NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination

Name

Capella University

NURS-FPX 4050 Coord Patient-Centered Care

Prof. Name

Date

Policy and Ethical Factors in Care Coordination

Greetings, I am Harman, a nurse at City Health Systems. Effective care coordination is crucial for providing comprehensive care to individuals with chronic conditions like diabetes. We align our coordination efforts with governmental policies such as HIPAA, the Health Insurance Portability and Accountability Act, and the Affordable Care Act (ACA), ensuring patient privacy and navigating coverage parameters. Initiatives like the National Diabetes Prevention Program support our efforts. Ethical considerations arise, balancing patient privacy with timely care. Upholding the nursing Code of Ethics, we prioritize equity and patient-centered care in our coordination efforts. We collaborate closely with organizations like the American Diabetes Association (ADA), leveraging resources and expertise to optimize care delivery and support for individuals with diabetes in our community. By integrating these principles, we strive to maximize health outcomes for individuals with diabetes while navigating regulatory requirements and promoting inclusivity.

Care Coordination

In order to guarantee thorough and patient-centered care, effective care coordination requires the smooth administration of healthcare services across several providers and settings. Enhancing the overall effectiveness and quality of patient care requires collaboration, communication, and integration of healthcare struggles (Khatri et al., 2023). The ADA emphasizes the importance of coordinated care in meeting the unique healthcare needs of individuals with diabetes. Care coordination within the ADA framework aims to deliver culturally competent and supportive care, reducing disparities and enhancing health outcomes for individuals living with diabetes by fostering communication and collaboration among healthcare professionals.

Governmental Policies Affecting the Care Coordination

The ADA and other organizations that coordinate care are significantly impacted by health and safety policies of the government HIPAA is a significant policy that guards patient privacy and health information security. HIPAA compliance affects how the ADA coordinates care by setting standards for the exchange of patient data among healthcare providers, insurers, and other entities involved in care delivery. For example, ADA staff must ensure that they adhere to HIPAA regulations when communicating with healthcare providers about a patient’s treatment plan or sharing medical records to ensure confidentiality and protect patient privacy (ElSayed et al., 2022). Moreover, policies stemming from the ACA play a significant role in shaping care coordination efforts.

ACA policies dictate coverage parameters and reimbursement mechanisms, directly impacting the availability and affordability of services for individuals with diabetes. For example, ACA provisions expand access to preventive services and essential health benefits, ensuring that patients receive comprehensive care. However, fluctuations in ACA regulations or funding allocations can affect the ADA’s ability to provide seamless care coordination, especially if specific treatments or services become ineligible for coverage or experience reimbursement limitations (Lee & Hale, 2020).

Furthermore, policies related to public health initiatives and chronic disease management also influence care coordination efforts. One example of such a program is the National Diabetes Prevention Program (DPP), which is funded by the Centers for Disease Control and Prevention (CDC). The objective of the DPP is to postpone or prevent the onset of type 2 diabetes by implementing lifestyle modifications like eating less, exercising more, and losing weight. By providing funding and resources to organizations like the ADA, the DPP supports efforts to implement evidence-based diabetes prevention programs within communities, thereby facilitating early intervention and reducing the burden of diabetes on the healthcare system (Ritchie et al.,2020).

Overall, governmental policies related to health and safety, including HIPAA regulations, ACA provisions, and public health initiatives, significantly impact the coordination of care within the ADA. Compliance with privacy standards, navigating coverage requirements, and leveraging resources from public health programs are essential components of effective care coordination for individuals with diabetes. By aligning with these policies and leveraging available resources, the ADA can ensure that patients receive comprehensive, patient-centered care while navigating regulatory requirements and promoting health equity within the community.

Care Coordination Ethical Questions or Dilemmas

Finding particular federal, state, and local policy regulations that raise moral concerns or provide challenges for care coordination within the ADA is necessary for navigating the complicated world of healthcare regulations. One policy is the HIPAA, which serves to safeguard privacy of patients and data safety. While HIPAA is essential for protecting patient confidentiality, its stringent requirements, such as obtaining patient consent before sharing medical information, can sometimes pose ethical dilemmas. This might lead to delays in urgent treatment decisions, potentially compromising patient outcomes.

Moreover, the intricate nature of HIPAA regulations may inadvertently result in breaches, raising ethical concerns despite organizational efforts to comply (Weitzman et al., 2021). Additionally, the provisions outlined in the ACA significantly impact care coordination efforts within the ADA. ACA policies expand access to preventive services and essential health benefits, promoting comprehensive care for individuals with diabetes. However, fluctuations in ACA regulations or funding allocations can introduce ethical dilemmas. For instance, changes in coverage parameters may lead to certain diabetes treatments or services being excluded, thereby creating barriers to accessing necessary care and exacerbating health disparities (Kelley et al., 2020).

NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination

Furthermore, public health initiatives like the DPP, funded by the CDC, contribute to care coordination efforts. Even though the goal of these programs is to use changes in lifestyle to prevent or postpone the onset of type 2 diabetes, concerns about equity and resource allocation may come up. Limited funding or resources may disproportionately affect underserved communities with higher diabetes prevalence rates, exacerbating health disparities. Additionally, ethical considerations arise regarding the sustainability and scalability of these programs, particularly in resource-constrained environments (Williams et al., 2021). These policy provisions raise ethical questions about balancing patient privacy with the need for timely information sharing, ensuring equitable access to care, and effectively allocating resources to address the burden of diabetes within communities.

The consequences of these ethical dilemmas include potential compromises in patient care, exacerbation of health disparities, and challenges in achieving optimal health outcomes for individuals with diabetes. The upper studies provide evidence of the ethical associations and concerns of particular policy provisions on care coordination within the ADA. They underscore the importance of navigating regulatory requirements while addressing the multifaceted challenges posed by diabetes management within evolving healthcare policies.

The Nurses Code of Ethics on the Coordination and Continuum of Care

The code of ethics for nurses plays a vital role in managing decision-making and actions within the healthcare system, including within organizations like the ADA. Nurses, as frontline healthcare providers, are often involved in the coordination and continuum of care for individuals with diabetes. By adhering to the principles outlined in the code of ethics, nurses contribute significantly to the provision of high-quality, patient-centered care. The coordination of treatment under the ADA is one crucial area where the code of ethics has an impact. Ethical precepts, including beneficence, non-maleficence, and respect for patient autonomy, adhere to nurses. These principles guide nurses in advocating for the best interests of patients, ensuring their safety and well-being, and respecting their preferences and choices regarding diabetes management.

As a result, the coordination of care within the ADA is influenced by nurses’ commitment to upholding these ethical standards, promoting collaboration among healthcare team members, and prioritizing the needs of individuals with diabetes (Hübner et al., 2022). Moreover, the ethics code for nurses also affects the care continuum provided by the ADA. Nurses are advocates for health equity and access to services for all individuals, including those affected by diabetes. They identify and deal with the social determinants of health that lead to inequalities in health and obstacles to receiving care. An individual’s capacity to effectively manage their diabetes can be significantly impacted by variables like their socioeconomic status, degree of education, and geographic location. Nurses, guided by the code of ethics, work to address these disparities by advocating for resources and services that promote health equity and empower individuals to overcome barriers to care access (Rogers & Schill, 2021).

Healthy People 2020 identifies social factors of health as critical factors influencing health outcomes and disparities. Nurses, through their adherence to the code of ethics, recognize the importance of addressing these determinants in the provision of care to individuals with diabetes. Nurses improve health outcomes and lessen disparities among people with diabetes by supporting laws and programs that address social factors like food insecurity, income inequality, and access to healthcare services (Briggs et al., 2020). The nursing code of ethics significantly impacts the ADA’s care continuum and coordination. Nurses address health disparities, support patient-centered care, and facilitate access to services for people with diabetes, all while adhering to ethical principles. Through their commitment to upholding the code of ethics and addressing social determinants of health, nurses play a vibrant role in improving health outcomes and enhancing the quality of care provided by the ADA.

Conclusion

In conclusion, effective care coordination for individuals with diabetes necessitates alignment with governmental policies like HIPAA and ACA while balancing ethical considerations such as patient privacy and equitable access. Collaboration with organizations like the ADA optimizes resources and expertise to enhance patient-centered care. Nurses, guided by the Code of Ethics, advocate for health equity and address social determinants of health, thereby improving outcomes within the continuum of care. Overall, navigating regulatory requirements, promoting inclusivity, and upholding ethical principles are integral to optimizing health consequences for people with diabetes.

References

Briggs, F. H., Adler, N. E., Berkowitz, S. A., Chin, M. H., Webb, T. L. G., Navas-Acien, A., Thornton, P. L., & Haire-Joshu, D. (2020). Social determinants of health and diabetes: A scientific review. Diabetes Care, 44(1), 258–279. https://doi.org/10.2337/dci20-0053

ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Leon, J., Lyons, S. K., Perry, M. L., Prahalad, P., Pratley, R. E., Seley, J. J., Stanton, R. C., & Gabbay, R. A. (2022). 7. Diabetes technology: Standards of care in diabetes—2023. Diabetes Care, 46(Supplement_1), S111–S127. https://doi.org/10.2337/dc23-s007

Hübner, U. H., Egbert, N., & Schulte, G. (2022). Ethical issues: Patients, providers, and systems. Health Informatics, 465–483. https://doi.org/10.1007/978-3-030-91237-6_31

Kelley, A. T., Nocon, R. S., & Brien, M. J. O. (2020). Diabetes management in community health centers: A review of policies and programs. Current Diabetes Reports, 20(2). https://doi.org/10.1007/s11892-020-1289-0

Khatri, R., Endalamaw, A., Erku, D., Wolka, E., Nigatu, F., Zewdie, A., & Assefa, Y. (2023). Continuity and care coordination of primary health care: A scoping review. BMC Health Services Research, 23(1). https://doi.org/10.1186/s12913-023-09718-8

Lee, J., & Hale, N. (2022). Evidence and implications of the affordable care act for racial/ethnic disparities in diabetes health during and beyond the pandemic. Population Health Management, 25(2), 235–243. https://doi.org/10.1089/pop.2021.0248

Ritchie, N. D., Baucom, K. J., & Sauder, K. A. (2020). Current perspectives on the impact of the national diabetes prevention program: Building on successes and overcoming challenges. Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy, 13, 2949–2957. https://doi.org/10.2147/dmso.s218334

NURS FPX 4050 Assessment 2 Ethical and Policy Factors in Care Coordination

Rogers, B., & Schill, A. L. (2021). Ethics and total worker health®: Constructs for ethical decision-making and competencies for professional practice. International Journal of Environmental Research and Public Health, 18(19), 10030. https://doi.org/10.3390/ijerph181910030

Weitzman, E. R., & Floyd, M. (2022). Chapter 6 – Privacy and diabetes digital technologies and telehealth services (D. C. Klonoff, D. Kerr, & E. R. Weitzman, Eds.). ScienceDirect; Academic Press. https://www.sciencedirect.com/science/article/pii/B978032390557200011X

Williams, J., Sachdev, N., Kirley, K., Moin, T., Duru, O. K., Brunisholz, K. D., Sill, K., Joy, E., Aquino, G. C., Brown, A. R., O’Connell, C., Rea, B., Craig-Buckholtz, H., Witherspoon, P. W., & Bruett, C. (2021). Implementation of diabetes prevention in health care organizations: Best practice recommendations. Population Health Management, 25(1). https://doi.org/10.1089/pop.2021.0044