Identifying outcomes of care for the home care patient with diabetes

Although existing agency data can be an excellent source for outcomes, there are positive and negative aspects of using such data (Dalton, 2004). For example, one positive aspect is that the data already have been collected and the burden on agency, staff, and patients is reduced. Negative aspects may include that the reliability of data such as OASIS must be tested, and the best method of measurement of blood sugar control may not be available (Hemoglobin A1C) (Goldstein, Little, Lorenz, Malone, Nathan, & Peterson, 2003; Setter, Corbett, Campbell, & Gates, 2003). A1Cs are not usually required for discharge from home care patients. In addition, the OASIS items include only two diabetes self care behaviors: the patient's ability to administer oral medication and to administer injectable medications. There are many other patient self care behaviors that are important outcomes for home care diabetes patients, such as glucose monitoring and diet adherence that are not measured by the OASIS. However, every home care agency can evaluate selected outcomes to measure patients' diabetes self-care ability using the available OASIS and clinical data. Agencies are encouraged to use the outcomes presented to evaluate patient self-care.