A retrospective chart audit of home health care clients with the primary diagnosis of insulin-dependent diabetes mellitus (IDDM) revealed that the average number of visits for care exceeded the average number of visits for teaching. Using Orem's Self-Care Deficit Theory of Nursing, a critical pathway was designed to extend the number of visits incorporating teaching and to sequence teaching so that the client/caregiver would not be overwhelmed with instruction at the beginning of care. Physiologic needs and safety are addressed first on the pathway, followed by health promotion and disease prevention. A flexible method for documentation minimizes variance.
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