Chronic Health Condition-Nursing Paper Samples

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Assessment: Diabetes (Chronic Health Condition-Nursing Paper Samples)

Diabetes is a chronic health condition prevalent in older people, especially those 65 years and above. It is associated with the body’s inability to produce or use insulin effectively, resulting in elevated or critically reduced blood glucose levels. Older people have an increased risk of developing type II diabetes. According to Halim and Halim (2019), aging impairs energy homeostasis and carbohydrate metabolism, increasing the risk of insulin secretion challenges and developing insulin resistance (Chronic Health Condition-Nursing Paper Samples).

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Chronic Health Condition-Nursing Paper Samples
Chronic Health Condition-Nursing Paper Samples

These abnormalities predispose elderly people to the adverse effects of diabetes. Cloete (2021) illustrates that the disease manifests in symptoms such as increased urination, excess fatigue, and difficulty in wound healing. They also experience blurred vision, headaches, gum problems, dry mouth, and increased appetite (Chronic Health Condition-Nursing Paper Samples).

Based on the analysis of the health issue you selected, explain how this issue affects the health care system and the patient. Consider cost, resources, and insurance companies.

The management and treatment of diabetes attract huge costs, which burden the healthcare system, making it challenging to satisfy the diabetic needs of patients appropriately. For instance, the US spent approximately $327 billion in 2017 to manage diabetes, with $$237 billion used on direct medical costs and $90 billion on reduced productivity (NCCDPHP, 2021). Individuals diagnosed with diabetes consume approximately 2-3 times the healthcare expenditure than patients suffering from other health conditions. These costs could be used to cover other chronic conditions or improve infrastructure for providing patient care (Chronic Health Condition-Nursing Paper Samples).

Besides, it requires huge resources like medications and manpower to monitor patients regularly. Furthermore, this overstretches the demand for healthcare professionals, making it challenging to provide improved care. Additionally, diabetic patients pay more for insurance coverage than those without the condition. The out-of-pocket payments for the patients are 30% higher than for those without diabetes. Similarly, Lee et al. (2020) illustrate that the government spent an additional 10.9 million on diabetes coverage between 2013 and 2016 under the Affordable Care Act (ACA), indicating an increased burden in managing the disease (Chronic Health Condition-Nursing Paper Samples).

Develop a search strategy to find literature related to the selected health issue to determine what is currently used to treat the issue. Based on the evaluation of the literature you selected, discuss the potential resolutions and the ensuing effect that the treatment has on the healthcare system in terms of cost and resources.

Literature on diabetes can be drawn from government websites, such as the Centers for Disease Control (CDC), the university library, and Google Scholar, which details the prevalence, symptoms, treatment, and the healthcare burden of the disease. Consequently, various literature on the treatment of diabetes can be drawn from the identified sources (Chronic Health Condition-Nursing Paper Samples).

For instance, Herkert et al. (2019) observe that insulin pumps are effective in diabetes treatment to maintain health and ensure effective blood sugar management. Moreover, the cost of insulin treatment in the US has tripled over the past decade ($6500). Hence, making it challenging for low-income patients to afford it (Payne et al., 2022). However, the inability to afford insulin treatment contributes to its underuse and prevalence of the disease and increased cost of management in the healthcare system (Chronic Health Condition-Nursing Paper Samples).

Besides, the US spends 1 in 4 healthcare dollars in diabetes treatment and management, translating to approximately $9600 per person for diabetic medications (NCCDPHP, 2021). Also, the diseases required enormous resources, such as healthcare workers and hospital beds for admitted patients (Herkert et al., 2019). Furthermore, this means that the healthcare sector must continuously hire nurses to help manage the staggering 37.3 million diabetic patients in the country (Chronic Health Condition-Nursing Paper Samples).

Discuss the ethical dilemma of managing a chronic disease when the patient does not follow a suggested treatment plan. Consider how socioeconomic, environmental, and cultural norms influence the patient as you assess the ethical dilemma.

A breach of patient autonomy and informed consent may occur in cases where a patient does not comply with the treatment guidelines. For instance, patients from low socioeconomic status may make inappropriate decisions not to buy expensive insulin pumps against the treatment requirements (Herkert et al., 2019). Such patients may disentitle themselves from the right to access improved healthcare due to the inability to afford the costs, exacerbating their conditions (Chronic Health Condition-Nursing Paper Samples).

Besides, culture may contribute to treatment boundaries, which nurses must respect to uphold a patient’s autonomy. For example, African Americans may decline insulin treatment due to the fear that the treatment complicates diabetes, including damaging internal organs (Sari et al., 2022). Lastly, environmental factors like poor human resource management and inadequate healthcare infrastructure may inhibit hospital patient autonomy. Molina-Mula and Gallo-Estrada (2020). Consequently, a low nurse-to-patient ratio may compel hospitals to make comprehensive decisions regarding patient treatment without focusing on the patient’s needs or treatment choices (Chronic Health Condition-Nursing Paper Samples).

Discuss any policies (local, state, or federal) that attempt to help manage the chronic disease and associated costs.

The Medicare CGM Access Act was established in July 2021 to reduce delays associated with continuous glucose monitoring (CGM) under Medicare (Galindo et al., 2022). Moreover, the delays were attributed to the four-time daily fingertip requirement to qualify for the CGM coverage, which increased the risk of exacerbating the condition. Consequently, Galindo et al. (2022) illustrate that CGMs are essential in providing real-time and dynamic information about individuals’ blood sugar levels to manage the condition properly. Furthermore, the legislation enhances the reduction in the cost of diabetes management by ensuring early management of the disease (Chronic Health Condition-Nursing Paper Samples).

Discuss the barriers to the implementation of the solution proposed in the policy (Chronic Health Condition).

Implementing the policy is challenging due to the issues associated with the CGM device, such as the high costs of the device, which prevents many people from using it (Galindo et al., 2021). This makes it challenging to enjoy the benefits of the legislation since it relies on the use of the device. Besides, the legislation does not cover individuals diagnosed with diabetes, restricting them from accessing the technology. Additionally, most practitioners may be unaware of the criteria and documentation process, hindering them from obtaining CGM for eligible patients (Galindo et al., 2021). In this case, primary care settings may not adequately implement legislation to determine a patient’s CGM eligibility and treatment process (Chronic Health Condition-Nursing Paper Samples).

Based on what you have discovered in the literature you evaluated, propose your recommendation as a DNP-prepared nurse to reduce expenditures while continuing to provide health care measures for older individuals with the selected disease. Be sure to consider Christian and ethical principles in developing your proposal.

Nurse case management should be employed to reduce the expenses in diabetes care. Consequently, nurse case management entails collaboration and coordination in assessing patients’ conditions and engaging with them to ensure improved care. Furthermore, Egede et al. (2021) explain that such a strategy can reduce the cost of diabetes care by enhancing patient-centered care. Hence, achieving improved clinical outcomes, and reducing readmission rates, which can be costly. Additionally, nurses should educate patients on effective diabetes self-management techniques, such as regular exercise, adequate fluids (water), a balanced diet, and self-foot checks (Bosetti et al., 2021) (Chronic Health Condition-Nursing Paper Samples).

Elderly patients can perform these activities at home, reducing the need for costly hospitalized care. Also, community health workers (CHWs) should be at the forefront of diabetes management to reduce hospital visits, increasing the care burden. Moreover, these recommendations align with the Christian need for holistic patient care. The practices can improve the patient’s health while maintaining their spiritual beliefs since they can care for the whole person (Cooper et al., 2020) (Chronic Health Condition-Nursing Paper Samples).

As a future DNP-prepared nurse, explain how you can impact policy and funding for this population.

DNP-prepared nurses can impact policy and funding for diabetes management by voluntarily participating in policy meetings (Mason et al., 2020). Besides, this can help contribute first-hand experience about diabetes care and possible measures for reducing care costs. They can also advocate for patients’ needs in policy meetings, leading to the development of patient-focused legislation. Moreover, they can advocate for eliminating unnecessary medications or treatment procedures that increase the cost of healthcare. Furthermore, nursing advocacy can lead to policy changes in favor of cost-effective patient care (Chronic Health Condition-Nursing Paper Samples).


Bosetti, R., Tabatabai, L., Naufal, G., Menser, T., & Kash, B. (2021). Comprehensive cost-effectiveness of diabetes management for the underserved in the United States: A systematic review. Plos One16(11), e0260139.

Cloete, L. (2021). Diabetes mellitus: An overview of the types, symptoms, complications, and management. Nursing standard (Royal College of Nursing (Great Britain): 1987)37(1), 61-66.

Cooper, K. L., Chang, E., Luck, L., & Dixon, K. (2020). How nurses understand spirituality and spiritual care: A critical synthesis. Journal of Holistic Nursing38(1), 114-121.

Egede, L. E., Dismuke, C. E., Walker, R. J., Williams, J. S., & Eiler, C. (2021). Cost-effectiveness of technology-assisted case management in low-income, rural adults with type 2 diabetes. Health Equity5(1), 503-511.

Galindo, R. J., Aleppo, G., Parkin, C. G., Baidal, D. A., Carlson, A. L., Cengiz, E., … & Umpierrez, G. E. (2022). Increase Access, Reduce Disparities: Recommendations for Modifying Medicaid CGM Coverage Eligibility Criteria. Journal of Diabetes Science and Technology, 19322968221144052.

Galindo, R. J., Parkin, C. G., Aleppo, G., Carlson, A. L., Kruger, D. F., Levy, C. J., … & McGill, J. B. (2021). What’s wrong with this picture? A critical review of current centers for Medicare & Medicaid Services coverage criteria for continuous glucose monitoring. Diabetes technology & therapeutics23(9), 652-660.

Halim, M., & Halim, A. (2019). The effects of inflammation, aging, and oxidative stress on the pathogenesis of diabetes mellitus (type 2 diabetes). Diabetes & metabolic syndrome: clinical research & reviews13(2), 1165-1172.

Herkert, D., Vijayakumar, P., Luo, J., Schwartz, J. I., Rabin, T. L., DeFilippo, E., & Lipska, K. J. (2019). Cost-related insulin underuse among patients with diabetes. JAMA internal medicine179(1), 112-114.Doi:10.1001/jamainternmed.2018.5008

Lee, J., Callaghan, T., Ory, M., Zhao, H., & Bolin, J. N. (2020). The impact of Medicaid expansion on diabetes management. Diabetes care43(5), 1094-1101.

Mason, D. J., Perez, A., McLemore, M. R., Dickson, E. (2020). Policy & politics in nursing and health care – e-book. (8th ed.). United States: Elsevier Health Sciences.

Molina-Mula, J., & Gallo-Estrada, J. (2020). Impact of nurse-patient relationship on quality of care and patient autonomy in decision-making. International Journal of Environmental Research and Public Health17(3), 835.

NCCDPHP (2021, December 21). Health and economic benefits of diabetes interventions. Centers for Disease Control and Prevention.,chronic%20condition%20in%20our%20nation.&text=%241%20out%20of%20every%20%244,caring%20for%20people%20with%20diabetes.&text=%24237%20billion%E2%80%A1(a)%20is,(a)%20on%20reduced%20productivity.

Payne, M., Pooke, F., Fulton, H., Shaw, H., Coulson, T., Knopp, J., … & Chase, J. G. (2022). Design of an open source ultra low-cost insulin pump. HardwareX12, e00375.

Sari, Y., Yusuf, S., Kusumawardani, L. H., Sumeru, A., & Sutrisna, E. (2022). The cultural beliefs and practices of diabetes self-management in Javanese diabetic patients: An ethnographic study. Heliyon8(2).

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