Assignment: Nursing in the Community: Local, Regional, and National
Assignment: Nursing in the Community: Local, Regional, and National
Community Nursing
Description of Community Health Problem
The selected health problem is the issue of poor self-management of diabetes type 2 among patients with diabetes type in my community. The prevalence of diabetes type 2 has been rising significantly in the community where the researcher resides. The rise in the cases is attributed to factors such as genetic predisposition and sedentary lifestyle that leads to obesity and overweight. The management of diabetes type 2 in the region depends largely on the use of medications, lifestyle and behavioral interventions. Lifestyle and behavioral interventions that are largely utilized include the adoption of healthy dietary habits and engaging in active physical activities. Despite the use of medications in addition to lifestyle and behavioral interventions, the prevalence of diabetes complications due to poor management have risen in the region. The number of patients admitted to the hospitals due to issues such as hypoglycemia, hyperglycemia, and uncontrolled diabetes has risen significantly over the past eight months. It therefore increases the need for the adoption of responsive policies that will reverse the current situation of the disease prevalence and poor management in the region.
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According to statistics given by the American Diabetes Association, the prevalence of diabetes in America in 2018 was that 34.2 million people had diabetes. This rate represented about 10.5% of the entire population in America. The organization further reports that of the above number of people affected by diabetes, 7.3 million people were undiagnosed while 26.8 million were diagnosed. The yearly rate of new diagnosis of diabetes in America is reported to be 1.5 million people (ADA, 2019). According to Saeedi et al., (2019), diabetes is ranked among the top ten leading causes of mortalities in adults globally. It was estimated to have led to deaths of about four million people globally in 2017. Diabetes can be classified into types that include type 1, 2, and gestational diabetes. As seen in the statistics reported by Saeedi et al., (2019), diabetes type 1 and 2 account for most of the cases, and have been rising on a yearly basis. However, diabetes mellitus type 2 accounts for more than 90% of the reported cases of diabetes. The complications of diabetes are largely documented in studies. They include diabetic nephropathy, retinopathy, foot, hypoglycemia, and hyperglycemia. Effective management of diabetes type 2 mellitus using exercises, dietary modifications, self-monitoring of glucose, and timely intake of the prescribed medications has been shown to minimize the risks of the complications (American Diabetes Association, 2018). Health education can also be utilized to empower the affected patients with the knowledge and skills needed for the effective management of diabetes. Therefore, healthcare providers should play the active role of ensuring that diabetic patients have the knowledge and skills related to the management of diabetes for the minimization of its complications and mortalities.
Policy Recommendation to Address the Identified Problem
The recommended policy that should be adopted in the region to improve the self-management of diabetes by the patients is the provision of self-management education classes in the community settings for the patients with diabetes. Self-management in diabetes entails the patients taking the responsibility of monitoring diabetes, taking medications, and initiating interventions such as dietary modification and engaging in physical exercises. The ability of the patients to engage in these self-management practices is often faced by a number of challenges. One of them is the lack of information by the patients on the self-management practices that they need to engage in to promote the effective management of diabetes. Patients should have knowledge about the diets, exercises, and frequency of blood glucose monitoring for the effective management of the disease (Kulhawy-Wibe et al., 2018). They should also understand the signs and symptoms of the complications of diabetes and the need to seek urgent medical attention.
Patients also fail to engage in self-management practices for diabetes due to the lack of adequate social support. The social support that these patients require for the self-management of diabetes could be from the family members, social support groups for patients with diabetes, and healthcare providers in the region. The provision of self-management educational opportunities for the patients with diabetes mellitus type 2 can address these issues by improving the level of awareness among the patients on the management of the disease (Kulhawy-Wibe et al., 2018). Consequently, it is anticipated that effective implementation of the policy on education on self-management of diabetes in communities will result in the reduction of complications of diabetes.
Stakeholders to be affected by the Policy Recommendation
Policy recommendations often target specific stakeholders in a society. Stakeholders in evidence-based practice projects and policy interventions refer to individuals that will be affected directly by the proposed changes. The stakeholders in this policy recommendation will include patients, their families, community, and healthcare providers. The proposed policy recommendation targets patients with type 2 diabetes mellitus. The recommendation seeks to improve the health outcomes of the patients with diabetes type 2 in the region by implementing an intervention that will reduce the risk of complications. Patients will benefit from the policy recommendation in different ways. They will be able to achieve their goals of diabetes management using the knowledge and skills gained from self-management education program for diabetes type 2. The patients will also benefit from reduced cost of care due to the minimized visits to the hospital due to complications of diabetes. They will also benefit from the provision of patient-centered self-management education for the management of the disease, which will enhance the realization of goals of care that include safety, efficiency, and quality.
The community and families of patients with type 2 diabetes also form part of the stakeholders to be affected by the recommended policy. They will be affected through the reduction in healthcare costs, improved productivity, and prevention of mortalities and morbidities due to complications of diabetes. The healthcare providers are also the other stakeholders to be affected by the policy recommendation. They will be affected through the reduction in workload due to patients seeking care secondary to diabetes complications and provision of patient-centered care. Nurses will benefit from the policy recommendation through their acquisition of evidence that can be used to promote the management of diabetes type 2 in community settings.
Feasibility and Projected Costs of Policy Recommendation
The feasibility of the recommended policy has been evaluated in studies. Guo et al., (2019) conducted a study that aimed at determining the efficacy and feasibility of self-management education for patients with type 2 diabetes mellitus. The results of the investigation demonstrated that self-management education improved self-management behaviors and glycosylated hemoglobin A1c levels in the participants. A pilot study that was conducted by Gamboa Moreno et al., (2016) to determine the feasibility of Spanish diabetes self-management program revealed it effective in promoting the management of the disease. The study revealed that the proposed policy recommendation led to improvement in blood pressure control, physical activity, self-efficacy, and dietary habits. Other studies also share close similarities in findings concerning the feasibility of self-management education for patients with diabetes mellitus type 2 (Eid et al., 2017; Whitehouse et al., 2019).
Costs will be incurred in the implementation of the policy recommendation. The costs will cover for all the activities that will be undertaken to ensure that the policy is successfully implemented in the region. As seen from the above feasibility studies, the implementation of the policy recommendation will require considerable input from the healthcare providers. Healthcare providers are needed in teaching the patients the self-management techniques for diabetes. The patients also need to be trained on the necessary knowledge and skills on self-management of diabetes. The patients in the community also require training for them to implement the activities of the policy recommendation successfully.
Motivators should also be provided to the healthcare providers and the patients for them to be committed towards ensuring the success of the policy. The patients and healthcare providers will also require reading resources that will act as source of information to them. They will also need interactive media such as video tapes on the types of physical activities to engage in as a way of achieving the desired goals of self-management of diabetes. The patients should also be followed up actively to ensure that they are embracing the prescribed lifestyle and behavioral interventions. Cumulatively, financial resources will need to be allocated for human resource development, empowerment and motivation, and management of any unexpected events that might affect the success of policy recommendation.
References
ADA. (2019). Statistics About diabetes. Retrieved from https://www.diabetes.org/resources/statistics/statistics-about-diabetes#:~:text=Prevalence%3A%20In%202018%2C%2034.2%20million,of%20the%20population%2C%20had%20diabetes.&text=Undiagnosed%3A%20Of%20the%2034.2%20million,and%207.3%20million%20were%20undiagnosed.
American Diabetes Association. (2018). 13. Management of diabetes in pregnancy: Standards of Medical Care in Diabetes—2018. Diabetes Care, 41(Supplement 1), S137-S143.
Eid, Y. M., Sahmoud, S. I., Abdelsalam, M. M., & Eichorst, B. (2017). Empowerment-based diabetes self-management education to maintain glycemic targets during Ramadan fasting in people with diabetes who are on conventional insulin: a feasibility study. Diabetes Spectrum, 30(1), 36-42.
Gamboa Moreno, E., Ochoa de Retana Garcia, L., del Campo Pena, M. E., Sánchez Perez, Á., Martinez Carazo, C., Arbonies Ortiz, J. C., … & Méndez Sanpedro, T. (2016). A pilot study to assess the feasibility of the Spanish Diabetes Self-Management Program in the Basque Country. Journal of diabetes research, 2016.
Guo, Z., Liu, J., Zeng, H., He, G., Ren, X., & Guo, J. (2019). Feasibility and efficacy of nurse-led team management intervention for improving the self-management of type 2 diabetes patients in a Chinese community: a randomized controlled trial. Patient preference and adherence, 13, 1353.
Kulhawy-Wibe, S., King-Shier, K. M., Barnabe, C., Manns, B. J., Hemmelgarn, B. R., & Campbell, D. J. (2018). Exploring structural barriers to diabetes self-management in Alberta First Nations communities. Diabetology & Metabolic Syndrome, 10(1), 1-7.
Saeedi, P., Petersohn, I., Salpea, P., Malanda, B., Karuranga, S., Unwin, N., … & Shaw, J. E. (2019). Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas. Diabetes research and clinical practice, 157, 107843.
Whitehouse, C. R., Long, J. A., Maloney, L. M., Daniels, K., Horowitz, D. A., & Bowles, K. H. (2019). Feasibility of Diabetes Self-Management Telehealth Education for Older Adults During Transitions in Care. Research in Gerontological Nursing.
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Your local health care official has asked you to prepare a paper of 5–7 pages, excluding the title and reference pages, about a policy that will improve the health of the community. Complete the following:
Review a situation in your local community, region, or state that you would like to see changed.
Develop a policy that would lead to the change.
Justify the development of this policy.
Support your policy with at least 2 scholarly articles published within the last 5 years.
Create a document of 5-7 pages, excluding the title and reference pages, following the APA Expectations document for the College of Nursing.
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Please click into this APA Style for CTU Students link for help with APA formatting. Use the CTU Writing Style Guide (templates provided) not the Introductory Writing Style Guide.
Individual Project Rubric
The Individual Project(IP) Grading rubric is a scoring tool that represents the performance expectations for the IP. This Individual Project grading rubric is divided into components that provide a clear description of what should be included within each component for the IP. It’s the roadmap that can help you in the development of your IP. Individual Project Grading Rubric
Describes a perceived community problem that can be impacted by a policy change. (Max 35 points) 20% Clearly describes a perceived community problem that can be impacted by a policy change. (31-35 points) Clarity is lacking in describing a perceived community problem that can be impacted by a policy change. (28-30 points) One of the criteria is not addressed: Describes a perceived community problem that can be impacted by a policy change. (25-27 points) More than one criteria is not addressed: Describes a perceived community problem that can be impacted by a policy change. (24 points or less)
States and discusses the policy recommendation to address the identified problem. (Max 35 points) 20% Clearly states and discusses the policy recommendation to address the identified problem. (31-35points) Clarity is lacking when stating and discussing the policy recommendation to address the identified problem. (28-30 points) One of the criteria is not addressed: States and discusses the policy recommendation to address the identified problem. (25-27 points) More than one of the criteria is not addressed: States and discusses the policy recommendation to address the identified problem. (24 points or less)
Describes and discusses stakeholders that would be affected by the policy recommendation. (Max 35 points) 20% Clearly describes and discusses stakeholders that would be affected by the policy recommendation. (31-35 points) Clarity is lacking in the description and discussion of stakeholders that would be affected by the policy recommendation. (28-30 points) One of the criteria is not addressed: Describes and discusses stakeholders that would be affected by the policy recommendation. (25-27 points) More than one criteria is not addressed: Describes and discusses stakeholders that would be affected by the policy recommendation. (24 points or less)
Describes the feasibility and possible projected costs of the policy recommendation. (Max 43.75 points) 25% Clearly describes the feasibility and possible projected costs of the policy recommendation. (39-43.75 points) Clarity is lacking in the description of the feasibility and possible projected costs of the policy recommendation. (35-38 points) One of the criteria is not addressed: the feasibility and possible projected costs of the policy recommendation. (31-34 points) More than one of the criteria is not addressed: the feasibility and possible projected costs of the policy recommendation. (30 points or less)
Spelling, Grammar, APA format; 5-7 pages excluding title page and reference page. (Max 26.25 points) 15% No spelling or grammatical errors. Less than 2 errors in APA formatting. (23-26.25 points) 1-2 spelling or grammatical errors. Less than 4 errors in APA formatting. (21-22 points) 4-5 spelling or grammatical errors. 4-6 errors in APA formatting. (19-20 points) More than 5 spelling or grammatical errors. More than 6 errors in APA formatting. (18 points or less)
100% Total score: 0
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