NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations TS

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations TS

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations TS

Diabtes Effect on Quality, Safety, And Costs

If present trends persist, one in every three Americans will get diabetes at some point in their lives. 1 Diabetes is a condition caused by an excess of sugar in the blood. Diabetes can harm key organs if it is not handled properly. Most diabetics have a shorter life expectancy than those who do not have the condition. The CDC’s National Diabetes Prevention Program (National DPP) provides an inexpensive, evidence-based lifestyle modification programme to help prevent or postpone type 2 diabetes. Lifestyle change programmes have been shown in studies to lower the risk of type 2 diabetes by more than 50% in persons who are at high risk. The CDC and its partners are seeking to provide access to the lifestyle modification programme to more Americans.

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations TS

All through 2-hour practicum, I observed and learned about multiple hospital readmissions caused by the patient’s raised glucose levels. She’d been to the hospital numerous times in the preceding period for heart problems and diabetes and high blood pressure. Issues were escalating as a result of the patient’s insufficient medical therapy. The various sorts of medicines were bewildering for her, and the medical personnel also administered her insulin two times in four hours since the nightshift nurse was oblivious of the previous dose. The preceding quantity was not noted on the record by the nurse. Communication gap among nurses likely contributes to inpatient medical errors, which can be catastrophic if left unaddressed. Several medications for his present ailment, which included cardiac problems, demanded a substantial cash outflow.. He was already on β – blockers and insulin for his diabetes, had high hypertension. He might have to acquire the diabetes test strips regularly that are required for appropriate blood glucose monitoring on a daily basis. In the preceding period, he got to visit a heart specialist physician for cardiac issues after hospitalised for two times. He seemed worried regarding his circumstances. Sheila had to reimburse her own bills since she didn’t have healthcare coverage or insurance. She lacked personal vehicle and had to rely on the shuttle to get to the clinic for treatment. 

In my hospital professional nursing, I’ve met many diabetic patients who were concerned about the cost with the medication and visit expenses. The overwhelming majority of people lacked healthcare coverage too and were obliged to pay from their own wallets. During a discussion with my charge nurse about the person’s reservations about costs and care, she told an incident on her earlier doctor appointment and yet still needed the expertise of a cardiac specialist. The nurse practitioner went over the policies and measures that I may use to facilitate the delivery of therapy. In addition, the head nurse underlined the financial and monetary support options applicable to diabetes patients.

It is critical to recognise that in medically complex payment and delivery systems, framework initiatives to reduce costs could have unintended and unanticipated repercussions. The conformal relationship among decrease in the usage of glycemic testing kits in patients with insulin-treated hyperglycemia and an upsurge in hospital readmissions, hospital expenditures, and mortality is concerning. Likewise concerning is the rising expense of insulin utilization, that is attributed in addition to a rising cost of injection, which can make a substantial quandary for individuals who received insulin and may not even be able to purchase it. Gains on outpatient treatment expenditures must be evaluated not just in terms of inpatient benefits, but also in terms of hospitalisation for patients with chronic problems that may occur as a result of inadequate clinical environments. Because amputations, and cardiac events are the most expensive problems, which can be caused due to mismanagement of diabtes (Park et al., 2017). 

Evidence-Based Role of Nursing Board and Organizations in Quality, Safety, and Cost 

Nurses remain essential to creating secure, increased treatment both at the personal and organisational levels. Nurses must address concerns, implement choices, prioritize tasks, and work collaboratively with other coworkers. Nurses need to detect and fix inadequacies in treatment that might jeopardise individuals’ safety. Patients necessitate a holistic treatment regimen to diabetes treatment, which comprises food and lifestyle regimen modification. Nurses have an insufficient awareness of diabetes nutrition guidelines. Dietary recommendations suggested by the National Health Services are not well understood within nurses (Gagliardino et al., 2017). The provision of desire to fully comprehend about recommendations, new applications, and training has been shown to be significantly positive to nurses’ grasp of diabetes care in medical institutions. Nurses’ knowledge in diabetes management had also been reported to be weak in general practice.

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations TS

Given the paucity of technical competency amongst nursing caregivers, the use of telemedicine and tech based integrated diabetes care management system is characterized in medical healthcare set – up. Perspectives on typical self – monitoring of blood glucose have altered in current medical practises. A inadequacy in training and educating, and also a nurse’s unwillingness to learn,, have delayed the widespread embrace of virtually monitoring system of diabetes. Performing extended work hours and in rotations shifts also has been associated with the increase in strain (Park et al., 2017).

One of most significant hurdle towards the acceptance of treatment was the patient’s inherent lack of information. Sheila was unaware of the fundamental norms and standards for appraising her wellbeing. She was indeed uninformed of any monetary assistance programmes for the treatment of diabetes. I highlighted the possible hazards of cardiovascular disease and stroke and the global frequency of DM2 to render her mindful of the approaching shift in regimens. She also successfully handled the joint perspective and perspective of her current health and wellbeing prospective health results (Gagliardino et al., 2017).

Diabtes Specilist Nurse’ (DSN) presence in general and community in general healthcare environments enhances patient-centered clinical outcomes. By collaborating with doctors and organisational stakeholders, DSN plays a designed role to assist in disease treatment. The nurse-led  clinical care provides help and learning to practitioners in order for them to provide quality of care. The adoption of the DSN raises a multitude of territorial organizational and operational issues that needs be solved (ADA, 2021). The guidelines in the Quality of Care include diagnostic screening, testing, and interventional measures that are established or thought to enhance the health of individuals with diabetes. Many of these therapies also have been proved to be actually cost considerative  (ADA,2021). 

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations TS

Throughout the hospitalisation, the DSN focuses the greatest effort and time treating the diabetic condition of the person (Kuo et al., 2021). Also with purpose of promoting recovery and comfort by maintaining ideal blood glucose in every patient, this endeavour may be somewhat intimidating. In order for patients to get great treatment, the skilled nursing physician must obtain the professional skills in glycaemic control that demonstrates evidence-based approach, irrespective of duration of professional background. Researches show that most of the nurses are administering patients’ care without a sufficient level of understanding about the diagnostic considerations that must be made while treating poeple with diabetes.

DSNs are critical in providing high-quality patient outcomes and encouraging self-care. DSNs specialise in diabetes management and may operate in a multitude of environments. A DSN is frequently people’s primary point of interaction, connecting them to further expert consultants. Diabetes Specialist Nurses, according to research, educate patients and health – care professionals in addition to providing appropriate treatment. Diabetes Specialist Healthcare staff are critical in care delivery, especially in medical settings. These enhance the patient experiences and interactions (Kuo et al., 2021).

Diabetes and its complications impose a tremendous pressure on degenerative illnesses. Its prevalence is expanding due to individuals’ non compliance with diabetes management techniques, an upsurge in pharmaceutical errors in facilities, and an inability to meet  for recommendations for protracted disease management. It jeopardises the standards of medical services in medical centers (Riddle et al., 2018). Secondly, the whole cost of the diseases in term of safety and identification strains the participant’s economic status. The health service is also beleaguered by such a high prevalence rate and a shortage of qualified educators (Huang et al., 2017). The CDC has also launched the National Diabetes Prevention Program (NDPP). The NDPP is a collaboration of governmental and corporate entities striving to avert or forestall type 2 diabetes. Advocates make it simpler for persons with risk of type 2 diabetes to engage in evidence-based health promotion programmes that lower the chances of developing type 2 diabetes  (CDC, 2021).

Strategies to Improve Quality, Safety, and Cost

The use of the American Diabtes Association (ADA) Standard Recommendations is essential to improve the effectiveness, efficiency, and cost of the therapy. It entails keeping blood sugar levels under a certain limit and adhering to nutritional adjustments. The interdisciplinary group can help achieve the goals of the regulations. Glycemic control instructions were introduced by the International Diabetes Federation, with only a specified limit of 6.9 per cent. The objective of all disease treatment, encompassing self-care and patient care, ought to be to keep blood sugar within average limits (Ye et al., 2021).   The American Heart Association recommends decreasing levels of cholesterol by improving dietary nutrients and avoiding unhealthy fatty acids. Persons can decrease their healthcare spending by safeguarding their apparatus, blood sugar testing machines , and drugs, especially at high glucose level (ADA, 2021).  

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations TS

Administrative culture is crucial in basic medical healthcare setting for ensuring comfortable, economical, and increased care. Governments and corporations can promote quality healthcare performance by providing awareness, development, and skilled labour recruitment. Increased collaboration among healthcare personnel and an integrated way to approach health related problems helps with in minimization of medication errors that result and other contexts. It also enhances post-discharge medication therapy and compliance practises (Gagliardino et al., 2017).  

Following Sheila’s presentation of the practicum questions, I addressed her present medical condition with my charge nurse. She seemed to be incredibly useful and trustable throughout the discussion. To her, the core of diabetes therapy was characterised as dietary modification, treatment management, and glucose monitoring. Sheila was desperate to take an opportunity to promote her health condition. She also explored obtaining monetary insurance for diabetes, hospital instruments, and medication (Zhang et al., 2021). The horrible state of diabetes’s exacerbated repercussions, such as severe discomfort and heart problems, could be lethal, contributing to strokes (Huang et al., 2017). 

Telehealth can assist diabetics in taking their medications appropriately at the proper amount and frequency and remembering to complete prescriptions. Text messages are one method for improving medication adherence in chronic illness patients. Telehealth also helps with access concerns. It enables us to interact with patients who might otherwise be unable to attend appointments (Kuo et al., 2021). Telemedicine removes barriers such as transportation challenges, health concerns, or socioeconomic limits, allowing for greater contacts between physician and patient. Telehealth can assist diabetics with taking their prescriptions appropriately.

NURS FPX 4900 Assessment 2 Quality Safety and Cost Considerations TS

Another strategy is to educate nurses about diabetes care management through the use of case study reviews. The case study technique provides a framework for evaluating and analysing difficult situations. It sheds insight on the comprehensive nature of nursing aproach and provides a viewpoint which can help enhance clinical outcomes. Staff educators can utilise the case study technique to help nurse practitioners improve their drawbacks, judgment call, and essential diabetes management skills. The case study is an excellent teaching approach for facilitating learning, improving critical thinking, and improving decision-making. They can assist us in coming up with fresh ideas (that might be tested by other methods). They are a significant method of presenting theories and may assist demonstrate how many parts of a person’s life are connected to one another (Dutra, 2018).

Medical mistakes such as prescription and medicine inaccuracies may be reduced in facilities as a result of the use of barcode technology. BCMA systems prevent medication mistakes by electronically confirming the ‘5 principles’ of medications dispensation at the nurse’s station , right patient, correct medication, correct drug administration technique, appropriate place, and route of administration. Procedures may have flaws that allow users to skip important steps, hence eliminating error protections. Interfacing between different medical computer systems might be difficult. Nurse workflow operations might be disrupted by barcode scanning, causing dissatisfaction and tiredness among employees. These can be decreased by monitoring and auditing barcode systems on a semi-annual or monthly basis (BCMA, 2021).

Reference 

Dutra, D. K. (2018). Implementation of case studies in undergraduate didactic nursing courses: a qualitative study. BMC Nursing12(1). https://doi.org/10.1186/1472-6955-12-15

American Diabetes Association. (2021). Economic costs of diabetes in the US in 2017. Diabetes care41(5), 917-928.

Gagliardino, J. J., Olivera, E., Etchegoyen, G. S., Guidi, M. L., Caporale, J. E., Martella, A., … & Bonelli, P. (2017). PROPAT: a study to improve the quality and reduce the cost of diabetes care. Diabetes research and clinical practice, 72(3), 284-291.

Huang, E. S., Zhang, Q., Brown, S. E., Drum, M. L., Meltzer, D. O., & Chin, M. H. (2017). The cost‐effectiveness of improving diabetes care in US federally qualified community health centers. Health services research42(6p1), 2174-2193.

Kuo, S., Ye, W., de Groot, M., Saha, C., Shubrook, J. H., Hornsby, W. G., … & Herman, W. H. (2021). Cost-effectiveness of Community-Based Depression Interventions for Rural and Urban Adults With Type 2 Diabetes: Projections From Program ACTIVE (Adults Coming Together to Increase Vital Exercise) II. Diabetes care44(4), 874-882.

Park, J., Zhang, P., Wang, Y., Zhou, X., Look, K. A., & Bigman, E. T. (2021). High Out-of-pocket Health Care Cost Burden Among Medicare Beneficiaries With Diabetes, 1999–2017. Diabetes Care44(8), 1797-1804.

Riddle, M. C., & Herman, W. H. (2018). The cost of diabetes care—an elephant in the room. Diabetes Care41(5), 929-932.

What is Barcode Medication Administration (BCMA)? (2021). Barcodedirect.com. https://www.barcodedirect.com/2017/01/30/barcode-medication-administration/

Ye, Wen, Shihchen Kuo, Edith C. Kieffer, Gretchen Piatt, Brandy Sinco, Gloria Palmisano, Michael S. Spencer, and William H. Herman. “Cost-Effectiveness of a Diabetes Self-Management Education and Support Intervention Led by Community Health Workers and Peer Leaders: Projections From the Racial and Ethnic Approaches to Community Health Detroit Trial.” Diabetes Care 44, no. 5 (2021): 1108-1115.

Zhang, P., Atkinson, K. M., Bray, G. A., Chen, H., Clark, J. M., Coday, M., … & Yanovski, S. Z. (2021). Within-trial cost-effectiveness of a structured lifestyle intervention in adults with overweight/obesity and type 2 diabetes: results from the Action for Health in Diabetes (Look AHEAD) study. Diabetes care44(1), 67-74.

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