Untitled document.edited - 2023-12-28T221004.148

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Diabetes Mellitus is becoming a public health issue in the 21st century as more and more people are becoming sick. The sharp increase in the number of diabetes patients over the last several decades is frightening since it is related to microvascular and macrovascular diseases such as stroke, cardiovascular disease, peripheral neuropathy, diabetic nephropathy, and retinopathy. From the viewpoint of type diabetes, heart failure is the main warning sign of cardiac problems Ⅱ and is a risk factor for death (Sheleme et al., 2020). However, current breakthroughs in proper management of diabetes have actually extended the life spans of diabetics, and the course of the disease has slowed. It is unlikely that people with diabetes will suffer complications. It is worth noting that several new studies suggest that the likely causes of death for diabetics have changed (Sheleme et al., 2020). Before disease management improved, the leading cause of death was cardiovascular disease. Now, other causes have become more prevalent. Quality of Care Effectively managing diabetes takes cooperation among caregivers, diabetics, the healthcare system, policy, and responsible community resources. Selvin et al. (2018) note that by pursuing a healthy lifestyle (e.g., exercising, maintaining control of one's blood pressure, eating less saturated fat and alcohol, and avoiding sweetened drinks), people can slow their progression from heart failure or stroke to nephropathy. Early detection, through regular eye exams and timely treatment, can prevent 90 % of diabetes-related blindness. Comparatively, studies have shown that with patient education and at least one examination of the feet a year, 85 % of diabetes-related amputations can be prevented (Selvin et al., 2018). These stakeholders can join hands and take the initiative to do something so they can improve the lives of people with diabetes. For example, in their research on the problems encountered by healthcare providers in providing quality care, Al-Alawi et al. (2019) utilized the theoretical framework of behavior change. On the other hand, nurses discovered that lack of knowledge and skills was not the real problem but that the lack of familiarity with optimal control for various groups of patients was something very commonly encountered. Skills-related barriers included keeping up with clinical information and also include prediabetes. Healthcare professionals also raised these points. The most common obstacle cited was the barriers to the health system. Inadequate consultation time was rated as the most important factor impairing adherence to clinical guidelines, followed by a need for more resources to meet all of the needs. Research from the patient's angle revealed that patients are unaware of what risk factors lead to diabetes. What they said was inadequate education about controlling and preventing diabetes. Patient Safety In diabetes management, patient safety takes top priority. The lack of an efficient reporting system, multidisciplinary cooperation, and knowledge are just a few of the barriers to patient safety. Most importantly, according to Neves et al. (2020), communication is a mortal necessity in the management of diabetes; poor communication can cause medical mistakes, slow diagnosis and treatment, and compromise decision-making and follow-ups. Moreover, inept reporting means that the patients will not take their medicine properly, bringing the danger of cardiovascular disease and other chronic ailments.

In addition, the lack of sufficient cooperation between healthcare providers led to the high rate of preventable error and the decline of care quality to the patients. Neves et al. (2020) further stress the importance of providers working together; if there is no coordination of patient care, this leads to poor quality of care and patient safety. Also, the fact that patients are not well trained has become an important factor that impacts patient safety by increasing medical mistakes and reducing the effectiveness of healthcare. To educate the patient, they must be told about the treatment mechanism, available information, required lifestyles, follow-up procedures, and so on. With the lack of this education, patients' lives and safety are often put in jeopardy. However, when doctors do not teach the patients how to manage their blood sugar or take care of their bodies, they push the patient into a higher risk of diabetes complications or even death. Cost Managing diabetes involves significant financial implications, with patients diagnosed with diabetes mellitus incurring substantial healthcare costs. According to the American Diabetes Association (2022), an estimated cost of around $327 billion is associated with identified diabetes. Of this total, $237 billion goes to direct medical expenses, and an additional $90 billion replaces decreased productivity. Within the breakdown of cost categories, healthcare for diabetic patients constitutes 25% of all healthcare expenses in the U.S., with over 50% attributed to direct expenditures. Diabetic patients individually bear an average of $16,750 in medical costs, with approximately $9,600 directed toward medications. Notably, these patients spend about 2.3 times more on healthcare compared to individuals without diabetes. The indirect costs of managing diabetes, including absenteeism at work ($3.3 billion) and low job productivity ($26.9 billion) for the employed, further underscore the substantial financial impact of diabetes on society (American Diabetes Association, 2022). The results include tangible and intangible losses, such as pain, the work of unreturned contributions, and costs assumed by cases that are not identified. Effects of Policies To take healthcare as an example, the Affordable Care Act (ACA) that President Obama signed in 2010 has made healthcare more accessible and more affordable (Angier et al., 2020). A major change brought by the ACA was a 2014 expansion in funding for Medicaid, improving access to health care for the frailest among us. Angier et al. (2020) demonstrate this principle by noting the assistance the ACA provides to people with diabetes in terms of diagnosis and treatment. The ACA was crucial in ending exclusions for pre-existing conditions and extending patients 'access to care. Such an increase in insurance coverage has also been of special advantage to racially and ethnically disadvantaged populations and helped improve their health, early detection, treatment wastage (noncomplying with the treatment process), follow-up, and lifestyle (Angier et al., 2020). Other variables, including knowledge of one's condition, attitudes about health, stress, depression stemming from chronic illness, dieting habits, stress levels at work, and the level of physical activity, may make this relation with insurance status difficult to discern, not to mention their effects on blood sugar control (Angier et al., 2020). Finally, the ACA's promotion of greater access to health care has also encouraged people to get an early diagnosis and treatment for

diabetes (the majority of patients take the preemptive step when they have the opportunity) and thereby intervene in the development of the disease. Strategies to improve quality of care, patient safety, and Cost Quality of Care The quality of patient care is key to ensuring that diabetes is effectively checked. A study by Selvin et al. (2018) indicated that inadequate patient knowledge (e.g., about their disease and medications) and lack of support are the main causes of insufficient adherence to prescribed medications and changes in lifestyle after their first diagnosis of diabetes. To address these challenges, nurses can employ the middle-range theory of nursing practice and individual- centered care, an evidence-based approach designed to guide nursing practice, enhance healthcare for diabetic patients, and improve overall outcomes. The middle-range theory emphasizes the significance of consulting patients on treatment plans to boost compliance. It focuses on assessing their willingness and readiness to make lifestyle changes in alignment with the new diagnosis (Jones, 2023). The initial patient contact evaluates the expected outcomes to establish medication compliance. Nurses are essential in utilizing effective communication and providing a safe space for informed decision-making. They also support patients in lifestyle modification and encourage them to adhere to prescribed medication. This ensures that patients clearly understand expectations during the treatment process. Patient Safety Improving patient safety calls for intensive work with patients and those caring for them. Neves et al. (2020) say the key is practical communication to help deliver safe, quality care. Since effective communication is associated with a reduced risk of patients failing to adhere to treatment regimens, nurses are required to have good communication skills and develop an ability to communicate effectively. Based on sound evidence, patient-centered care helps increase patient satisfaction and promote quality and safety. Studies have shown that incorporating the patient's plan of care into treatment improves both quality and Cost savings can be achieved. Jones (2023) demonstrated these benefits in trials with individual-centered care use instituted for patients undergoing treatments at several hospitals worldwide. Using this evidence- based approach to involve the patient in their treatment actively raises more significant potential for success and improves safety. Cost Regarding costs, the American Diabetes Association emphasizes that prevention and early diagnosis through proper treatment and evaluation can only lower them (ADA, 2022). The ADA has developed four strategies to relieve the financial burden on diabetes patients in their treatment. First of all, it means lowering people's blood glucose to healthier levels, as early diagnoses should be the goal. Secondly is increasing education for high-risk groups to reduce various costs arising from dealing with diabetes complications. The third is to cooperate with health workers and mobilize community resources to improve disease outcomes. Finally, the fourth strategy is breaking down obstacles to treatment. The barriers to care highlighted here include increasing accessibility of medicine, providing better emotional and social support

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systems, and a growing understanding of the necessity for following medical protocols outlined by the American Diabetes Association (2022). We can expect that reducing therapy charges for people with diabetes will improve adherence to medications and lifestyle monitoring. Part 2: Assessing the problem To better understand the situation, I interviewed Mrs Norah (not his real name), who is 63 years old. She is a high-risk patient for uncontrolled blood sugars and has been experiencing such difficulties for half a year now. In the interview, Mrs. Norah displayed a total ignorance about diabetes as well as increased worries over lifestyle adjustment to make up for his history of alcoholism and adherence to a sedentary schedule due to high blood pressure. During this time, I introduced Mrs Norah to the evolving middle-range nursing theory, which aims to attain proper blood glucose levels and management through behavioral change. On evaluating his ability to make lifestyle changes, Mrs. Norah said she was more than willing and would be happy to look for a new approach to controlling the condition, insisting on doing whatever is necessary just so that she could have a chance to grow old. With such support, guidelines and a team approach would be helpful to her journey forward. From this interchange, we could see that several obstacles hinder disease management, and the significance of overcoming them was made apparent. Conclusion All in all, for diabetic patients, health care must be individualized and multidisciplined. It also requires a broader scope of activity by nurses. Patient-centered care and evidence-based frameworks are essential to effective patient care, as these approaches allow each patient's needs to be met based on their specific circumstances rather than forcing them into a one-size-fits-all mold. The preference for better management practices is directly related to satisfaction with quality and safety in patient care. Discussion of Cost, therefore, is best done from an integrated management viewpoint, focusing on prevention, early treatment, control of blood glucose levels, and reducing patients 'burden. They also suggest that this should be accompanied by multidisciplinary networking of information about disease control factors to break down barriers to the sharing of information and the elimination of obstacles in illnesses. Also, the importance of the near-sighted goal of influencing policy (such as the Affordable Care Act, which is revolutionary in terms of healthcare access and effectiveness in targeting patients with high blood sugar levels) should be addressed. Such assessments are all characterized by listening to patients, understanding a patient's particular circumstances, and acting based on evidence. In the end, it is all to ensure better relations in disease control and greater benefits for sufferers and to ease the overall burden of diabetes.

Untitled document.edited - 2023-12-28T221004.148

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