-live

Ortega-Loubon, C., Culquichicón, C. and Correa, R., 2017. The importance of writing and publishing case reports during medical training. Cureus9 (12). Available at: https://ezproxy.derby.ac.uk/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=cmedm&AN=29492353&site=eds-live

Riley, D.S., Barber, M.S., Kienle, G.S., Aronson, J.K., von Schoen-Angerer, T., Tugwell, P., Kiene, H., Helfand, M., Altman, D.G., Sox, H. and Werthmann, P.G., 2017. CARE guidelines for case reports: explanation and elaboration document. Journal of clinical epidemiology89, pp.218-235. Available at: https://ezproxy.derby.ac.uk/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S0895435617300379&site=eds-live

Rubric guidance

On the following page you will find the rubric that your marker will use as a guidance for marking. The rubric will help identify different areas of strength and those areas in need of further improvement. Your marker will also provide personalised feedback and feedforward in relation to the Learning Outcomes for this module.

Assessment Rubric

Level 6 

Rubric 

Exceptional 

(100-80) 

Excellent 

(79-70) 

Very Good 

(69-60) 

Good 
(59-50) 

Satisfactory 

(49-40) 

Unsatisfactory 

(39-35) 

Poor 

(34-21) 

Very Poor 
(20-0) 

Critical Analysis

and Evaluation 

(25%) 

Exceptional level of critical analysis & evaluation 

A high level of critical analysis & evaluation 

A very good level of critical

analysis & evaluation 

A good level of critical analysis & evaluation 

A fair level of critical analysis & evaluation 

Lack of critical analysis and evaluation 

Significant lack of critical analysis & evaluation 

Very significant lack of critical analysis & evaluation 

Originality of Ideas 

(10%) 

Exceptional 

originality of ideas 

A high level of originality in ideas 

Significant originality

of ideas 

Good originality of ideas 

Some originality of ideas 

Lack of originality of ideas 

Lack of evidence of originality of ideas 

Very significant lack of evidence of originality of ideas 

Research Informed 

(20%) 

Exceptional 

well researched 

Very well researched 

Well researched 

Quite well researched 

Adequately researched 

A lack of research evidence 

Significant lack of research evidence 

Very significant lack of research evidence 

Knowledge and

Understanding of Area 

(25%) 

 

Exceptional 

Knowledge; trivial errors 

A high level of knowledge; trivial and minor errors 

Very good knowledge and understanding demonstrated 

Good knowledge and understanding demonstrated 

Sufficient knowledge and understanding demonstrated  

Misunderstandings and errors in knowledge and understanding 

Significant lack of knowledge & understanding 

Very significant lack of knowledge & understanding 

Clarity and

Coherence 
inc. structure and logical flow 

(10%) 

Exceptional 

clarity of ideas; excellent coherence & logic 

A high level of clarity of ideas coherence & logic 

Overall, the work is

clear & coherent 

Generally clear & coherent 

Fairly clear & coherent 

Work lacks some clarity & coherence 

Poor clarity & coherence to work 

Very poor clarity & coherence 

Presentation 
inc. grammar, spelling and referencing 

(10%) 

 

Exceptional 

presentation 

High quality presentation 

A very good standard of presentation 

A good standard of presentation 

Acceptable standard of presentation 

Presentation requires improvement 

Significantly requires improvement 

Very significantly requires improvement 

Anonymous Marking

Submissions in Turnitin and Blackboard

You must submit your work using your student number to identify yourself, not your name. You must not use your name in the text of the work at any point. When you submit your work in Turnitin you must submit your student number within the assignment document and in the Submission title field in Turnitin.

Assessment Regulations

The University’s regulations, policies and procedures for students define the framework within which teaching and assessment are conducted. Please make sure you are familiar with these regulations, policies and procedures.


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