Early Detection And Effective Management

Managing diabetes needs continuum of care to improve the health of the population, reduce per capita costs of care and improve the experience of care. Continuum of care is defined as a care system that guides and tracks the clients through a myriad of health services at all levels, stages and intensity of care (HIMSS.com, 2015). The provisions of Title II-Subtitle E provide new options for long-term services and support. The provision of community first choice allows the lower income diabetes patients to have access to long-term healthcare at an affordable cost (Obamacarefacts.com, 2013). Empowered by HIT, nurses can find community resources, develop patient

The National Kidney Foundation information is provided in a question and answer format with one or two sentence simple answers provided. The Merck Manual site utilizes headers with information ranging between one to three paragraphs. Links available on the National Kidney Foundation Website keep the reader on the site and frequently take them back to the donation page. The Website provides a section for “Professional” users, however, the majority of the area is again written for the general public. One area reviewed provides an “Education and Research” option that takes the professional reader to more technical writing sources contained within the National Kidney Foundation Website. The Merck Manual links allow the reader to visit other Websites for additional subject information. The National Kidney Foundation Website offers additional educational opportunities via Webinars and seminars. No such offerings were noted on the Merck Manual site.

Chronic kidney disease (CKD) is a worldwide problem that is currently three times higher for African Americans, Hispanics, Pacific Islanders, American Indians and seniors (The National Kidney Foundation, 2013). CKD occurs when the kidneys are damaged by a pathogen or injury and they can no longer adequately maintain proper levels of regulated chemicals in the bloodstream. There are many risk associated with CKD. According to the National Kidney Foundation, two of the major risks are Chronic Renal Failure (CRF) and Cardiovascular Disease. Currently twenty million American adults have CKD and millions of others are at increased risk. Age has no barrier on getting CKD. People with pre-existing health issues, and a part of certain population

Ms. Conlon applies the nursing process to systems or processes at the unit/team/work group level to improve care. Deirdre has been the primary nurse for 6 hemodialysis patients. She has involved patients and families in monthly interdisciplinary meetings to promote self-efficacy and quality of life. With the help of the interdisciplinary team Deirdre has worked collaboratively to address and reinforce nutritional needs, social/family issues, barriers to care, and safety concerns. All of her primary care patients have maintained a goal of 100% for dialysis adequacy (benchmark is 85%) and a vascular access rate of 100% and dictated by KDOQI standards.

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

The role of nurse practitioner is valuable when discussing collaborative care. There are so many levels of care, so many health entities, and so many insurer criteria involved that it is instrumental to have a role that can work towards help bring all aspects together. In addition to diagnosing, treating, and managing care, the role of the nurse practitioner is to manage simple and episodic acute health issues along with chronic disease (Sangster-Gormley, Martin-Misener, & Burge, 2013). It is important to note that although this is a function of this role, nurse practitioners also practice from a holistic point of view which allows them to help manage patient conditions or wellness in a more complete fashion. This includes helping patients have access to care beyond primary and secondary care settings. This encourages nurse practitioners to work alongside other health care and allied health professions, and families to create an individualized plan for every patient (van

Budzi, Lurie, Singh, and Hooker (2010) state, “Nurse Practitioners’ (NP) interpersonal skills in patient teaching, counseling, and patient centered care contribute to positive health outcomes and patient satisfaction.” According to their research they encourage healthcare systems in the U.S. to hire more NPs to allow for better access affordable, and quality care (Denisco & Barker, 2016). With the demand for primary care providers, The NP role aids in delivering a solution to some of the healthcare issues that exist today. Organizations like the Institute of Medicine (IOM) and Centers for Medicare and Medicaid (CMS) all agree to allow nurses to practice to their full abilities to make healthcare more accessible and affordable, especially for the aging baby boomers and less accessible rural neighborhoods, and densely populated urban areas. Research has proven that NPs that provide primary care have similar health outcomes to primary care physicians (DeNisco et. al., 2016). NPs particularly take pride in their holistic approach, forming therapeutic relationships between other providers of the healthcare team, patients, and their families, aiding the informed decision making process, use of the evidence based practice approach in health management (Brown, 2005). Some of the other actions or qualities that

The success of NPs depends on practicing evidence-based care with competency in assessment, diagnosing, managing patients, and maintaining a caring practice. The nursing component of the NP role continues to be challenged from within nursing, as well as by large national physician organizations. NPs are extensions of nursing practice who are guided by nursing theory. The transformation from nurse to the advanced practice role of NP involves development of advanced knowledge and skills for listening, knowing, being with patients, connecting patients to their communities, promoting health,

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.

BMJ published the results of a systematic review of 11 trials which assessed cost-effectiveness of nurse practitioners in primary and specialized ambulatory care (Misener et al, 2015). This study evaluated nurse practitioners as alternative and in complementary care and outcomes. The primary outcome analysis was based on cost-effectiveness and included use of services, cost of healthcare and use of health resources. Additional outcomes of health status, quality of life, patient satisfaction and provider’s quality of care and job satisfaction were also evaluated. Four trials found that nurse practitioners could function at least to the level of physician comparators with equal or lower cost and 4 studies showed care was at least as equivalent to general practitioner in outcomes. One study showed patients managed by nurse practitioners had a larger drop in diastolic blood

If you think health care is not imperative, try knowing that you cannot go to a doctor because you could not afford it financially and that if there is something wrong, it may cause your severe disability or your death because you could not get treatment. Heck, you could not even take advantage of early preventive care programs. Even many who do have insurance will go bankrupt because the insurance companies think only of their "bottom lines," if it flatlines the people.

Chronic Kidney Disease (CKD) is a disease that is described as a loss of kidney function gradually over time. As kidney function decreases, the waste collection in the body’s blood becomes high and makes the individual feel sick. This disease can lead to other complications in the body such as anemia, poor nutritional health, high blood pressure, and nerve damage. These complications will begin to progress and show as CKD progresses to advanced stages. Early detection of this disease is essential when it comes to treatment. If CKD is diagnosed early enough the disease progression can be slowed down and managed. This disease will eventually lead to failure of the kidneys

Diabetes is associated with wide range of complications such as chronic renal failure, blindness, amputations, heart disease, high blood pressure, stroke, and neuropathy (Alotabi, A., et al., 2016). There is no known cure for diabetes, but the disease can be controlled through health management that includes multiple perspectives of care such as medications, blood glucose monitoring, diet, nutrition, screening for long-term complications and regular physical activity (Alotabi, A., et al., 2016). Managing diabetes may be complicated and requires the knowledge and skills of both healthcare providers and the clients. Studies have shown that to prevent or delay diabetic complications due to diabetes, counseling and other lifestyle interventions are the effective therapy. Even with many policies set up for diabetes, 8.1 million Americans are undiagnosed with diabetes mellitus, and approximately 86 million Americans ages 20 and older have blood glucose levels that considerably increase their risk of developing Diabetes Mellitus in the next several years (CDC, 2015). For diabetes care to be successful there needs to be a good understanding of the disease and management by both patients and healthcare providers,

Chronic kidney disease (CKD) is an irreversible condition that progresses causing kidney dysfunction and then to kidney failure. It is classified by a GFR of <60mL/min for longer than 3 months. There are five stages of CKD: Stage 1 has kidney damage but has a GFR ≥ 90. Stage 2 has mild damage and a GFR of 60-89. Stage 3 has moderate damage and a GFR of 30-59. Stage 4 has severe damage and a GFR of 15-29. Stage 5 is also known as end stage renal disease (ESRD), this is kidney failure with a GFR of ≤ 15 and theses patients are typically on dialysis or in need of an immediate transplant. The leading cause of CKD is diabetes. Hypertension is also a major cause. Since most DM patients have HTN,

To examine the efficacy and safety of insulin and other pharmacological interventions for lowering glucose-lowering levels in patients with diabetics and Chronic Kidney Disease (CKD).