The healthcare problem discussed in this assignment is diabetes mellitus, which is increasingly becoming the leading cause of disability across the world. The disease manifests itself through hyperglycemia, and it is categorized into type 1 and type 2. Type 2 diabetes is the most prevalent and it consists of close to 90% of all infections. The causes of this disease are varied, including gestation, drugs, and lifestyles. Its complications affect all body organs, leading to lethal implications. The population to be studied in this assignment majorly comprises older people with diabetes type 2 in a setting with nurse-led management.
The presence of this problem is substantiated by diverse information and data from different researchers. Macido (2019) found that Diabetes mellitus is among the leading medical concerns in the United states and the world at large. The researchers used data from the Centers for Disease Control and Prevention, where more than 12% of older people in the US live with the condition (Macido, 2019). Additionally, a significant number of the population remain undiagnosed with diabetes mellitus. According to the American Diabetes Association (ADA) (n. d.), the issue remains the seventh cause of death and morbidity, and there are more than one million newly reported cases per year. Therefore, diabetes is chronic illness that currently strains healthcare and stakeholders.
The research is relevant because there is a need to improve population/patient knowledge and adherence to management strategies. Furthermore, the study will inform caregivers on better patient approaches beyond the clinical setting. Nikitara et al. (2019) states that most patients develop complications due to poor knowledge of self-management and adherence to treatment courses. At the same time, uncontrolled diabetes mellitus is likely to increase hospitalizations and emergency visits in healthcare facilities. Thus, this research is relevant to inform on various aspects that could lead to shorter lengths of stay in a hospital and improved wellness outcomes after discharge.
Various literature reveals that the prevalence of diabetes is rising. The number of people infected with the disease is expected to reach close to 350 million by 2030 (Macido, 2019). The most notable demographic transition is the rising number of patients older than 60 years. Nikitara et al. (2019) found that nurses should check for further clinical manifestations of the disease. They include a cool feeling, moist skin, add higher than normal blood sugar levels. The nurse can use automatically generated procedures to manage the disease but intravenous administration of medication could be necessary when treating lethargic patients. In case of extreme hyperglycemia, the caregivers should report to the physician, who will, perhaps, transfer them to intensive care units and follow the appropriate treatment procedures such as intravenous insulin administration, or other fluids. Data reliability would depend on its currency, relevance, authority, accuracy and purpose. It would be unreliable of it misses the importance research needs, apart from being outdated and having incorrect and untrue information.
There are many barriers hindering the implementation of evidence-based practice in addressing diabetes mellitus. Limited time allotted for primary care appointments with healthcare providers hinders the implementation of evidence-based remedies (Macido, 2019). Additionally, poor patient-provider communication affects the quality of information gather to inform treatment plans. Lower patient educational levels also hinder their ability to understand their health and management protocols. Poverty is an obstacle because it places patients at a higher risk of complications. Nurses also struggle to cope with the changing treatment targets due to limited resources, compromising the quality of care. Similarly, some of them lack confidence in their understanding of guidelines and abilities in particular tasks. They might also fail to share responsibility with clients, and therefore not support behavior change. Nikitara et al. (2019) found that responsibilities have changed between physicians, and secondary and primary caregivers, creating uncertainty on the appropriate clinical responsibility. This failure creates frustration among them because it affects patient adherence to treatment.
Nursing standards and policies are effective in improving the health outcomes of a patient and the overall population. They emphasize care that is shared and nurse-led to achieve the desired health results. Nursing standards focus on autonomy, which helps patients manage the disease for lifelong bases. They emphasize day-to-care management to be individually-oriented and include skin care, dietary changes, physical activity and rest, self-monitoring, consulting healthcare professionals, and adherence to medication (AADE, 2017). They have brought changes that allow them to prescribe medicine. This step improves health outcomes, apart from reducing outpatient attendance and unnecessary referrals. Nurses set policies as advanced caregivers to be involved in conducting physical examinations and provide the best practice patient treatment.
Nurses play significant roles in policy making to improve patient outcomes, illnesses, and hospital readmissions. For example, they participate in setting care coordination procedures, which improve health outcomes for diabetic patients. The stakeholders include pharmacists, dieticians, endocrinologists, and primary care educators. The coaches provide teaching procedures on care and management of diabetes. Similarly, they support policies that promote wellness to prevent the risk of developing complications associated with diabetes mellitus (Abou-Hafs, 2018). The policies also help to address unacceptable behavior such as smoking and alcoholism during the treatment of diabetes. They advocate for the establishment of ample care environments to improve nurse productivity and retention. The references consulted provide supporting evidence consistent with the current nursing practice.
The nursing ideology applicable for this research is the self-care deficient theory. With it, the caregiver’s role depends on the patient’s factors. As such, a nurse will intervene when the patient is unable to engage in the effective self-care. For example, a client suffering from uncontrolled diabetes type 2 or living with damaged lower circulatory compartments requires a caregiver’s intervention (Abou-hafs, 2018). The roles of a nurse in this situation include guiding, teaching, and supporting patients, apart from providing an environment that promotes personal development and better client outcomes.
Governments help to prevent and manage diabetes by setting the appropriate laws and rules. For example, they establish measures such as taxation on sugars, apart from regulating pre-school settings for adolescents and young children (Timpel et al., 2019). Laws safeguarding pregnant women and parents in the reproductive age set protocols to reduce gestational diabetes among the highly vulnerable women. In schools, governments control school meal standards such that they emphasize a reduction in saturated fats and encourage more fruit intake (Timpel et al., 2019). They also fund awareness programs to education people on early diagnosis and the risk of developing diabetes and its complications. Governments help to remove inequalities concerning vulnerable target groups, especially the illiterate people living in low socio-economic statuses. The intensity of federal action on healthcare should meet population needs and disadvantages.
The leadership strategies to improve outcomes, patient-centered care, and the patient experience related to the patient include staff facilitation to follow healthcare guidelines and establishing positive environment for providing the best practices. Leaders should also support and influence organizational processes and structures to improve patient outcomes and overall care. Managers are responsible for role modeling the desire to work, apart from reinforcing clinical policies and goals meeting evidence-based care. Leaders should recognize skills such as teamwork, optimism, and reliability, apart from empowering and enabling juniors to manage critical situations.
Leadership teams have a crucial role to play in diabetes prevention and management because patients are higher risks of developing cardiovascular diseases. They should encourage patient-focused management approaches, which incorporate comprehensive plans to reduce risks. Such plans include blood pressure management, weight control, physical activity, healthy diets, lipid control, and smoking cessation and prevention (Macido, 2019). Leaders play a vital role in diabetes advocacy, which refers to proactively supporting and engaging the advancement of a policy. It is required to improve how patients live with diabetes and its risk factors. Such vulnerability issues include lack of physical exercise, obesity, smoking, and poor diets. Through diabetes advocacy, stakeholders can address and transform the social determinants of their root causes.
The appropriate collaboration and communication strategies in addressing diabetes greatly concern patient-nurse relationships. The association should focus on power balance and prevent criticism, apart from minimizing risks and ensuring consistency in healthcare provision. Care providers should provide information to patients in plain language. They should avoid showing aggressive behavior because it is an obstacle to effective communication. Respect, trust, and psychological support are important in diabetic patient managing (Abou-Hafs, 2018). Appropriately collaborating with clients is crucial to encourage self-expression and to conceptualize the disease and its management strategies, treatment outcomes, as well as emotional wellness of the patient.
The proposed change management strategies include patient-centeredness, and quality care. The first principle includes respectful and responsive care delivery to patients, meeting their needs, preferences, values, and decisions. There should be true relationships between patients and healthcare providers. This model also encourages nurses to develop personalized and comprehensive care plans that give equal needs to mental health and population needs during treatment. The treatment procedure include coordinated, collaborative, and accessible care at the right time place. It should also ensure emotional health and physical comfort to the patient. The management strategies should consider client values, cultural norms, and socioeconomic statuses. The time spent with the individuals is two hours, and the management strategy will include complete and timely information sharing among patients, families, and caregivers to make informed decisions.
Conclusively, this project focused on diabetes mellitus, which is increasingly becoming the leading cause of death and disability. Research revealed that the disease is prevalent among older adults and its causes include inheritance from previous family members, lifestyle changes, and particular drug consumption. Nurses play a crucial role in education and policy creation to manage the disease. Governments set regulatory standards to control behaviors, prevent the illness, and treat patients living with the condition. Leadership teams have a crucial role to play in diabetes prevention and management because patients are at higher risks of developing cardiovascular diseases. The barriers hindering the implementation of evidence-based practice in addressing diabetes mellitus include poverty and limited time for primary care appointments, among others.
References
Abou-Hafs, A. (2018). Nurse´ s role in diabetes management: Challenges and facilitators. Web.
American Association of Diabetes Educators. (2017). AADE7Self-care behaviors. Web.
Macido, A. (2019). A nurse-led inpatient diabetes self-management education and support program to improve patient knowledge and treatment adherence.Journal of Health Education Teaching, 10(1), 1-10. Web.
Nikitara, M., Constantinou, C. S., Andreou, E., & Diomidous, M. (2019). The role of nurses and the facilitators and barriers in diabetes care: A mixed methods systematic literature review.Behavioral Sciences, 9(6), 61. Web.
Timpel, P., Harst, L., Reifegerste, D., Weihrauch-Blüher, S., & Schwarz, P. E. (2019). What should governments be doing to prevent diabetes throughout the life course?Diabetologia, 62(10), 1842-1853. Web.