NHS FPX 6004 Assessment 2 Policy Proposal

Student Name

Capella University

NHS-FPX 6004 Health Care Law and Policy

Prof. Name

Date

Policy Proposal

The high mortality rate among diabetic patients is largely attributed to the ineffectiveness of foot and HbA1c evaluations in providing early therapies to prevent future complications. Effective self-care practices are crucial for patients with chronic conditions, reducing the risk of adverse outcomes (da Rocha et al., 2020). Inadequate treatment methods for diabetes contribute to the current challenges. At Mercy Medical Center, there is a decline in assessments for feet and HbA1c, which are vital in identifying patients at risk and preventing complications. This decline is associated with higher healthcare costs, increased mortality, lower quality of life, and poor prognosis related to diabetes complications.

Need for Policy and Practice Guidelines

Analysis of dashboard data reveals a decline in eye tests, HgbA1c testing, and foot assessments at Mercy Medical Center. These trends fall below national and state averages, leading to increased risks for diabetes-related complications. Poor examination of feet and HbA1c not only impacts financial stability but also reduces patient satisfaction levels, contributing to hospital readmissions. Despite the inevitable risk of complications, routine assessments can significantly reduce the burden on hospitals and patients (Demir et al., 2021). Insufficient high-quality strategies for diabetes management are evident in the organization’s failure to meet assessment targets, emphasizing the need for a quality indicator.

Proposed Policy Guidelines

New policies should be implemented at Mercy Medical Center to increase the frequency of feet and HbA1c assessments, enhancing prognosis and minimizing potential complications. The proposed guidelines recommend conducting foot and HbA1c assessments at least three times a year for diabetes patients. This approach aligns with evidence suggesting that inadequate self-care management and irregular assessments contribute to diabetes complications (Lee et al., 2021). To effectively control glucose levels and prevent complications, regular foot and HbA1c measurements are essential.

To address the declining frequency of assessments at Mercy Medical Center, the proposed guidelines emphasize the importance of an interdisciplinary team approach. Involving a nurse practitioner, anesthetist, physician, primary healthcare RN, dietitian, and administrator is crucial for comprehensive diabetes care and prevention of complications (Miller et al., 2021). Interdisciplinary collaboration provides a foundation for addressing all potential risks associated with diabetes complications.

To structure an effective quality improvement methodology, the proposal suggests three key strategies:

• Develop Practical Guidelines: Establish clear recommendations for the health center to improve the frequency of annual foot and HbA1c examinations, promoting interdisciplinary cooperation.
• Identification of Diabetic Patients: Utilize three yearly foot and HbA1c measurements to identify individuals at increased risk, ensuring targeted interventions through an interdisciplinary approach.
• Scheduling Follow-ups: Implement follow-up procedures for patients at increased risk, emphasizing adherence to self-care requirements and medication.

To facilitate efficient connectivity between patients and healthcare providers during follow-up appointments, communication strategies should be improved. Enhanced communication is essential to address problems promptly, reducing the likelihood of adverse outcomes related to diabetic complications (Breuing et al., 2021).

Evidence-Based Strategies

Researchers have identified evidence-based strategies to enhance the assessment of HbA1c and foot conditions in diabetic patients. Regular foot and HbA1c checks, treatment adherence, and lifestyle modifications are effective measures to reduce the frequency of complications (Oni, 2020). The SMART framework, focusing on signs and symptoms, medication, appointments, results, and conversation, provides a structured approach to diabetes management (Hiong et al., 2020). Implementation of these evidence-based strategies is crucial to achieving successful outcomes in diabetes care.

Creating an Organizational Policy

Organizational policy changes are necessary to improve the management of diabetic cases and reduce the risk of complications. Adequate staffing is a key organizational strategy, ensuring an efficient patient-to-nurse ratio for effective care (Azami et al., 2018). Monitoring patient numbers and matching them with the facility’s staff can help maintain appropriate staffing levels for inpatient facilities. Upholding patient confidentiality supports multidisciplinary practice, contributing to rigorous quality standards and improved patient outcomes.

Stakeholder Involvement in Implementing Proposed Strategies

The success of the proposed strategies depends on the willingness of Mercy Medical Center’s leadership and staff to embrace change. An interdisciplinary team comprising experts from various healthcare organizations, including nursing directors and physicians, is essential for effective implementation (Strain et al., 2018). Involvement of all hospital members, including training for staff, posting protocols in patient care areas, and promoting awareness, is crucial for the success of the project.

Conclusion

In conclusion, the proposed policy aims to address the ineffective foot and HbA1c evaluations contributing to the high mortality rate among diabetic patients. Implementing new policies, evidence-based strategies, and organizational changes at Mercy Medical Center can significantly reduce the risk of complications and improve patient outcomes. The commitment of the organization’s leadership and staff, along with interdisciplinary collaboration, is paramount for the success of these initiatives.

References

Azami, G., Soh, K. L., Sazlina, S. G., Salmiah, M. S., Aazami, S., Mozafari, M., & Taghinejad, H. (2018). Effect of a nurse-led diabetes self-management education program on glycosylated hemoglobin among adults with type 2 diabetes. Journal of Diabetes Research, 257. https://doi.org/10.1155/2018/4930157

Breuing, J., Joisten, C., Neuhaus, A. L., Heß, S., Kusche, L., Haas, F., Spiller, M., & Pieper, D. (2021). Communication strategies in the prevention of type 2 diabetes and gestational diabetes in vulnerable groups: A scoping review. Systematic Reviews, 10(1), 301. https://doi.org/10.1186/s13643-021-01846-8

Cole, J. B., & Florez, J. C. (2020). Genetics of diabetes mellitus and diabetes complications. Nature Reviews. Nephrology, 16(7), 377–390. https://doi.org/10.1038/s41581-020-0278-5

da Rocha, R. B., Silva, C. S., & Cardoso, V. S. (2020). Self-care in adults with type 2 diabetes mellitus: a systematic review. Current Diabetes Reviews, 16(6), 598–607. https://doi.org/10.2174/1573399815666190702161849

Demir, S., Nawroth, P. P., Herzig, S., & Ekim Üstünel, B. (2021). Emerging targets in type 2 diabetes and diabetic complications. Advanced Science (Weinheim, Baden-Wurttemberg, Germany), 8(18). https://doi.org/10.1002/advs.202100275

Grunberger, G., Sherr, J., Allende, M., Blevins, T., Bode, B., Handelsman, Y., Hellman, R., Lajara, R., Roberts, V. L., Rodbard, D., Stec, C., & Unger, J. (2021). American Association of clinical endocrinology clinical practice guideline: The use of advanced technology in the management of persons with diabetes mellitus. Endocrine Practice: Official Journal of the American College of Endocrinology and the American Association Of Clinical Endocrinologists, 27(6), 505–537. https://doi.org/10.1016/j.eprac.2021.04.008

Hiong, Y. M., Yusof, B. N. M., Chuan, N. O., & Samsudin, S. (2020). Assessments of dietary characteristics, adherence and glycemic control in individuals with type 2 diabetes: a sampled from a selected public hospital in Malaysia. Sciences, 10(16), 96-108. https://pdfs.semanticscholar.org/cfb2/b4159fc21ff51c755837480522256603c5a6.pdf

Lee, S., Liu, T., Zhou, J., Zhang, Q., Wong, W. T., & Tse, G. (2021). Predictions of diabetes complications and mortality using hba1c variability: a 10-year observational cohort study. Acta Diabetologica, 58(2), 171–180. https://doi.org/10.1007/s00592-020-01605-6

NHS FPX 6004 Assessment 2 Policy Proposal

Miller, R. C., & Rodriguez, H. P. (2021). Interdisciplinary primary care team expertise and diabetes care management. Journal of the American Board of Family Medicine: JABFM, 34(1), 151–161. https://doi.org/10.3122/jabfm.2021.01.200187

NHQDR Data Tools | AHRQ Data Tools. (2020). Ahrq.gov. https://datatools.ahrq.gov/nhqdr

Oni D. (2020). Foot self-care experiences among patients with diabetes: a systematic review of qualitative studies. Wound Management & Prevention, 66(4), 16–25. https://doi.org/10.25270/wmp.2020.4.1625

Pourkazemi, A., Ghanbari, A., Khojamli, M., Balo, H., Hemmati, H., Jafaryparvar, Z., & Motamed, B. (2020). Diabetic foot care: knowledge and practice. BMC Endocrine Disorders, 20(1), 40. https://doi.org/10.1186/s12902-020-0512-y

Scain, S. F., Franzen, E., & Hirakata, V. N. (2018). Effects of nursing care on patients in an educational program for prevention of diabetic foot. Revista Gaucha De Enfermagem, 39. https://doi.org/10.1590/1983-1447.2018.20170230

Strain, W. D., Hope, S. V., Green, A., Kar, P., Valabhji, J., & Sinclair, A. J. (2018). Type 2 diabetes mellitus in older people: a brief statement of key principles of modern-day management including the assessment of frailty. A national collaborative stakeholder initiative. Diabetic Medicine: A Journal of the British Diabetic Association, 35(7), 838–845. https://doi.org/10.1111/dme.13644

Vigersky, R. A., & McMahon, C. (2019). The relationship of hemoglobin A1C to time-in-range in patients with diabetes. Diabetes Technology & Therapeutics, 21(2), 81–85. https://doi.org/10.1089/dia.2018.0310

Wang, M., & Hng, T. M. (2021). HbA1c: More than just a number. Australian Journal of General Practice, 50(9), 628–632. https://doi.org/10.31128/AJGP-03-21-5866

Yoroidaka, A., Kurita, S., & Kita, T. (2022). HbA1c measurement may save COVID-19 inpatients from overlooked diabetes. Journal of Diabetes Investigation, 13(11), 1925–1933. https://doi.org/10.1111/jdi.13869

NHS FPX 6004 Assessment 2 Policy Proposal