Diabetes in Home Health

Running head: DIABETES IN HOME HEALTH 1

DIABETES IN HOME HEALTH 8

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Diabetes in Home Health

Background

Diabetes has become one of the major health issues across the globe and most importantly in America. Presently, the number of pre-diabetic and diabetic adult patients in America has passed the 100 million mark. In 2015, a total of 30.3 million individuals in America (9.4%) of the country’s population had diabetes (CDC, 2017). The diabetes statistics in United States are very alarming meaning that urgency is needed in addressing this issue. To reduce the high pressure in healthcare organizations, home healthcare has become very essential for diabetic patients. Diabetic patients, usually older adults are discharged from rehabilitation centers or hospitals earlier after being diagnosed with diabetes (American Diabetes Association, 2019). Therefore, these patients are taught how to manage diabetes while at home care facilities, particularly through various interventions. Home healthcare produces the desired health outcomes especially if there is an effective coordination between home care nurses and the patient. This discussion, therefore, focuses on diabetes and how a well-managed home healthcare can lead to the desired health outcomes.

Problem Statement

Owing to the huge number of individuals diagnosed with diabetes or prediabetes, patient pressure has mounted in healthcare facilities. This implies that home healthcare has become the next best alternative for diabetic patients. Diabetes is a chronic disease that impairs the ability of the body to process blood sugar. If not properly managed, diabetes results in buildup of blood sugars, thereby increasing the risk pertaining to serious conditions, for example, heart disease and stroke (American Diabetes Association, 2015). It is surprising that diabetes is not necessarily associated with old age. As a matter of fact, more than 250,000 individuals below 20 years in America are diagnosed with diabetes (Hoffman, 2014). Management of diabetes requires a high level of consistency and this can only be better achieved in home healthcare. Therefore, discovering workable solutions that aim at improving patients’ health outcomes is a priority especially considering that diabetes is a major cause of death in U.S., being ranked at number seven out of the major causes of deaths. This proposal is based on the following question; how effective is home healthcare compared to hospital-based in improving health outcomes of diabetic patients?

Purpose of Change Proposal

The principal purpose regarding change proposal is the identification and implementation of healthcare plan that could help in the improvement of diabetes management in home healthcare. The purpose of home care for patients with diabetes is to improve their health outcomes by consistently adopting various interventions such as medications, doing routine physical exercises, eating the proper diet etc. as recommended by the health professionals. Again, the change proposal aims at providing solutions on how home healthcare can be successful both to the hospitals that could have otherwise admitted the patients and the patients themselves through collaboration with home care nurses. Since diabetes is a pressing concern in America and hospitals have been overburdened by large number of diabetic patients, improving home healthcare is a priority (CDC, 2017). For this reason, the change proposal aims at giving an insight on some of the improvements that could be actualized in order to improve the quality of health outcomes for diabetic patients.

Intervention

The cost of healthcare has significantly increased in America especially considering that millions of Americans who are diagnosed with diabetes require medical care. Therefore, it is imperative to implement various intervention measures for prevention or management of diabetes. In essence, provision of home healthcare is the best intervention owing to the fact that diabetes is a chronic disease. Home healthcare incorporates services and activities such as routine physical exercises, self-administering of insulin, self-examination of blood sugar level, observation of dietary habits as well as observation of other lifestyle behaviors that could increase the risk of diabetes. This intervention does not only help to manage diabetes but also reduces the risk of other lifestyle diseases as well as prolonging the patient’s life (Hoffman, 2014).

Comparison

Healthcare for diabetic patients is either provided at home or in hospitals. Home healthcare has proved to be very effective as far as improving health outcomes for diabetic patients is concerned. To assess this effectiveness, certain questions could be used. How comfortable is the provision of healthcare services at home compared to hospitals? Does management of diabetes at home with assistance of home care nurses differ from such management in a hospital setting? How does home healthcare improve patient outcomes? Actually, home-based care is the best option since it reduces healthcare costs, offers specialized services and it is convenient and comfortable (American Diabetes Association, 2019).

Outcome

It is evident that home healthcare has resulted to the improvement of health outcomes of diabetic patients. These patients require some autonomy and comfort that can only be best provided under home healthcare, something that is very crucial in improving the patients’ quality of life. With respect to management of symptoms, homecare health is very effective since it provides a supportive environment for the various recommended activities that specifically address diabetes symptoms (Hoffman, 2014).

Time

The timeframe of the intervention is dependent on the specific health requirements of the patient. For example, for a diabetic patient who is overweight, it would require them to undertake routine physical exercises probably early in the morning and the evening. Also, checking for blood sugar levels could be done on a weekly basis while administration of insulin is done during the time recommended by the physician. Lastly, the visits by the home care nurse should be organized depending on the convenience of both the patient and the nurse or depending on emergencies.

Literature Search Strategy

The strategy employed for searching literature with regard to management of diabetes in home healthcare incorporates the use of credible and quality sources of information that specifically relates to the issue at hand. Therefore, the literature used has been gathered from peer-reviewed journal articles, credible websites of health-related organizations, books, newspapers, magazines and diabetes-related reports. Also, the bibliography sections of articles and reports were also utilized in gathering more credible information. To obtain the finest details with regard to the topic under discussion, the researcher also incorporated the use of key words and terms that pertain to diabetes and home healthcare. In order to obtain recent information, the search was limited to the last five years.

Literature Evaluation

First of all, the information used in this discussion is very relevant to the topic at hand because it is gathered from credible and quality sources. Secondly, the most current literature has been obtained by using sources published over the last five years. Thirdly, the sources utilized provide specific information that is very specific with regard to addressing both the problem statement and the research question. Again, the available literature on this topic is factual since it is based on scientific research which based on evidence and real case studies regarding diabetes and home healthcare.

Nursing Theory Applied

Self-management theory explains how self-efficacy can be enhanced in improving patient health outcomes especially for patients suffering from chronic conditions like diabetes. Essentially, healthy behaviors like successful symptom self-management have the potential of reducing suffering from diabetes (CDC, 2017). Here, home care nurses are very crucial as they play a significant role in the development of a plan regarding symptom self-management that is critical in the optimization of the patients’ behaviors regarding self-management of symptoms.

Proposed Implementation Plan and Outcome Measures

Implementation plan incorporates provision of diabetes-related education to the patient and/or their family with regard to prevention and management of diabetes; administration of insulin, blood sugar tests etc. It would also incorporate the provision of specialized services to the patient by home care nurse in the home setting as well as providing the patient with necessary equipment and resources to perform specific tasks (American Diabetes Association, 2019). Outcome measures would be related management of symptoms including; reduction of weight, reduction in fatigue, normal urination, improvement in vision etc.

Implementation Barriers and Ways of overcoming them

One of the barriers to implementation of the above plan is non-compliance by the patient to the list of recommended activities. This can be overcome by letting the patient understand the repercussions of non-compliance. Another barrier is lack of support by the family members. Here, the family members can be educated on how to provide a comfortable environment for the patient. Moreover, scarcity or inadequacy of home care nurses may also hinder the implementation process. The patient can seek the services of private nurses depending on their financial well-being. In addition, diabetes is chronic condition that requires huge costs for its management; therefore, the implementation could also be halted by high healthcare costs. These costs can be avoided through seeking government-sponsored healthcare programs like Medicaid or Medicare (CDC, 2017)

References American Diabetes Association. (2015). Home Helathcare and Diabetes Assessment, Care, and Education. Retrieved from https://spectrum.diabetesjournals.org/content/16/4/217. American Diabetes Association. (2019). Statistics About Diabetes. Retrieved from https://www.diabetes.org/diabetes-basics/statistics/. CDC. (2017). New CDC Report: More Than 100 Million Americans Have Diabetes or Prediabetes. Retrieved from https://www.cdc.gov/media/releases/2017/p0718-diabetes-report.html. Hoffman, A. (2014). Enhancing Self-Efficacy for Optimized Patient Outcomes Through the Theory of Symptom Self-Management.Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3526102/#_FFN_sectitle.

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What is the most likely cause of this patient’s current pulmonary complaints?

discussion 1 Clinical case scenario

A 39-year-old homeless man presents to the emergency department for cough and fever. He says that his illness has been worsening over the past 2 weeks. He originally had dyspnea on exertion and now is short of breath at rest. On questioning, he tells you that he lives in a homeless shelter when he can, but he frequently sleeps on the streets. He has used IV drugs (primarily heroin) “on and off” for many years. He denies medical history but the only time he gets medical attention is when he comes to the emergency department for an illness or injury. On review of systems, he complains of fatigue, weight loss, and diarrhea. On examination, he is a thin, disheveled man appearing much older than his stated age. His temperature is 100.5°F (38.0°C), his blood pressure is 100/50 mm Hg, his pulse is 105 beats/min, and his respiratory rate is 24 breaths/min. His initial oxygen saturation is 89% on room air, which comes up to 94% on 4 L of oxygen by nasal cannula. Significant findings on examination include dry mucous membranes, a tachycardic but regular cardiac rhythm, a benign abdomen, and generally wastedappearing extremities. His pulmonary examination is significant for tachypnea and fine crackles bilaterally, but no visible signs of cyanosis. His chest x-ray is read by the radiologist as having diffuse, bilateral, interstitial infiltrates that look like “ground glass.”

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1. What is the most likely cause of this patient’s current pulmonary complaints?
2. What underlying illness does this patient most likely have?
3. What testing and treatment should be started now?

1 Scholarly Resource in APA format.

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Discussion Case Scenario

Read and answer questions

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Answers Do Not Have to be in APA Format.

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discussion1ClinicalcasescenarioDXSXIM.docx

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