Diabetes Nurse Specialists

Diabetes affects nearly 10% of the total population and national cost of more than $200 billion each year in the United States (Center for Diseases Control and Prevention, 2017). Before the patient protection and affordable care act (PPACA), many low-income diabetes patients had no or very limited access of health insurance coverage due to financial disadvantage. PPACA Title II-Role of public programs expanded Medicaid coverage to individuals under 133% of the federal poverty level (Obamacarefacts.com, 2013). Nurses directly interact with low-income diabetes patients to guide, advocate, educate and navigate the complex healthcare system to deliver the best evidenced care (Marquis &

The study had an overall total of 1150 participants. Although there were many participants to begin with, they did not provide all of the feedback the researchers had requested.  This resulted in the expulsion of their participation, so their results were not included in the final reports of the study. The number of patients that did provide the essential information added up to a total of 901. The profile for a participant was a patients diagnosed with Type 2 diabetes in the last 6 months, but has been diagnosed no more than 10 years ago. They had to be between 35-70 years of age. Their BMI had to be more or less than 24 kg/m2 and have an HbA1c more or less than 6.5%. They also had to have treatment with a diet or oral glucose lowering medication. Those needing insulin shots, had been diagnosed with chronic diseases, or had a change in diet or lifestyle 3 months prior to the study were not included in the overall

This essay will focus on type 2 diabetes, which is becoming one of the fast growing chronic health conditions in the United Kingdom (UK). Approximately 700 people are diagnosed with type 2 diabetes each day in the UK (Diabetes Uk, (2014)a). It is costing the NHS about £10billion pounds each year to treat diabetes along with its complication and it is expected to rise in the next couple of years (Diabetes UK, (2014)b).

There is a growing trend where physicians are choosing different specialties instead of choosing primary care, primarily due to the low reimbursement rate in primary care. According to Iglehart (2014),” the Association of American Medical Colleges (AAMC) still projects a shortage of 130,000 physicians by 2025, split almost equally between primary and specialty care” (para. 1). With this decline comes an answer, an increase in the number of nurse practitioners providing patient care, reported 154,00 in 2012 and growing every year (Iglehart, 2014). This increase in nurse practitioners’ helps fill that gap, allow greater health care access to the community, especially special populations. By gaining access to healthcare were a nurse practitioner is the provider not only with the special population have high quality affordable health care, a trusting long lasting relationship will develop. This relationship will break the barriers of; lack of trust, lack of health care education and discrimination. Nursing is a trusted profession that provides education and care that no other health care professional

These include hospital stay and the high rate of readmission to hospital for screening and due to complications. Medications for the patients also contribute significantly to diabetes management since the drugs are prescribed for maintenance of the condition and thus need to be taken regularly. Inpatient visits to the hospital is the leading value of cost in the management of the disease (American Diabetes Association, 2013). The people who have diabetes are sicker and weaker when compared to the general population. The cost of their health care spending is also higher than the cost for healthy individuals. On the view of indirect costs due to diabetes, there are several conditions that lead to an increase in expenditure of the patients. For instance, the likelihood of developing disabilities due to complications as a result of diabetes is quite high. The workforce is therefore negatively affected and leads to a decline in the economy of the country. Out of all the deaths reported in the year 2012, the number in which diabetes was named as the primary cause amounted to 30% diabetes (American Diabetes Association, 2012; National Diabetes Statistics Report, 2014; American Diabetes Association, 2013). The premature deaths due to diabetes led to loss of income and loss of productivity in the country. The public therefore needs to be educated to reduce this cost as it is shown that the cost of managing diabetes is reduced when the patient has enough information about the condition. For instance, persons with better glycemic control have low levels of developing complications and report a decrease in visits to a doctor with those with uncontrolled diabetes having to visit the hospital three to eight times more (Handelsman et al.,

It also shows that not having someone to help these patients manage their diabetes as an obstacle to good diabetes management. This study created a plan and this plan was able to be tested to show its effectiveness in diabetes

The percent change in spending for heart disease was attributed to a 68.6% increase in cost per treated case and a 30.3% increase in the population treated. Heart disease spending was the largest among 15 medical conditions experiencing the largest rise in spending. Interestingly, the rise in cost per treated hypertension case accounted for 60% of the overall growth in spending for hypertension compared with a 19% rise in treated prevalence of the disease. This was attributed to the emergence of new and more costly antihypertensive drugs. In contrast, 50% of the rise in health care spending for diabetes was a result of a rise in treated prevalence and only 24% was attributed to an increased cost per treated case. The total spending for diabetes increased from $8.6 billion in 1987 to $18.28 billion in 2000. Spending for diabetes will surely rise exponentially in the next 10 years because of the continued increase in prevalence of the population being treated and an increased cost per case as new diabetic drugs enter the pharmacologic armamentarium. The spending for diabetes and the spending for heart disease are obviously intertwined.

Dominique presented on Population Health Management and Standardized Care in Type 2 Diabetes. The meeting was held November 1st at 3:00-4:00pm in the Corporate Auditorium at Centura Health Corporate Building. The concentration of her presentation was based on Figure 2 and Figure 2 maps. Figure 1 represents the increase shade of blue proportional to the increase of percentage being told they had diabetes (Centers for Disease Control and Prevention,

The management of co-morbidities in America is an escalating dilemma for advance practice nurses (APNs). As an advance practice nurse (APN) continues to expand in her direct care role the depth and breadth of his/her advanced practice will focus on ongoing management and care of diverse populations that present to the APNs practice with hypertension and other co-morbidities which must be treated suitably with the best evidenced based approach and current guidelines aimed at promotion, maintenance and advancement of patient’s health, prevention or reduction in progression of maladies burden and cost. Hypertension and co-morbidities such as Type 2 diabetes mellitus (DM) and Hyperlipidemia are health problems frequently seen by practitioners with potentially ravaging, though preventable outcomes.

Lastly, a study by Stanik-Hutt, J., et al. (2013) provides data showing APRNs improve quality of the healthcare system. This study validates what many of the aforementioned studies have already revealed. Furthermore, clinical nurse specialists (CNS) were found to reduce the length of time a patient was in the hospital setting; patients cared for in the primary care setting had the same outcomes as MDs in regards to blood pressure, glucose and

In a paper of 750-1,000 words, summarize the main idea of the research findings for a specific patient population. Research must include clinical findings that are current, thorough, and relevant to diabetes and the nursing practice.

The article explained that an increased pressure is placed on the physician to provide all that care that the client with a chronic illness needs. The conclusion of this article is that there needs to be maintained investment in primary health care so that those patients with multiple disease can be cared for without an inflation of chronic conditions as they advance in age. This article displays the need for outsourcing care of patients to outpatient care. This will affect the care that I provide as a nurse in a positive way because I believe that as these increased needs get sorted out the care that nurse will be able to give to the client will increase in

Average annual expenditure incurred by a person with diabetes in 2012 was $13,700 (American Diabetes Association [ADA], 2013). This is 2.3 times higher than a person without diabetes. These costs can include office visits, emergency care, hospitalizations, medications, and equipment for home care. Not only does the individual suffer a colossal financial burden from diabetes, so does the economy. The total cost of diabetes to the American economy in 2012 was $245 billion, $176 billion of which went toward direct medical costs such as hospital and emergency care, office visits, and medications (ADA, 2013). Sixteen percent of healthcare expenditures attributed to diabetes were spent on inpatient hospitalizations and six percent on emergency visits (ADA, 2013). These numbers show a necessity for improved diabetes education and overall increased attention to diabetes in our

Despite the growing burden of diabetes and the lack of diabetes care providers, barriers and resistance for utilization of Advanced Practice Registered Nurses (ARPRNs) to provide diabetes care continues to exist. According to the Centers for Disease Control and Prevention (CDC) (2017), an estimated 30.3 million people have diabetes, with greater than 90% having Type Two Diabetes. In Saline County, Kansas, 12 % of the population has been diagnosed with diabetes (Robert Wood Johnson Foundation, 2016). A previous gap analysis identified the lack of outpatient diabetes education and management services in Saline County, Kansas. Follow-up SWOT (strength, weakness, opportunities and threats) identified barriers and potential solutions that must

Your post is quite informative! I totally agree with you about comprehending the culture of organizations that influences nurse’s health and well-being of communities. It is quite evident to me that during your milestone 3 you have identified that “there was a lack of awareness of diabetes and the complications” that impacted your community. There is no doubt in my mind that as the community/public health nurse, your interventions on diabetes and what you brought to your community should have a lasting effect on the residents. Great interventions! With your recommendation to the Institute Medicine (IOM), let us hope that they can advance research and data analysis as soon as possible. This would give you the necessary tools that you