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 ineffective foot and HbA1c evaluations to provide early therapies and stop future problems are one of the main causes of the high mortality rate for patients with diabetes. Effective self-care techniques are necessary for patients with chronic illnesses and conditions to lower the chance of consequences (da Rocha et al., 2020). Poor treatment methods for the illness have led to these problems. Assessments for the feet, and HbA1c, which identify patients at risk of complications or a bad prognosis, are becoming less common at Mercy Medical Center. Diabetes problems such as damage to the nerves, kidneys, eyes, and feet are linked to higher healthcare costs, mortality, lower quality of life, and a poor prognosis.

Need for Policy and Practice Guidelines

According to dashboard data analysis, nearly 50 patients had eye tests in the first three months of 2019, but by the fourth quarter, only 42 remained. In 2020, just 41% of diabetes patients underwent eye exams, fewer than the 75% national average. HgbA1c testing was performed on 60 individuals in the first quarter of 2019 and 42 patients in the fourth quarter, respectively. Less than the 79% state average, 48.3% of MMC’s diabetic patients had their HgbA1c levels checked in 2020. Sixty-two persons underwent foot tests in the first three months of 2019, compared to 70 in the past three months. In 2020, just 41.7% of people received a foot checkup, falling short of the desired 84% (NHQDR Data Tools | AHRQ Data Tools, 2020). 

Poor examination of feet and HbA1c can result in poor financial stability and poor quality of life, lowering patient satisfaction levels. One in 10 diabetes patients, for instance, are readmitted to hospitals because of inadequate self-care management, resulting in expensive care costs that could be addressed. Even though the danger of diabetes complications brought on by evaluation failure cannot be eliminated, they can be greatly reduced, lessening the load on hospitals and patients (Demir et al., 2021). The organization is not offering sufficient high-quality strategies for controlling and managing diabetes if assessment results show a significant failure rate. Therefore, a quality indicator for glycemic control in the healthcare context is the patient’s appraisal of their feet and HbA1c levels.

NHS FPX 6004 Assessment 2 Policy Proposal

The present quality improvement proposal’s main goal is to provide methodologies and frameworks that could help the hospital lower the number of diabetes consequences by doing routine evaluations of the feet and HbA1c. Engagement in quality improvement initiatives requires cooperation among stakeholders and adherence to the established standards for treating the condition (Cole et al., 2020). Mercy Medical Center is a facility that is of concern for quality improvement. The institution offers a comprehensive range of services for inpatients and outpatients, extending from severe to quasi-care. 

To improve assessments of the patient’s foot and HbA1c, the quality improvement initiative process must be assessed, analyzable, improved, and regulated. Mercy Medical Center pledges to uphold the highest levels of professionalism and efficiency in providing healthcare services. The healthcare facility expressed concern about the large examples of failure discovered during the most recent quality improvement meeting regarding the annual assessments of the feet and HbA1c (Wang et al., 2021). Suppose Mercy Medical Center is to ensure that diabetic problems are appropriately avoided through routine assessments of feet and HbA1c. In that case, it must raise the number of feet and HbA1c that have been lowering over time. Mercy Medical Center must pledge to take steps to lower the risk of complications from diabetes for all patients by requiring examinations, including an evaluation of the patient’s foot and an HbA1c.

Proposed Policy Guidelines 

It is necessary to implement new policies, use clinical recommendations to increase the number of feet, and HbA1c tests to enhance prognosis and lessen potential problems. Mercy Medical Center should encourage foot and HbA1c assessments at least three times a year to avoid complications and provide prompt or appropriate treatment. To avoid the potential consequences of inadequate diabetes treatment, diabetic patients in the United States should have their foot and HbA1c assessed thrice yearly (Lee et al., 2021). The study found that inadequate self-care management, foot monitoring, and elevated HbA1c levels are frequently thought to hasten comorbidities of diabetes. Most of these issues can be avoided by ensuring that patients are routinely evaluated for their foot and HbA1c (Lee et al., 2021).

Therefore, the development of comorbidities and a poor prognosis should be avoided by avoiding unnecessary risk elements for diabetes and its complications. Effective interventions during the foot and HbA1c examinations can help prevent diabetes consequences (Vigersky et al., 2019). To ensure that repercussions from diabetes are avoided, these evaluations must be encouraged. Examinations of the foot and HbA1c are deteriorating at Mercy Medical Center, which may be linked to a higher risk of chronic conditions and a lower standard of living. To achieve efficient glucose control and avoid any consequences, foot, and HbA1c measurements should be provided three times per year (Yoroidaka et al., 2022). A serious issue in managing diabetes is the hospital’s falling frequency of these evaluations.NHS FPX 6004 assessment 2 Policy Proposal

Due to a decline in examinations, the facility’s overall HbA1c and feet assessments are still below average, which shows that diabetic patients face a significant risk of problems. The hospital must implement methods to enhance patient outcomes and give patients the best possible health outcomes by promoting the frequency of hospital visits to fulfill increased rates of foot and HbA1c screenings. Diabetes problems, according to Yoroidaka et al. (2022), can be greatly reduced to low levels but not completely eradicated (Yoroidaka et al., 2022). 

Employing an interdisciplinary team strategy to improve the intervention and promote better overall healthcare outcomes is the best way to manage diabetes. A nurse practitioner, anesthetist, physician, primary healthcare RN, dietitian, and administrator are also team members (Miller et al., 2021). Each of these professions is essential to the fight against diabetic complications. Interdisciplinary collaboration is a practical foundation for mitigating the effects of consequences by encouraging foot and HbA1c examinations three times a year because teamwork gives a foundation for tackling all potential risks for diabetic complications.

NHS FPX 6004 Assessment 2 Policy Proposal

To establish a structured methodology for overall quality improvement, encouraging an interprofessional approach satisfies patients with diabetes’ desire for the highest security and safety requirements. The team representatives must collaborate to advance innovation and high standards of care for diabetic patients. Additionally, the suggested adjustments enhance the quality improvement strategy for lowering the risk of comorbidities from diabetes (Demir et al., 2021). Holistic needs and utilizing a multidisciplinary approach toward the provision of care have raised the standard of care and improved patient outcomes. This has also enhanced the quality of life for diabetic patients. The following three key strategies will be considered:

Develop Practical guidelines:

Create an effective set of recommendations for the health center to improve the frequency of annual foot and HbA1c examinations for individuals (Lee et al., 2021). To avoid complications, diabetes patients should be urged to support productive interdisciplinary cooperation.

Identification of Diabetic Patients:

The second strategy uses three yearly foot and HbA1c measurements to classify individuals who are at increased risk of getting diabetic complications and to make sure that an interdisciplinary risk proposed methodology is effectively used to do so (Miller et al., 2021). With this method, patients who are likely to undergo diabetes evaluations can be found. As a result, the treatments are certain to be effective and focus on a particular population.

Scheduling Follow-ups:

To help patients at increased risk of diabetes problems, scheduling foot, HbA1c measurements, and follow-up procedures is necessary to ensure they appropriately adhere to the tight self-care requirements and requirements for the medication. Encourage patients at risk for diabetic problems to schedule follow-up consultations for foot exams and HbA1c measurements. Regular foot and HbA1c assessments are required to monitor the patient’s condition by physicians or registered nurses (Scain et al., 2018).

NHS FPX 6004 Assessment 2 Policy Proposal

To guarantee that patients or those caring for them offer important data during follow-up appointments and examinations of the feet and HbA1c, efficient connectivity with patients and doctors must be improved. In order to address problems when they arise as adverse outcomes for diabetic complications and lessen the likelihood of poorer outcomes that necessitate hospitalization, communication is essential (Breuing et al., 2021). To evaluate patients and provide proper follow-up, cooperation, and teamwork are necessary to lower the risk of developing problems related to diabetes.

Evidence-Based Strategies 

Researchers have been studying the causes of diabetic complications for many years. Several of these researchers have found evidence-based tactics that might be implemented at the institution to boost health assessment of their HbA1c and foot. The frequency of diabetic complications can be decreased by altering various parameters. Some measures to enhance life quality and treat potential problems include treatment adherence and routine foot and HbA1c checks (Oni, 2020). A positive outcome that can lower the risk of diabetic complications is following the advice to examine the foot and HbA1c three times annually.

Additionally, according to Pourkazemi et al. (2020), physiological risk factors such as poor treatment and a failure to do foot and HbA1c tests may raise the risk of developing diabetes. A SMART strategy for designing interventions is one of several additional strategies. These include patient guidance and assistance to modify lifestyle to accommodate the healing process, self-care practice standards and career education, and improving quality care through multidisciplinary practice. Effective healthcare management and follow-up procedures are linked to creating guidelines for improving foot and HbA1c tests, which are anticipated to lower the likelihood of complications from diabetes. Smart-discharge treatments concentrate on steps to lower the likelihood of complications from diabetes (Hiong et al., 2020). 

• The SMART framework’s first focus area is signs and symptoms (S), which addresses how well-prepared registered nurses and doctors are to thoroughly assess the patients and address unbiased and subjective findings to build the care plan. 
• Second, the medication (M) strategy guarantees that patients obtain efficient and secure medications that improve control of their feet and HbA1c (Hiong et al., 2020). Medication should be current, indicated for a particular infection, and appropriately regulated. 
• Counselors and doctors must coordinate patients’ consultations and follow-ups to lower the risk of diabetic complications, which brings us to the third component, an appointment (A). 
• The fourth strategy is the results (R) method, which addresses the feet and HbA1c factor account and diagnostic data to give the patients adequate solutions for patients.
• The final strategy is the conversation (T), which motivates patients to express their worries or inquiries about how they feel and the steps they should take to lessen the possibility of diabetic complications (Hiong et al., 2020).NHS FPX 6004 assessment 2 Policy Proposal

Creating an Organizational Policy

In order to improve the management of diabetic cases and lower the risk of complications, the intervention necessitates a change in organizational policy. Appropriate staffing should be the primary organizational policy strategy to ensure an efficient patient-to-nurse ratio (Azami et al., 2018). The right staffing of inpatient facilities to provide crucial care for patients with diabetes and improve foot and HbA1c assessments might be successfully ensured by tracking the patients’ numbers and matching them with the employees in the facility. They also coordinate patient confidentiality to facilitate multidisciplinary practice and uphold rigorous quality. These steps can help people with diabetes live healthier lives and lower their risk of complications.

Stakeholder Involvement in Implementing Proposed Strategies

The willingness of Mercy Medical Center’s leadership and staff to accept change will be crucial to the policy’s success. The interdisciplinary group will be made up of experts from different healthcare organizations who are knowledgeable on proper diabetic management. Leaders like nursing directors will also be crucial suppliers of the information needed to meet the suggested assessment standards (Strain et al., 2018). As was just mentioned, each hospital member will be involved in the implementation. A doctor will support the policies and collaborate with nursing staff, patient coordinators, counselors, clinical staff, and psychiatrists to ensure they serve their intended purposes (Grunberger et al., 2021). To ensure that the project reaches its intended goal, the team will lead it. 

The main component of the policy is the nursing profession. As previously stated, staff will receive training on patient education and how to react to the patient’s condition. The strategy’s implementation is planned to aid in reducing the risk of diabetes-related complications. All hospital employees will participate in foot and HbA1c examinations. In addition to HbA1c tests and foot training, posters with the protocols will be put up in various patient care areas to ensure everyone is aware of them and following the rules.

Conclusion

The ineffective foot and HbA1c evaluations to provide early therapies and stop future problems are one of the main causes of the high mortality rate for patients with diabetes. Poor examination of feet and HbA1c can result in poor financial stability and poor quality of life, lowering patient satisfaction levels. Mercy Medical Center must pledge to take steps to lower the risk of complications from diabetes for all patients by requiring examinations, including an evaluation of the patient’s foot and an HbA1c. The willingness of Mercy Medical Center’s leadership and staff to accept change will be crucial to the policy’s success.NHS FPX 6004 Assessment 2 Policy Proposal

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

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

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