The diabetes education process for self-management training shall include the following standards:

1. (1) Needs assessment.

   1. (A) The healthcare provider shall conduct an individualized educational needs assessment with the participation of the patient, family, legal guardian, or support systems to be used in the development of the educational plan and interventions.

   2. (B) The educational needs assessment shall include, but not be limited to, the following:

      1. (i) Health history;
      2. (ii) Medical history;
      3. (iii) Previous use of medication;
      4. (iv) Diet history;
      5. (v) Current mental health status;
      6. (vi) Use of healthcare delivery systems;

      7. (vii) Lifestyle practices, such as:

         1. (a) (a) Occupation;
         2. (b) (b) Education;
      8. (c) (c) Financial status;

      9. (d) (d) Social and cultural and religious practices; and

         1. (e) (e) Health beliefs and attitudes or preventive behaviors;

      10. (viii) Physical and psychological factors, including:

          1. (a) (a) Age;
          2. (b) (b) Mobility;
      11. (c) (c) Visual acuity;

      12. (d) (d) Manual dexterity;

          1. (e) (e) Alertness;
          2. (f) (f) Attention span; and
          3. (g) (g) Ability to concentrate;

      13. (ix) Barriers to learning, such as:

          1. (a) (a) Education;
          2. (b) (b) Literacy level;
      14. (c) (c) Perceived learning needs;

      15. (d) (d) Motivation to learn; and

          1. (e) (e) Attitude;
      16. (x) Family and social support; and
      17. (xi) Previous diabetes education, including actual knowledge and skills;

2. (2) Education plan. The healthcare provider shall develop a written education plan in collaboration with the patient and his or her parent, spouse, or legal guardian from information obtained in the needs assessment, including the following:

   1. (A) Desired patient outcomes;
   2. (B) Measurable, behaviorally stated learner objectives; and
   3. (C) Instructional methods;

3. (3) Education intervention.

   1. (A) The healthcare provider shall create an educational setting conducive to learning with adequate resources for space, teaching, and audio-visual aids to facilitate the educational process.
   2. (B) The healthcare provider shall use a planned content outline.

   3. (C) The content outline shall be provided based on the needs assessment and may include:

      1. (i) Diabetes pathophysiology;
      2. (ii) Stress and psychological adjustment;
      3. (iii) Family involvement in disease management;
      4. (iv) Medical nutrition therapy as defined by the American Diabetes Association;
      5. (v) Exercise and physical activity;
      6. (vi) Medications and insulin administration;
      7. (vii) Blood glucose monitoring and use of results;

      8. (viii) Diabetes management, which is the relationship between:

         1. (a) (a) Nutrition;
         2. (b) (b) Exercise;
      9. (c) (c) Medication; and
      10. (d) (d) Blood glucose levels;
      11. (ix) Prevention, detection, and treatment of acute complications;
      12. (x) Prevention, detection, and treatment of chronic complications;
      13. (xi) Foot, skin, and dental care;
      14. (xii) Behavior change strategies, goal-setting risk factor reduction, and problem solving;
      15. (xiii) Benefits, risks, and management options for improving glucose control;
      16. (xiv) Uses of healthcare systems and community resources; and
      17. (xv) Preconception care, pregnancy, and gestational diabetes;
4. (4) Evaluation of learner outcomes. The healthcare provider shall review and evaluate the degree to which the person with diabetes is able to demonstrate diabetes self-management skills as identified by behavioral objectives;

5. (5) Plan for follow-up for continuing learning needs. The healthcare provider shall:

   1. (A) Review the educational plan; and
   2. (B) Recommend any additional educational interventions to meet continuing learning needs; and

6. (6) Documentation. The healthcare provider shall:

   1. (A) Maintain written files; and
   2. (B) Thereby completely and accurately document the educational experiences provided and communicate such to the referring physician.