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Introduction
The burden of cardiovascular disease and diabetes is known to be increasing nationwide in the United States. The rates of mortality, caused by these illnesses, have gone record-breaking over the last decade. As to the incidence, people aged after 60 usually belong to a high-risk group and represent 23% of the sufferers on a global scale (Prince et al., 2015). Naturally, this fact refers them to the category requiring more intense therapy and better care delivery.
However, not only seniors suffer from cardiovascular disorders: representatives of younger- and middle-age social categories show a clear tendency to have obesity and heart failure problems due to inactive and stressful lifestyle. Eventually, the issue has forced both the US government and healthcare organizations to take a serious approach to fighting the problem on a legislative level and start looking for effective measures of occurrence reduction.
Description of an initial program
The introduction of a nationally coordinated program Lets Move in 2010 was a significant step forward in the governments attempts to fight obesity and cardiovascular problems. The main task of the program was to increase the citizens interest for a healthier way of life and physical activities in particular.
This policy received immediate support from a number of healthcare organizations: the structured patient education systems were developed to encourage the promotion of self-care, reduce the risk of chronic illnesses, and improve an overall situation with diseases reoccurrence. These systems actively cooperated with other chronic disease programs, such as Behavioral Risk Factor Surveillance System (BRFSS) to define the degree of burden of both cardiovascular disorders and diabetes ( Heart disease, stroke, 2017).
Legislators involved in the policy development
As to specific legislators involved in the policy, the Physical Activity Guidelines for Americans Act of 23.05.2013 was primarily introduced by members of the 113th Congress to ensure that the Physical Activity Guidelines were updated on a regular basis. These measures would guarantee that American citizens received all the latest information about a recommended set of physical exercises. In accordance with the act, the Secretary of Health and Human Services (HHS) was obliged to update guidelines every ten years, recommend people of all ages to do exercises, and require federal agencies to participate in guidelines promotion (Prince et al., 2015).
Another legislators initiative, launched by Washington state Governor Jay Inslee in 2014, focuses on healthy eating and active living among our states youth ( Diabetes epidemic, 2014, p. 4). The same year the state acquired a grant to implement their Healthier Washington Initiative, which created a favorable environment for reduction of costs and improvement of care delivery ( Diabetes epidemic, 2014).
The role of the APRN
Naturally, advanced practice registered nurses (APRNs) play one of the key roles in policy implementation, especially those working in emergency medical services. As was mentioned earlier, individuals with cardiovascular and diabetes disorders are treated as a high-risk category of patients, who are subjected to regular readmissions due to deterioration in their health conditions. This statement makes particular sense when speaking of the senior age people, representing a larger group of sufferers. According to Donald et al. (2013), advance practice nurses are associated with improvements in several measures of health status and behaviours of older adults in long-term care settings (p. 2148).
As an attempt to engage APRNs in the policy, the EverCare program was introduced to reduce the readmission rates and provide primary care for home residents with diabetes and cardiovascular problems (Donald et al., 2013). A proper delivery of treatment is, in the majority of cases, a responsibility of advance practice registered nurses, whose professional skills quite often determine whether a patient with HF or diabetes will receive a required assistance or not.
Influence of the policy on a clinical practice
The figures show that the policy has a beneficial impact on a clinical practice: an estimated $120.000 in federal funds from the Centers for Disease Control and Prevention were used by the Department of Health on work related to the Diabetes Prevention Program between July 1, 2013 and June 30, 2014 ( Diabetes epidemic, 2014, p. 38). The Washington Healthcare Improvement Network (WHIN) provides an individualized training of staff of clinics and health organizations interested in patient-centered practice development.
This network greatly assists in the monitoring of population health metrics, such as hypertension, and chronic disease management. A total number of 31 clinics across the USA participated in coaching and webinars aimed at more effective treatment delivery. All in all, the WHIN program is funded by the Centers for Disease Control at $990.000 annually ( Diabetes epidemic, 2014).
Concerning the results that have been achieved due to the policy implementation, a higher number of patients with diabetes and cardiovascular disorders receive now clinical services to address the diseases they suffer from ( Diabetes epidemic, 2014). A highly professional and trusted staff of clinicians is placed in every community service, where patients of all incomes and disabilities can get information and support regarding a whole variety of issues. Priority is given to people of senior age, whose incomes are lower compared to a younger category of sufferers (Prince et al., 2015). As the number of seniors continues to grow, the staff of clinicians becomes enlarged on a regular basis. It is tracked through the use of interprofessional teams.
Usage of the policy by interprofessional teams
As to the usage of the policy by interprofessional teams, the Diabetes Network Leadership Team was formed of more than 20 self-selected agencies and organizations to promote the disease prevention program among the US citizens ( Diabetes epidemic, 2014). The Department of Health utilized above $60.000 in federal funds on teams management derived from the Centers for Disease Control. The work was primarily targeted at supporting patients with all types of diabetes, same as people with high-risk HF issues.
It was also designed to encourage private partners, researchers, and non-profit organizations to become the members of the Diabetes Network Leadership Team as well. This fact leads to the conclusion that the policy can be used by the teams to expand the staff of workers involved in a care delivery process and provide more efficient assistance regardless of the form of a disease.
Conclusion
Summarizing the findings, the introduction of the Lets Move program back in 2010 created a formidable background for improvements in HF and diabetes treatment delivery. In the following years, some serious measures were taken on a legislative level to provide a more efficient care of high-risk patients and reduce the medical services costs. The Centers for Disease Control issue enough funds for the programs, such as WHIN, to operate properly and demonstrate positive results. This approach allows the patients of all social layers and disabilities to receive equal treatment and be closely monitored. All in all, the policy has a beneficial influence on a clinical practice since a higher number of risk group patients can be provided a required health care.
References
Diabetes epidemic & action report. (2014).Â
Donald, F., MartinMisener, R., Carter, N., Donald, E. E., Kaasalainen, S., WicksonGriffiths, A., & DiCenso, A. (2013). A systematic review of the effectiveness of advanced practice nurses in longterm care. Journal of Advanced Nursing, 69(10), 2148-2161.
Heart disease, stroke, and diabetes data and publications. (2017).Â
Prince, M. J., Wu, F., Guo, Y., Robledo, L. M. G., ODonnell, M., Sullivan, R., & Yusuf, S. (2015). The burden of disease in older people and implications for health policy and practice. The Lancet, 385(9967), 549-562.
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