Nursing Literature Review

This first chapter gives overview about the nature of change will be carried by the author through implementing of the new nursing facility within the organization. Moreover, the rationale for selecting this particular change project and its aims, objectives and place of the change will be mentioned as well. Chapter two will display the literature review and their input related to the dissertation topic. It will cover several themes that are diabetes prevalence, diabetic ketoacidosis, insulin pump complication, and insulin pump therapy today. At the end of literature review, chapter’s author will discuss the critical of patient safety and team in management for diabetes mellitus. The methodology will be in the following chapter number

The foremost problems will be decline or decrease if the project implemented to decrease insulin pump candidates waiting time, improve quality of care in insulin pump program, increase number of installed pump and increase patients and staff satisfactions. HSE health service executive model of change was used with its four steps for the whole change process. For any successful improvement, kotter keys of change could be applied at some points and that what author did to create a sense of urgency. To help processing the change, stakeholders have been analyzed by stakeholder's matrix depending their influence on the project. Change plan was started by increasing staff about the change aim and its benefit for the organization. New patient's pathway was introduced through frequent lectures and in-service for participants. The urgency for this change was creating by decrease quality of care due to log waiting list and miss arrangement among the team in pump program that lead to discomfort among

However, children and adolescents with type one diabetes mellitus are still at risk of death and morbidity. The main cause for that is one of a diabetic serious acute metabolic complication known as diabetic ketoacidosis DKA (Curtis, Muirhead, Cummings, & Daneman, 2002). According to national UK case-control study, patient with diabetic ketoacidosis is expected to have cerebral edema (accumulation of fluid in the brain) due to abnormality in sodium, potassium and urea concentration (Edge et al., 2006). Cerebral edema, deep vein thrombosis (blood clotting in vein), pulmonary embolism (blood clotting in the artery) and congestive heart failure ( medical condition with a body part block) are not frequent diabetic life threating complication associated with diabetic ketoacidosis DKA but they occur and need special care in intensive care unit (Pischke, 1922). Diabetic ketoacidosis DKA leads to recurrent hospitalization because of uncontrolled blood sugar and dehydration. Treatment of diabetic ketoacidosis includes correction of dehydration, hyperglycemia (high blood sugar), ketoacidosis and electrolyte deficit (Chiasson et al., 2003). Consequently, there is a significant influence on patient outcome and care cost connected with diabetic ketoacidosis DKA