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NURS FPX 6011 Assessment 3 Evidence-Based Population Health Improvement Plan EN

Evidence-Based Population Health Improvement Plan

NURS FPX 6011 Assessment 3 Evidence-Based Population Health Improvement Plan EN

Diabetes is currently one of the most pressing public health issues in the United States. Obesity is a major risk factor for diabetes and cardiovascular disease, both of which are avoidable diseases. All of these things may be avoided with proper information and lifestyle habits. Diabetes is the sixth largest cause of mortality in the United States, with diabetes being a co-morbidity in 25% of those who die due to other diseases (CDC, 2021). Thirty million individuals in the United States have been diagnosed, with seven million more waiting to be diagnosed (CDC, 2021).  This research will shed light on the recent events of diabetes, its demographics in the US, and what should be future health-related plans to decrease it.

Environmental and Epidemiological Data

In the United States, researchers discovered that persons of different races have varied rates of diabetes. Among the five racial groups covered in the US Census, Pacific Islanders and American Indians do have the highest incidence of diabetes. They’re more than two times more prone to have the disease than white people, who have an 8% risk of developing it as adults (Centers for Disease Control and Prevention, 2020). African-Americans and Asian-Americans are also more likely than whites to get diabetes. Rates can also differ based on ethnicity. Asian Indians are 2-3 considerably more probable than Korean-Americans to develop diabetes (Centers for Disease Control and Prevention, 2020). It is far less common among Alaska Natives than among American Indians in the US state of Southern Arizona.

Researchers are continuously looking into several variables that may increase the risk of diabetes in persons of specific races or ethnicity. But thus far, they’ve examined a few possibilities for why the discrepancies exist. 

Type of body. Getting overweight or obese increases your risk of developing type 2 diabetes significantly. But it’s also crucial to know how much of body weight is made up of adipose and where it’s stored. Asians have somewhat higher excess fat than whites of similar height and weight. According to studies, African-Americans have less potassium in their body than whites. Potassium shortage has been related to an increased risk of type 2 diabetes. At the very same time, African-Americans may be stronger at producing insulin than whites in general. 

Diet and way of life. It’s also important to consider how and where you live. Diabetes affects a higher percentage of Chinese-Americans than it does in rural China. When compared to Japanese, the same would be true for Japanese-Americans. The disparity might be due to high-fat, high-sugar Western diets, according to researchers. According to a recent study, the more Mexican-American youngsters adopted a conventional American lifestyle, the higher their diabetes rates were. Researchers believe it’s since more Americanized youngsters are more likely to eat fast food and receive fewer workouts. 

NURS FPX 6011 Assessment 3 Evidence-Based Population Health Improvement Plan EN

The genetics. Despite the disparities in race and ethnicity, most studies have indicated that genes have little effect on diabetes risk. No matter what the individual’s background is, the same behaviors and situations that increase the chances apply to everyone.

Diabetes affected 37.3 million Americans in 2019, or 11.3 percent of the population. Type 1 diabetes affects almost 1.9 million Americans, including 244,000 children and young adults. According to the data collected by American Diabetes Association, (2022), for those who have been diagnosed and those who have not been diagnosed: 28.7 million of the 37.3 million individuals with diabetes were diagnosed, whereas 8.5 million went undiagnosed. Seniors’ prevalence: At 29.2 percent, or 15.9 million seniors, the number of Americans aged 65 and more remains high (diagnosed and undiagnosed). Every year, 1.4 million people in the United States are diagnosed with diabetes. Prediabetes: 96 million Americans aged 18 and over had prediabetes in 2019. Around 283,000 Americans under the age of 20 are projected to have diabetes, accounting for about 35% of the population. The yearly prevalence of diagnosed diabetes in adolescents was expected to be 18,200 cases of type 1 diabetes and 5,800 cases of type 2 diabetes in 2014–2015. 4.5 percent of American Indians and Alaska Natives live in the United States. Non-Hispanic blacks account for 12.1% of the population. Hispanics make up 11.8 percent of the population. Asian Americans make up 9.5 percent of the population. Non-Hispanic whites make up 7.4% of the population. In 2017, the overall cost of confirmed diabetes in the United States was $327 billion. Direct medical costs totaled $237 billion. Reduced productivity costs $90 billion. After accounting for variations in population age and sex, average medical costs among persons with diabetes were 2.3 times greater than they would be if they didn’t have diabetes.

During this research, there were some information gaps observed such as the relation of nurses with the treatment of diabetes. There were few and far between sources that had any sort of data available for study. There were unanswered questions on whether there are any permanent treatments for diabetes for the patients that have already acquired it. Upon further inspection of this question, it came to light that there are still some voids left in healthcare for the treatments, for now, there are preventive measures and medications for those that have it.

Ethical Health Improvement Plan

The ethical health improvement plan includes the promotion of lifestyle changes on a governmental stage. Changes in healthcare policies so that both the patients and the healthcare providers are benefitted from these updated regulations. Education and awareness of diabetes should be made especially in the most vulnerable population as well as training and educational courses for nurses and other health care providers so that they are more efficient in their care and treatment plans for diabetic patients. Changes in the documentation and records of diabetic patients should be made so that both the patient and healthcare provider have easy access to them. Testing and diagnosing every individual in the community for diabetes has to be done so that there is as much data available for scientists in their research so that they can figure out the factors that influence diabetes, the cause as well as produce new treatments for such patients that cannot use the market available medications. Use of telehealth for meeting and holding sessions with patients as well as other healthcare providers that are separated by a huge distance but hold necessary information and data for the treatment. Weight loss programs should be widespread in every community like gyms with trainers skilled in weight loss. Behavior counseling has to be available for the patient virtually and in person, especially for those that have issues regarding their eating plans, and lifestyle changes, and those that show carelessness in taking their medicine in the correct dosage and at the right time. 

NURS FPX 6011 Assessment 3 Evidence-Based Population Health Improvement Plan EN

An ethical improvement plan would include goals and strategies for the patients, the community, the state, and the healthcare providers as stakeholders (Golden et al., 2017). From this research, it is clear that only lifestyle changes and help from healthcare professionals can decrease the chances of diabetes. A similar plan has been implemented in Europe called the DE-PLAN, where exercises, changes in lifestyle choices as well as medical help have been altered for the individuals that have diabetes and those who are likely to get it in the future (Gilis-Januszewska et al., 2018). 

In this study by Schmittdiel et al., (2017), it is clear that the health system needs improvement in the quality and care of diabetic patients. The issues seen in the healthcare system are mainly related to documentation, individual needs, and not-so-good care plans. Gruss et al. (2019) have explained the much-needed plan for the US taking into account the socioeconomic and health care policies, community resources, environmental factors, and healthy food choices promotions.

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Strategies for Communication

Nurses should communicate with coworkers, patients, and their families in an ethical and culturally appropriate manner. Even if there are some language problems and gaps in knowledge, the first step nurses can do is to follow etiquette, such as researching the cultural concerns and customs of patients and their relatives before approaching them directly (Chen, 2020). Furthermore, refraining from using slang in communication might assist nurses and professionals in employing more appropriate phrases.  In a cross-cultural setting, speaking slowly is essential to ensure that patients comprehend typical dialogues. This will give the audience more time to process the information. 

Furthermore, engaging in active listening with coworkers is essential for improving cross-cultural interaction. It is their responsibility to ensure that nurses accurately understand elders. It is the responsibility of nurses to ensure that elders are understood accurately, and they must take turns speaking while attentively listening (Brooks, 2019). The language barrier is a possible stumbling block, which is why nurses should study several languages and take an interest in expanding their vocabularies, like vocabularies from the most prevalent languages in the US, which may help them communicate with patients more effectively.

References

CDC. (2021, December 16). Type 2 Diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/type2.html#:~:text=More%20than%2037%20million%20 Americans

Golden, S.H., Maruthur, N., Mathioudakis, N. et al. The case for diabetes population health improvement: evidence-based programming for population outcomes in diabetes. Curr Diab Rep 17, 51 (2017). https://doi.org/10.1007/s11892-017-0875-2 

Centers for Disease Control and Prevention. (2020). National diabetes statistics report, 2017 estimates of diabetes and its burden in the United States background. In CDC. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf

American Diabetes Association. (2022, February 4). Statistics about diabetes | ADA. Www.diabetes.org. https://www.diabetes.org/about-us/statistics/about-diabetes

NURS FPX 6011 Assessment 3 Evidence-Based Population Health Improvement Plan EN

Gilis-Januszewska, A., Barengo, N. C., Lindström, J., Wójtowicz, E., Acosta, T., Tuomilehto, J., & Hubalewska-Dydejczyk, A. (2018). Predictors of long-term weight loss maintenance in patients at high risk of type 2 diabetes participating in a lifestyle intervention program in primary health care: the de-plan study. PLoS One, 13(3), e0194589. https://doi.org/10.1371/journal.pone.0194589

Schmittdiel, J. A., Gopalan, A., Lin, M. W., Banerjee, S., Chau, C. V., & Adams, A. S. (2017). Population health management for diabetes: health care system-level approaches for improving quality and addressing disparities. Current Diabetes Reports, 17(5), 1-5. https://doi.org/10.1007/s11892-017-0858-3

Gruss, S. M., Nhim, K., Gregg, E., Bell, M., Luman, E., & Albright, A. (2019). Public health approaches to type 2 diabetes prevention: US national diabetes prevention program and beyond. Current Diabetes Reports, 19(9), 1-11. https://doi.org/10.1007/s11892-019-1200-z

Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). culturally sensitive communication in

healthcare: a concept analysis. Collegian, 26(3), 383-391. DOI:10.1016/j.colegn.2018.09.007

Chen, L., Wu, Y., Zhou, C., Li, X., & Zhao, H. (2020). Value, knowledge, and implementation of evidence‐based practice among nurse managers in china: a regional cross‐sectional survey. Journal Of Nursing Management, 28(1), 139-147. DOI: 10.1111/jonm.12907

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