NR 503 Week 2 Assignment-Healthy People 2020 Impact Paper
This paper will explore and analyze the disease process related to Chronic Kidney Disease, often called Chronic Renal Failure or Stage Renal Disease. The report will further provide the risk, mortality, and morbidity of this chronic illness that typically leads to reduced quality of life due to having to be placed on hemodialysis to sustain life.
Problem Identification
Chronic Kidney Failure (CKF), as defined by The Lancet (2014), is when an individual presents with a glomerular filtration rate (GFR) that is persistently below 15 mL/min per 1·73 m² This signifies the last stage of kidney disease. Diabetes is one of the most common causes of CKD. Therefore, much education and prevention of diabetes is a part of the disease prevention of Healthy People 2020.
Many factors contribute to such a high risk of death in chronic kidney failure, such as diabetes, obesity, hypertension, atherosclerosis, and smoking, all of which many patients present with a very complex medical situation.
Problem Overview
For this paper, the data will focus on the national problems with CKD. Research reflects that the mortality of patients diagnosed with CKD on some form of renal replacement therapy (hemodialysis, Peritoneal dialysis) is usually impacted by many factors, socioeconomic, lack of access to healthcare or dialysis centers, lack of transportation, other pre-existing medical are some the issues that patients die prematurely.
Chronic Kidney disease usually leads to the highest form of CKD, Stage Renal Disease (ESRD), which is vascular and occurs due to the deterioration of the vascular system. With much progress in hemodialysis services, the number of deaths from kidney disease is still very high compared to the number of people diagnosed.
NR 503 Week 2 Assignment-Healthy People 2020 Impact Paper
Epidemiologic and demographic data
According to HealthyPeople.gov (2018), data was collected from two national organizations: the National Institute of Health (NIH) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The incidence of new diagnoses of ESRD has been reduced by ten percent from 2009 to 2014. The occurrence of CKD related to diabetes has been reduced by ten percent nationally from 2009 to 2014. Although we have seen a decrease in both those categories nationally, there has continued to be an increase in incidence in the African-American population.
This disparity is attributed to the lack of access to primary care providers and the education on the factors that can lead to CRF, such as diabetes and uncontrolled hypertension. The high incidence of CRF has significantly impacted our country’s financial and physical health and wellness. The complications and severity of this disease are essential in beginning the education and reducing the number of new cases as healthy as educating those in high-risk populations and areas with high disparities, such as rural areas. The course of treatment if the patient is not a transplant candidate is more than likely hemodialysis.
Goals and Objectives of Healthy People 2020
As noted by (Wetmore et al., 2017), prevention is always the first initiative, and this has been a challenge for healthcare institutions; CRF patients tend to require frequent intense hospitalizations, usually due to non-compliance and fluid overload due to other system failures. This disease places a significant demand on the healthcare delivery team caring for those patients due to the complexity of care due to increased commodities within that population group. Based on findings (CDC 2018), the severity of CRF has led to a rise in death and disability from CRF, and there continues to be a consistent increase in populations of middle to low-income areas.
The risk of disease progression is the next priority, and the key factors or aspects that must be addressed are access to dialysis centers and education to the patients and caregivers about their disease and management of care.
Program plan of action and implementation strategies
When examining the strategies of Healthy People 2020, which involves each territory within the U.S., I read several states’ plans, and many similarities focus on prevention through education. The Community Health Improvement Plan from Alabama was exceptional. This plan required support and involvement from local government, professional organizations, health care providers, private businesses, and government agencies. The projects are based on collaborative programs that address nutrition, physical activity, mental health, and, most importantly, creating access to healthcare that would reduce the risk of CKD, it also included establishing more dialysis centers in low-income areas and bringing healthcare services to rural areas.
References
Garcia-Garcia, G. & Jha, V. (2015). Chronic kidney disease in disadvantaged populations.
Nephrology (Carlton, Vic.), 20(3), 113-116. doi:10.1111/nep.12367
Ishii, J. H., Takahashi, F. & Kitagawa (2015). Multimarker approach to risk stratification for long-term mortality in patients on chronic hemodialysis, (79) 656–663.
Stenvinkel, P. & Larsson, T.E. (2013). Chronic kidney disease: A clinical model of premature aging. American Journal of Kidney Disease, 62: 339–51.
Thompson, S., James, M., Wiebe, N., Hemmelgarn, B, & Manns, B. (2015). Journal of the American Society of Nephrology, 26: 2504-2511.
U.S. Department of Health and Human Services. (2011). Healthy People 2020. Retrieved from www.healthy people.com
Wetmore, J. B., Liu, J., Li, S., Hu, Y., Peng, Y., Gilbertson, D. T., & Collins, A. J. (2017). The Healthy People 2020 Objectives for Kidney Disease: How far have we come, and where must we go? Clinical Journal of the American Society of Nephrology: CJASN, 12(1), 200–209. http://doi.org/10.2215/CJN.04210416
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Question
NR 503 Week 2 Assignment-Healthy People 2020 Impact Paper
Select a topic of interest from Healthy People 2020. Provide an overview of the case and the Healthy People 2020 goal for the problem. Identify a program to reduce morbidity and mortality for that problem on a city, county, or statewide level. In a one to two-page summary, address the following:
- Identify the problem
- Provide an overview of the problem.
- Review of epidemiologic and demographic data on mortality/morbidity and risk
- Present the goals and objectives of Healthy People 2020
- Discuss the identified program plan, including activities and implementation strategies