Assessing the Problem-Quality, Safety, and Cost Considerations

Part 1 Impacts of Diabetes Mellitus

I have spent a total of four direct practicum hours in a multidisciplinary team tasked with diabetes care in our facility. The team was responsible for managing diabetes outcomes in the in-patient and out-patient care settings and within the community. I focused on patient experiences and talked with members of the multidisciplinary team to understand diabetes mellitus and other aspects of the disease, including its impact on the quality of care, patient safety, and costs of care.

Diabetes mellitus is a long-standing disease that is associated with various complications, such as costly cardiovascular and oral health complications. With the increasing rate of diabetes in the U.S. and the world, it is important to explore the disease impacts on the quality of care, patient safety, and the costs of care at both the individual and system levels. Is your assignment devastating you ? Get in touch with us at eminencepapers.com. Our homework help will save you tons of time and energy required for your assignment papers.

Impacts on the Quality of Care

Diabetes mellitus is associated with a reduced health-related quality of life (HR-QOL). Diabetic patients face a lot of stigmatization within their social settings (Himmelstein & Puhl, 2021). Stigmatization is related to depression and anxiety. Diabetic patients also live with the fear of death and are more fearful of how people perceive them. A majority of them have a negative view of their health status. These negative feelings may lead to feelings of discouragement in continuing with the treatment plan. The negative self-perception and reduced diabetic patients’ quality of life have been associated with poor attitudes towards self-care (Borba et al., 2019). The lack of self-care may worsen the diabetic conditions and risk other health complications related to diabetes.

The prevalence of diabetes in the U.S. is higher among the lower social classes and mostly among African Americans and other minority groups. With the current healthcare disparities in the U.S., diabetes, and associated complications, patients may be unable to access quality care services such as screening and medications (Hill-Briggs et al., 2021). On the other hand, the need to effectively manage diabetes and associated diseases and complications has improved research focused on managing diabetes, leading to the development of new strategies and methods that improve the quality of care.

Impacts on Patient Safety

Most complications associated with diabetes may result in patient harm or disability. Data on the prevalence of preventable harm in medical settings suggest that one in every 20 patients under care is prone to harm (Panagioti et al., 2019). Notably, a study by Sampson et al. (2018) concluded that diabetic patients are at higher risk of harm. The treatment process for diabetes and related morbidities increases the risk of medication errors due to the multiple drugs used to manage the disease and related complications. The frequency and length of stay periods for diabetic patients also increase the risks of hospital-acquired infections (HAIs).

Impacts on Costs of Care at the Individual and System Levels

Diabetes is a significant clinical and economic burden on patients and the U.S. healthcare system (Willey et al., 2018); it has long-term impacts on the health of the patient. Different factors drive the costs of care for individual patients and the system. Diabetes is associated with an increased risk of cardiovascular complications, stroke, kidney nervous system issues, feet, eyes, and other complications. These make the diseases very expensive to treat. Diabetic patients are also more likely to be hospitalized, increasing the cost of care. People who are diagnosed with diabetes are more likely to be charged more for similar medical procedures as compared to non-diabetic patients. An economic evaluation study on the costs of diabetes Type 2 in Europe noted that diabetic-related complications and hospitalization cost £3 billion more than non-diabetic hospitalizations, with the cost thought to triple for diabetes Type 1 (Stedman et al., 2020). The increased length of stay for diabetic patients increases the overall care costs for the individual.

The costs of care associated with diabetes are continuously increasing. According to (Willey et al., 2018), the continued increase in the cost of diabetes treatment is an indicator of a growing disease prevalence and costs of diabetes management. According to the Centers for Disease Control (CDC) (2022), the cost of diabetes treatment in the United States is estimated to be above $327 billion annually.

Impacts of Board Nursing Standards and Government Policies

Nursing practice standards and government policies in every state and U.S. territory provide a government for nursing practice and guide the actions of nurses. They define what a nurse in their professional capacity is expected to do and not to do. These policies and standards impact the quality of care, patient safety, and care costs.

Impact on the Quality of Care

Board nursing practice standards and government policies regulate and determine the level of education required for nurses to operate at a particular level. Board nursing practice standards set protocols that define a baseline of quality patient care. These protocols ensure that nurses taking care of diabetic patients meet the set minimum standards of quality care that benefit the patients. The government also sponsors nursing research focused on diabetes, thereby supporting evidence-based practice (EBP) in diabetes treatment. Accordingly, data has related EBP to improved quality of care in health and medical settings (Cullen et al., 2020).

Impact on Diabetic Patient Safety

Board nursing practice standards create basic standards of accountability for nurses in practice. These standards of accountability in nursing practice ensure that nurses and other health care professionals tasked with managing diabetes and diabetic patients provide care services that are safe and consistent with the set government policies. The nursing practice standards ensure that the nurses possess the skills and knowledge to manage diabetes and related complications safely. The standards of practice and government policies promote research on the safe management of diabetes patients and reduce harm during care. The translation of research evidence into practice not only improves the quality of care but also improves patient safety (Leming-Lee & Watters, 2019).

Impact on Diabetes-Related Costs of Care at the Individual and System Levels

Government policies greatly impact the costs of care for the treatment of diabetes. For instance, the Affordable Care Act (ACA), through its “Essential Health Benefits,” created federal standards that describe the provisions of insurance coverage for diabetes (American Diabetes Association (ADA), 2021). The ACA made it mandatory that insurance plans consider existing medical conditions like diabetes. The ACA requires that insurance plans provide coverage for all critical diabetes management services, including diabetes screening, prescription drugs, and other services in treating diabetes. Without the ACA, the 23 million people in the U.S. today who are under diabetes treatment plans supported by insurance covers would have to pay out of pocket for such services. This would not only negatively impact the affordability of diabetes treatment but also lead to developing diabetes-related complications with further impacts on the cost of care.

Strategies to Improve Quality of Care

The improvement of the quality of care for diabetes patients will be achieved through patient and population education. The multidisciplinary team tasked with diabetes management will be required to develop health promotion programs that focus on educating the community and the patients on self-care, providing support for diabetes patients, and reducing the stigmatization of diabetic patients. Diabetes education provides knowledge and skills and changes patients’ behavior and community perception of diabetes (Świątoniowska et al., 2019). Education can improve compliance with the treatment plan. This also impacts factors of quality care, such as collaboration in the treatment process, disease awareness and related risks and complications, and psychological reliance. Data has proved that diabetes education significantly improves life habits and self-care behaviors, which, in turn, improve self-efficacy in the management of diabetes (Lee et al., 2019).

Strategy to Enhance Patient Safety

The recommended strategy to enhance patient safety during the treatment of diabetes is through improved patient monitoring. Improved patient monitoring will help identify and manage complications as they emerge. It will also help ensure that patients receive the safest and most suitable medications to prevent medication errors and reduce cases of adverse drug effects on diabetes patients. Improved monitoring includes the education of the nurses and other clinicians on patient safety, diabetes medications, drug interactions, and related risks, knowledge of individual diabetes patients, and complications related to diabetes. Data suggests that advanced education significantly influences all dimensions of patient safety culture in all healthcare settings (Titlestad et al., 2018).

Strategy to Reduce Care Costs to Individuals and the System

The recommended strategy to reduce the costs of care related to diabetes for both individuals and the entire healthcare system is through the prevention of diabetes and related complications. The cost of treating diabetes, as earlier noted, is high and costs thousands of dollars per person per year. The prevention of diabetes and related morbidities is a significant strategy that can reduce the associated costs and improve the quality of life and diabetes mortality rates. Diabetes prevention strategies that target individuals at risk of diabetes are cost-effective and reduce the costs of overall disease prevention (Zhou et al., 2020). Research data further links the adoption of these cost-effective diabetes prevention measures to significantly reduce the cost of diabetes care (Riddle & Herman, 2018).

Part 2

I met with the multidisciplinary and interprofessional team tasked with managing diabetes in the facility and the community. The team comprised diabetes specialist nurses, physicians, a nutritionist, social community health workers, and a few diabetic patients. I learned that diabetes management requires an integrated multidisciplinary approach to meet the various diabetes treatment objectives.

I reviewed websites and documents in such websites related to diabetes mellitus, such as the WHO and CDC websites, the diaTribe Foundation’s website, the American Diabetes Association (ADA), and the World Diabetes Foundation websites. I learned that although diabetes mellitus is a chronic metabolic disease and lacks a cure, it can be successfully managed and the associated complications reduced. However, the management plan depends on the type of diabetes.

I have learned that leadership, collaboration, communication, change management, nursing practice standards, and policies can be facilitators or barriers to diabetes management plans. For instance, the existing government policies and nursing practice standards define the scope of my practice. This hindered how well I could contribute to the multidisciplinary team and how I attended to the patients. Further, the team agrees on the relevance of diabetes mellitus to nursing practice. I communicated openly about the dangers diabetes poses on an individual’s health and that of the community and the costs associated with diabetes and associated complications. I did not make any changes to the definition of diabetes. However, I should have focused on defining diabetes from the patient’s perspective rather than the professional perspective.

References

American Diabetes Association (ADA). (2021). Preserving the Affordable Care Act is Crucial to People with Diabetes. https://www.cdc.gov/diabetes/data/statistics-report/.

Borba, A. K. de O. T., Arruda, I. K. G., Marques, A. P. de O., Leal, M. C. C., & Diniz, A. da S. (2019). Knowledge and attitude about diabetes self-care of older adults in primary health care. Ciência & Saúde Coletiva, 24(1), 125–136. https://doi.org/10.1590/1413-81232018241.35052016

Centers for Disease Control. (2022, January 24). The Facts, Stats, and Impacts of Diabetes. https://www.cdc.gov/diabetes/library/spotlights/diabetes-facts-stats.html

Cullen, L., Hanrahan, K., Farrington, M., Anderson, R., Dimmer, E., Miner, R., & Rod, E. (2020). Evidence-based practice change champion program improves quality care. JONA: The Journal of Nursing Administration, 50(3), 128-134.

Hill-Briggs, F., Adler, N. E., Berkowitz, S. A., Chin, M. H., Gary-Webb, T. L., Navas-Acien, A., Thornton, P. L., & Haire-Joshu, D. (2021). Social Determinants of Health and Diabetes: A Scientific Review. Diabetes Care, 44(1), 258–279. https://doi.org/10.2337/DCI20-0053

Himmelstein, M. S., & Puhl, R. M. (2021). At multiple fronts: Diabetes stigma and weight stigma in adults with type 2 diabetes. Diabetic Medicine, 38(1), e14387. https://doi.org/10.1111/DME.14387

Lee, S. K., Shin, D. H., Kim, Y. H., & Lee, K. S. (2019). Effect of Diabetes Education through Pattern Management on Self-Care and Self-Efficacy in Patients with Type 2 Diabetes. International Journal of Environmental Research and Public Health 2019, Vol. 16, Page 3323, 16(18), 3323. https://doi.org/10.3390/IJERPH16183323

Leming-Lee, T. S., & Watters, R. (2019). Translation of Evidence-Based Practice: Quality Improvement and Patient Safety. Nursing Clinics, 54(1), 1–20. https://doi.org/10.1016/J.CNUR.2018.10.006

Panagioti, M., Khan, K., Keers, R. N., Abuzour, A., Phipps, D., Kontopantelis, E., Bower, P., Campbell, S., Haneef, R., Avery, A. J., & Ashcroft, D. M. (2019). Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. The BMJ, 366. https://doi.org/10.1136/BMJ.L4185

Riddle, M. C., & Herman, W. H. (2018). The Cost of Diabetes Care—An Elephant in the Room. Diabetes Care, 41(5), 929–932. https://doi.org/10.2337/DCI18-0012

Sampson, M., Jones, C., Allan, B., Benbow, S., Castro, E., Dashora, U., De, P., Dhatariya, K., Flanagan, D., George, S., Gregory, R., Haq, M., Harrold, C., Higgins, K., Hillson, R., James, J., Jones, D., Kelly, T., Lewis, A., Worthington, J. (2018). Joint British Diabetes Societies for Inpatient Care: clinical guidelines and improving in-patient diabetes care. Diabetic Medicine : A Journal of the British Diabetic Association, 35(8), 988–991. https://doi.org/10.1111/DME.13672

Stedman, M., Lunt, M., Davies, M., Livingston, M., Duff, C., Fryer, A., Anderson, S. G., Gadsby, R., Gibson, M., Rayman, G., & Heald, A. (2020). Cost of hospital treatment of type 1 diabetes (T1DM) and type 2 diabetes (T2DM) compared to the non-diabetes population: a detailed economic evaluation. BMJ Open, 10(5), e033231. https://doi.org/10.1136/BMJOPEN-2019-033231

Świątoniowska, N., Sarzyńska, K., Szymańska-Chabowska, A., & Jankowska-Polańska, B. (2019). The role of education in type 2 diabetes treatment. Diabetes Research and Clinical Practice, 151, 237–246. https://doi.org/10.1016/J.DIABRES.2019.04.004

Titlestad, I., Haugstvedt, A., Igland, J., & Graue, M. (2018). Patient safety culture in nursing homes – a cross-sectional study among nurses and nursing aides caring for residents with diabetes. BMC Nursing, 17(1), 1–8. https://doi.org/10.1186/S12912-018-0305-Z/TABLES/3

Willey, V. J., Kong, S., Wu, B., Raval, A., Hobbs, T., Windsheimer, A., Deshpande, G., Tunceli, O., Sakurada, B., & Bouchard, J. R. (2018). Estimating the Real-World Cost of Diabetes Mellitus in the United States during an 8-Year Period Using 2 Cost Methodologies. American Health & Drug Benefits, 11(6), 310. /pmc/articles/PMC6207315/

Zhou, X., Siegel, K. R., Ng, B. P., Jawanda, S., Proia, K. K., Zhang, X., Albright, A. L., & Zhang, P. (2020). Cost-effectiveness of Diabetes Prevention Interventions Targeting High-risk Individuals and Whole Populations: A Systematic Review. Diabetes Care, 43(7), 1593–1616. https://doi.org/10.2337/DCI20-0018

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Question

This is assessment 2 under my last BSN course, ” Capstone for Nursing”. Please instructors are so strict for the last course. Please follow all instructions, rubric, and the practicum focus sheet assessment which i will submit under regular message. Also at the start of the paper, write the total number of hours estimated that you spent so i can put it under CORE ELMS form.

Assessing the Problem-Quality, Safety

In a 5-7 page written assessment, assess the effect of the patient, family, or population problem you’ve previously defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form. Report on your experiences during your first two practicum hours.

Introduction

Organizational data, such as readmission rates, hospital-acquired infections, falls, medication errors, staff satisfaction, serious safety events, and patient experience can be used to prioritize time, resources, and finances. Health care organizations and government agencies use benchmark data to compare the quality of organizational services and report the status of patient safety. Professional nurses are key to comprehensive data collection, reporting, and monitoring of metrics to improve quality and patient safety.

Preparation

In this assessment, you’ll assess the effect of the health problem you’ve defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.

To prepare for the assessment:

Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
Conduct research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.
Review the Practicum Focus Sheet: Assessment 2 [PDF], which provides guidance for conducting this portion of your practicum.
Note: Remember that you can submit all, or a portion of, your draft assessment to Smarthinking for feedback, before you submit the final version. If you plan on using this free service, be mindful of the turnaround time of 24-48 hours for receiving feedback.

Instructions

Complete this assessment in two parts.

Part 1
Assess the effect of the patient, family, or population problem you defined in the previous assessment on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 2 [PDF] provided for this assessment to guide your work and interpersonal interactions.

Part 2
Report on your experiences during your first 2 practicum hours, including how you presented your ideas about the health problem to the patient, family, or group.

Whom did you meet with?
What did you learn from them?
Comment on the evidence-based practice (EBP) documents or websites you reviewed.
What did you learn from that review?
Share the process and experience of exploring the influence of leadership, collaboration, communication, change management, and policy on the problem.
What barriers, if any, did you encounter when presenting the problem to the patient, family, or group?
Did the patient, family, or group agree with you about the presence of the problem and its significance and relevance?
What leadership, communication, collaboration, or change management skills did you employ during your interactions to overcome these barriers or change the patient’s, family’s, or group’s thinking about the problem (for example, creating a sense of urgency based on data or policy requirements)?
What changes, if any, did you make to your definition of the problem, based on your discussions?
What might you have done differently?
CORE ELMS

Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in CORE ELMS.

Requirements

The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

Explain how the patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Cite evidence that supports the stated impact.
Note whether the supporting evidence is consistent with what you see in your nursing practice.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect the problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Describe research that has tested the effectiveness of these standards and/or policies in addressing care quality, patient safety, and costs to the system and individual.
Explain how these standards and/or policies will guide your actions in addressing care quality, patient safety, and costs to the system and individual.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of care quality, patient safety, and cost to the system and individual.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Discuss research on the effectiveness of these strategies in addressing care quality, patient safety, and costs to the system and individual.
Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form.
Use paraphrasing and summarization to represent ideas from external sources.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5-7 pages in length, not including the reference page.
Supporting evidence: Cite at least 5 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
Explain how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual and document the practicum hours spent with these individuals or group in the Core Elms Volunteer Experience Form.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Competency 8: Integrate professional standards and values into practice.
Use paraphrasing and summarization to represent ideas from external sources.
Apply APA style and formatting to scholarly writing.
In a 5-7 page written assessment, assess the effect of the patient, family, or population problem you’ve previously defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form. Report on your experiences during your first two practicum hours.