Introduction
Diabetes mellitus is a chronic illness characterized by high sugar levels in the blood. In the United States, Hispanic people and African Americans are more likely to have diabetes than whites who are non-Hispanic (Gurka et al., 2018). The essay examines the population health problem in the capstone project and assesses the issue from leadership, collaborative, communication, policy, and change management perspectives.
The Population Health Problem in Focus
Diabetes is among the chronic non-communicable diseases that affect how people’s body converts food into energy. It may be caused by environmental or genetic factors. According to the Centers for Disease Control and Prevention (CDC), more than 37 million Americans are suffering from diabetes (American Diabetes Association, 2023). Therefore, this high number reveals that the illness affects 1 out of 10 people in the US, indicating that it is amounting to a public health issue (Moini, 2019). Further, the reports from the CDC highlight that one is aware and diagnosed with the illness for every five people with diabetes.
Consequently, the prevalence of this disease is high and a small number of people diagnosed with diabetes reveal that it is termed as a silent killer disease. It plays a central role in the health of people, including those people who are affected by Coronavirus. The high diabetes prevalence is equally matched to the death rate it leads to in the country. Diabetes is positioned number seven as the leading cause of death in the US, with approximations showing more than 87,000 mortalities annually (ADA, 2023). Further, despite causing death, the disease contributes to poor health outcomes, for example, stroke, kidney failure, cardiovascular illness, blindness, and limb amputations. From the healthcare cost perspective, diabetes costs American citizens an approximated $327 billion to manage and treat the affected Americans and incurs more losses in wages and workforce (Centers for Disease Control and Prevention, 2022). Given the statistics on this illness and its effects on public health, it must be treated and contemplated as a public health issue that needs a solution.
In the report assessment, I will work with Alejandra, an 84-year-old female who lives with diabetes. Nonetheless, the minimal access to comprehensive healthcare patient education persisted in affecting her health as she continues to smoke while having diabetes, hypertension, and pancreatitis. The proof of care gap comprises that she came to the hospital reporting symptoms, for example, lower limb numbness, extreme fatigue, frequent hunger and thirst, and frequent infections. The assessment revealed that the lower limb numbers emanate from peripheral neuropathy, which may result in limb amputation when the situation is not treated and managed well (Moini, 2019). In the patient’s needs of care, I should play a critical role in offering the patient guidance, education, and care she requires to minimize or resolve the symptoms of diabetes. For instance, dietary and lifestyle changes, including stopping eating unhealthy foods like fatty foods and high sugar and stopping smoking as some of the reasons that her health has worsened (Liang, 2022). Luckily, developing the necessary lifestyle modifications may ensure enhanced diabetes condition management and; hence, health outcomes.
The Evidence from Peer-reviewed Literature and Professional Sources
Nurses have an essential role to play in healthcare to deliver care services to diabetic patients in all healthcare facilities. Nurses who offer care within the in-patient and out-patient environment experience some obstacles such as the lack of knowledge, limited time, and the unwillingness of the patient to adhere to self-care measures (Nikitara et al., 2020). Therefore, patient education is significant in enhancing compliance, which has proved to play a key role in enhancing treatment outcomes and self-care levels. Patient education should focus on areas comprising the complications and effects of diabetes, self-care proficiencies, alterations in the treatment routine, and enhanced knowledge of insulin use and other anti-diabetic medicines. In the past, for instance, the obstacles to effective diabetes management comprised poor glycemic levels management, which is the main cause of inefficient diabetes management (Uelmen & MacLeod, 2020). In addition, the nurses involved in care and education must concentrate on the lifestyle modifications needed to enhance diabetes management, which may be achieved with effective nursing practice training.
Further, the studies have shown that there is the significance of nursing interventions in enhancing diabetes management and self-care, which has created key influences on patient care outcomes. Some of the effective and efficient nursing interventions comprise a decline in levels of HbA1c and an essential determinant of whether the symptoms of the patient worsen or improve (Mayo, 2020). Nurse capacity development and preparedness are significant to the success of health programs. Therefore, the evidence supports the importance of nursing theories, for example, the environmental nursing theory, which stresses the significance of enhancing the care setting to increase health outcomes. The nursing theory guides the practical decisions and actions taken in the practicum. It is critical to adopt and implement evidence-based practice in managing diabetes. The nurse must play a role in the care environment, comprising patient education, and lacking areas because of the gaps in knowledge concerning diabetes among health practitioners (Levis-Peralta et al., 2020). Therefore, diabetes care in the United States is lacking in the country.
The guidelines in the sources of policy information comprising the Healthy People 2030 vision support the role of health practitioners in resolving the health effects of diabetes. For instance, the major goal of managing diabetes is a reduction in the disease burden and enhancing community and individual quality of life involving those who are diabetic and at risk of contracting diabetes (Office of Disease Prevention and Health Promotion, 2022). The policy illustrates that the nurses, the number of healthcare providers in the care settings, have a key role in health enhancement and minimizing associated risks. The policy directions and evidence reviewed reveal that nurses have an essential role in managing and caring for diabetes towards enhancing individual and public health (Courtemanche et al., 2020). The nursing theories, for instance, the nursing environmental theory stress the significance of enhancing care settings to improve diabetic people’s health outcomes.
Government, Organizational, and State Board Policies on the Treatment Outcomes
The guidelines and policies of Florida’s nursing board influence diabetes treatment and care. The impacts’ evidence includes Florida Nurse Practice Acts’ influence directing on practice like nursing staff qualifications. In response, any nurse posing a danger to a patient’s care and health is considered unfit to practice. Additionally, organizational policies impact patient outcomes and diabetes care. The examples include healthcare guidelines and policies to offer care interventions towards improving care management (Carvalho et al., 2021). The other guideline of organizational practice influencing diabetes care seems to be comprehensive diabetes education provision to target populations and individual patients that influences patient wellbeing and treatment outcomes. The organizations’ and nursing state boards’ impacts are similarly matched by policy guidelines at the federal and state levels. The government policy that influences diabetes outcomes and care is the 2010 Affordable Care Act (ACA) which expanded its health coverage amongst populations and groups not covered initially. Besides, the ACA stresses care coordination importance, recommends health data technology adoption, and enhances care quality but not quantity (Courtemanche et al., 2020). The impact is improving care outcomes of diabetes and guarantees improved health of the population.
Leadership strategies toward the patient experience, outcome, and patient-centered care
Nurses have the main role in offering the knowledge needed by the patients to improve their well-being and health. The nurse’s roles entail working as a provider and an educator of advanced care such as improved management of the disease. The most vital indicator of care quality when taking care of patients with diabetes is improving glycemic control being the main key to reduced symptoms and improved management of the disease (Levis-Peralta et al., 2020). Besides, the recommended strategy for improving patient outcomes and diabetes care is through team-based care that guarantees patients access to the information, guidance, and education they require to relish improved health. In guiding care practice, team members who should be featured are psychotherapists, pharmacists, nutritionists or dieticians, physicians, and nurses. The third practice approach to guaranteeing patient-centered is involving the patient during planning and care coordination to ensure leadership provided and care given attains the unique care requirements (Mayo, 2020). The ideal leadership approach to apply when caring for patients with diabetes, especially when providing team-based care seems to be the collaborative practice assuring different team members offer their input on the care provided.
Conclusion
The care report experienced regarding an 84-year-old patient called Alejandra indicated that she has had diabetes for a long. However, recently, her health deteriorated partly because of lacking patient education and comprehensive guidance from a care provider. Based on the case, the recommended guidelines of treatment are comprehensive education of a patient under the inter-professional care team guidance. Besides, the initiative of patient education will improve outcomes and health while mending disease management. The role of the nurse is significant in enhancing care rendered such as changes made in the short and long term for maximum outcomes of health.
References
American Diabetes Association. (2023). Statistics about diabetes. Web.
Carvalho, M., Dunne, P., Kwasnicka, D., Byrne, M., & McSharry, J. (2021). Barriers and enablers to sustaining self-management behaviours after completing a self-management support intervention for type 2 diabetes: A protocol for a systematic review and qualitative evidence synthesis. HRB Open Research, 4, 129. Web.
Centers for Disease Control and Prevention. (2022). Cost-effectiveness of diabetes interventions. Web.
Courtemanche, C., Marton, J., Ukert, B., Yelowitz, A., & Zapata, D. (2020). The impact of the Affordable Care Act on health care access and self‐assessed health in the Trump era (2017‐2018). Health Services Research, 55(S2), 841-850. Web.
Gurka, M. J., Filipp, S. L., & DeBoer, M. D. (2018). Geographical variation in the prevalence of obesity, metabolic syndrome, and diabetes among US adults. Nutrition & Diabetes, 8(1), 6-76. Web.
Levis-Peralta, M., González, M. D., Stalmeijer, R., Dolmans, D., & de Nooijer, J. (2020). Organizational conditions that impact the implementation of effective team-based models for the treatment of diabetes for low income patients—A scoping review. Frontiers in Endocrinology, 11. Web.
Liang, H. (2022). Patient-centered care and elderly healthcare. The Impact of Patient-Centered Care, 1(3), 31-50. Web.
Mayo, P. (2020). Type 2 diabetes in older people: Pathophysiology, identification and management. Nursing Older People, 32(4), 33-41. Web.
Moini, J. (2019). The epidemic and prevalence of diabetes in the United States. Epidemiology of Diabetes, 1(3), 45-55. Web.
Nikitara, M., Constantinou, C. S., Andreou, E., Latzourakis, E., & Diomidous, M. (2020). Facilitators and barriers to the provision of type 1 diabetes inpatient care: An interpretive phenomenological analysis. Nursing Open, 8(2), 908-919. Web.
Office of Disease Prevention and Health Promotion. (2022). Addressing healthy people 2030 diabetes objectives during the COVID pandemic webinar. Web.
Uelmen, S., & MacLeod, J. (2020). Diabetes education reimagined: Educator-led, technology-enabled diabetes population health management services. Diabetes Digital Health, 4(1), 25-36. Web.