Literature Review

Literature review instructions:

• Sources should be recent; should not be older than 5 years.
• Part I: 1-50 Pages
• Part II: 1-51 Pages

Review is to be sectioned according to the following headings:

1. Review of the literature itself.
2. Display the dependent variable
3. Introducing the independent variables
4. Reference to the relationship between the variables (dependent and independent)
5. Conclude the chapter of the literary review and reveal the research hypothesis.

A literature review is an up-to-date list of literature including studies, articles, books, websites and any other written material on research topics. All study variables must be addressed.

It is necessary to start the review with an explanation one the following:

1. Diabetes, as an epidemic, spread, occurrence, its complications, effect on quality of life, and the economic burden that diabetes causes.

2. On the treatment of diabetes and the fact that it’s challenging, as should be according to the latest, effective, early treatment guidelines including guidance on a healthy lifestyle, stress reduction, sleep and of course according to the ADA, EASD. That the new guidelines are adapted to cardiovascular and renal (renal) complications. It is also about combining advanced treatments from the GLP1 and SGLT2 families, of course also understanding the possibilities of combination therapy; combining these or other treatments. Ambiguities regarding the side effects of the treatments and appropriate guidance (and on the importance of appropriate guidance), and on the importance of being keeping up with updates and innovations when it comes to diabetes treatment. All this will lead the treating staff to know how to tailor the appropriate treatment to the specific patient.

3. Treatment of diabetes in the community in a primary clinic, by a treating physician, nurse and dietitian. Emphasis on the importance of the need to update the knowledge and awareness of treating staff on treatment changes and updates; both due to patient’s changing needs and new innovations, and guidelines updates. The staff, especially doctors and nurses, should show their knowledge and control on effective treatment, with fewer side effects. Choosing a patient-centered treatment. Treatment should include close monitoring of the glucose levels, maintaining a balanced state, proper inclusion of new diabetes drugs according to the guidelines, close monitoring of the blood lipid levels,LDL. It is important to ensure the level of knowledge on diabetes treatment and treating skills of the entire system; treating staff, and even healthcare system, i.e. ensuring a multi-systemic balance.

4. The role of the treating team in maintaining a therapeutic continuum in a diabetic patient in the community. Reference separately the role of physician, nurse and dietitian. Here, the follow-up on the nurse’s role in the primary clinic should be detailed.

5. Managing diabetes in the community, what does it include, who is responsible, and what is being done worldwide, in all sorts of countries, to improve disease management.

6. NURSE PRACTITIONER IN DIABETES: NP’s contribution to improving diabetes control measures, including reduced levels of glycated hemoglobin (HbA1c) and cholesterol levels to target values, as well as high patient satisfaction and increased confidence in self-care capacity. Reduction in hospitalizations, referrals to the emergency room. NOTE: Here, there will be a reference on the fact that the role of NP in Israel began in 2015, and has existed in the world since the 1960s and 1970s. The role of the Diabetes Clinical Nurse Practitioner, including his/her authority (what they can and cannot do and the extent to which they contribute in the treatment), their place amongst the healthcare system in Israel, the nurse’s influence on staff education according to the literature, their influence on improving the quality of care and why it is important to integrate DCNPs in the process of treating staff education.

7. The health system in Israel – primary health services (community medicine). How is it conducted in Israel.

8. Case management, implementation of intervention programs (held by NPs). Treatment management can be provided by a physician or other healthcare professional to ensure the appropriate and required treatment for the patient. This requires up-to-date knowledge, skill, treatment planning, follow-up and maintenance of treatment sequence.

9. Empowerment of the treatment team: refers to factors that influence knowledge improvement, treatment control, self-efficacy, staff empowerment, strengthening self-confidence such as enrichment programs, advanced training and other organizational methods.

10. Teamwork – refer to teamwork in general and then the role of the nurse in a primary clinic, the role of the doctor as a primary caregiver in a primary clinic.

11. Efficacy of the treating staff ,the medication and its suitability for the patient, being more efficient in the treatment and the innovations in the management of the diabetes treatment.

12. The importance of knowledge regarding a sensible diet for a diabetic patient, and what’s needed in order for them to receive tools for explaining and guiding the patient.

13. Practical applications in the clinic (therapist-patient relationship, intelligent study of cases). In reviewing a patient-caregiver relationship address the importance of effective guidance and a clear explanation, an extended explanation, devoting sufficient time to the patient.

14. Learning by presenting cases ( as this would be one of the recommended methods to teach and train the treating staff. Mentoring would be done by NPs).

15. Updating knowledge on a variety of topics.

In a literature review we refer to each variable that appears, what the variable is affected by, how it affects, in what context it appears in the literature.

– Independent Variable:

1. Implementation of an educational program (School of Diabetes) provided by a Nurse Specialist in Diabetes NP (NURSE PRACTITIONER) (Explanation of educational programs in the field of diabetes in the world combined with an explanation of the NP leading such a program.) The contribution of this, its impact on results.

– Dependent variables:

1. A literary review extensively addresses what self-efficacy is, what affects it (skill level, past successes), and what it affects in improving diabetes indices, and how it affects the quality of diabetes management, how all this will affect outcomes ? Does the Diabetes Educational Program strengthen self-comprehension in diabetes treatment, What is its contribution? What is the connection between them?

2. Satisfaction of the treating staff – An explanation of the effect of the satisfaction of the treating staff on providing quality diabetes treatment and improving the management of the disease, how it contributes to the improvement of diabetes indices and other outcomes relating to the patient.

3. Knowledge level of the treating staff: What is the contribution of having the sufficient and proper knowledge or improvement of the knowledge of the treating staff to improving the diabetes indices and managing the disease. An extended reference to what self-generalization (self-efficacy) is, what affects it (skill level, past successes), and how it affects diabetes indices, and how does it affect the quality of diabetes treatment, how will all this affect the outcome? What is the contribution of knowledge about improving diabetes indices and disease management.

4. Quality of care – what does it mean in the management of diabetes, reference to the role of the nurse in leading quality, professional care to a diabetic patient. What are the parameters for measuring the quality of nursing care. Quality of treatment on what affects the diabetes indices, how it affects the results. How to improve the quality of care for diabetics for example by following the guidelines, patient-centered approach, patient participation, prevention of complications and maintaining quality of life.

5. Adherence to diabetes medication – The role of the therapist is to improve therapeutic responsiveness, their skills, therapeutic approach: simple, effective, customized method.

– Clinical dependent variables:

1. HbA1c and fasting glucose levels
2. Fat profile: total cholesterol, fasting triglycerides, LDL
3. Blood pressure (systolic and diastolic)
4. Number of Purchases of Prescription Drugs for Diabetes (Adherence to Medication)
5. Frequency of visits for laboratory tests (performing routine follow-up tests for diabetes, for example urine protein, eGFR, HBA1C, LDL
6. Number of appointments at the clinic where the patient came – frequency of clinic visits.
7. A number of meetings with a dietitian in which the patient was present – visits to a dietitian.
8. Number of follow-ups (comprehensive training by the nurse, including guidance on hypoglycemia, hyperglycemia, disease management, medication, side effects)
9. Frequency of preforming diabetic foot examination (refer to the diagnosis and prevention of diabetic foot complications)

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