Diabetes Management Policy

Continuation of last assignment Write a 4–6-page policy proposal and practice guidelines for improving quality and performance associated with the benchmark metric underperformance you advocated for improving in Assessment 1. Propose an organizational policy and practice guidelines that you believe will lead to an improvement in quality and performance associated with the benchmark underperformance you advocated for improving in Assessment 1. Be precise, professional, and persuasive in demonstrating the merit of your proposed actions. Requirements The policy proposal requirements outlined below correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence. • Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws. • What is the current benchmark for the organization and the numeric score for the underperformance? • How is the benchmark underperformance potentially affecting the provision of quality care or the operations of the organization? • What are the potential repercussions of not making any changes? ▪ What evidence supports your conclusions? Recommend ethical, evidence-based practice guidelines to improve targeted benchmark performance prescribed by applicable local, state, or federal health care policy or law. o What does the evidence-based literature suggest are potential strategies to improve performance for your targeted benchmark? o How would these strategies ensure performance improvement or compliance with applicable local, state, or federal health care policy or law? o How would you propose to apply these strategies in the context of Eagle Creek Hospital or your own practice setting? o How can you ensure these strategies are ethical and culturally inclusive in their application? Analyze the potential effects of environmental factors on your recommended practice guidelines. o What regulatory considerations could affect your recommended guidelines? o What resources could affect your recommended guidelines (staffing, financial, and logistical considerations, or support services)? Explain why particular stakeholders and groups must be involved in further development and implementation of your proposed policy and practice guidelines. o Why is it important to engage these stakeholders and groups? o How can their participation produce a stronger policy and facilitate its implementation? Organize content so ideas flow logically with smooth transitions. o Proofread your proposal, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your proposal. Use paraphrasing and summarization to represent ideas from external sources. o Be sure to apply correct APA formatting to source citations and references. Affordable Care Act The ACA has a direct impact on practice guidelines, policies, and the success and sustainability of health care organizations. The following articles present a variety of perspectives on the ACA: • Blendon, R. J., & Benson, J. M. (2017). Public opinion about the future of the Affordable Care Act. The New England Journal of Medicine, 377(9), e12(1)–e12(7). • Butler, S. M. (2016). The Future of the Affordable Care Act: Reassessment and revision. JAMA, 316(5), 495–497. • Gaffney, A., & McCormick, D. (2017). The Affordable Care Act: Implications for health-care equity. The Lancet, 389(10077), 1442–1452. • Gliad, S., & Jackson, A. (2017). The future of the Affordable Care Act and insurance coverage. American Journal of Public Health, 107(4), 538–540. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343718/ • Guiliot, C. (2014). Gauging the Affordable Care Act. Internal Auditor, 71(1), 54–59. • Himmelstein, D. U., Lawless, R. M., Thorne, D., Foohey, P., & Woolhandler, S. (2019). Medical bankruptcy: Still common despite the Affordable Care Act. American Journal of Public Health, 109(3), 431–433. • Levitt, L. (2017). Is the Affordable Care Act imploding? JAMA, 317(20), 2051–2052. • Centafont, D. (2014). Contract management systems: An effective compliance tool. Journal of Health Care Compliance, 16(5), 41–42, 78. • Health care organizations typically have hundreds or even thousands of different contracts for different reasons, parties, terms and clauses, termination regulations, and more. It is imperative that there be a robust contract management system to establish and maintain order for all agreements from a legal and regulatory perspective. This article provides insight on the benefits such a system can offer. Policy Proposal Scoring Guide CRITERIA NONPERFORMANCE BASIC PROFICIENT DISTINGUISHE D Explain the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws. Does not explain the rationale for a policy and practice guidelines addressing benchmark underperforman ce. Explains the rationale for a policy and practice guidelines addressing benchmark underperforman ce, irrespective of a particular need. Explains the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws. Explains the need for creating a policy and practice guidelines to address a shortfall in meeting a benchmark metric prescribed by local, state, or federal health care policies or laws. Diabetes Management Policy

Clearly articulates the effects of benchmark underperforman ce and draws sound conclusions about the potential repercussions of inaction, based on credible evidence. Recommend ethical, evidencebased practice guidelines to improve targeted Does not recommend practice guidelines to improve targeted benchmarked performance prescribed by Recommends practice guidelines to improve targeted benchmarked performance prescribed by applicable local, Recommends ethical, evidencebased practice guidelines to improve targeted benchmarked Recommends ethical, evidence-based practice guidelines to improve targeted benchmarked performance CRITERIA NONPERFORMANCE BASIC PROFICIENT DISTINGUISHE D benchmarked performance prescribed by applicable local, state, or federal health care policies or laws. applicable local, state, or federal health care policies or laws. state, or federal health care policies or laws. performance prescribed by applicable local, state, or federal health care policies or laws. prescribed by applicable local, state, or federal health care policies or laws. Provides clear and compelling justification, substantiated by credible evidence, for applying ethical and culturally inclusive performance improvement strategies. Analyze the potential effects of environmenta l factors on recommende d practice guidelines. Does not identify environmental factors that can affect recommended practice guidelines. Identifies environmental factors that can affect recommended practice guidelines. Analyzes the potential effects of environmenta l factors on recommende d practice guidelines. Analyzes the potential effects of environmental factors on recommended practice guidelines. Identifies clear cause-andeffect relationships and the influence of those factors on specific recommendatio ns. Explain why particular stakeholders Does not explain why particular stakeholders Identifies stakeholders and groups who are not the most Explains why particular stakeholders and groups Provides a perceptive and succinct explanation of NONPERFORMANCE BASIC PROFICIENT and groups must be involved in further development and implementati on of a proposed policy and practice guidelines. and groups must be involved in further development and implementation of a proposed policy and practice guidelines. logical choices to be involved in further development and implementation of a proposed policy and practice guidelines. must be involved in further development and implementati on of a proposed policy and practice guidelines. why particular stakeholders and groups must be involved in further development and implementation of a proposed policy and practice guidelines. Offers clear and convincing rationale for stakeholder and group engagement and how it strengthens policy and facilitates changes in practice. Organize content so ideas flow logically with smooth transitions. Does not organize content for ideas to flow logically with smooth transitions. Organizes content with some logical flow and smooth transitions. Organizes content so ideas flow logically with smooth transitions. Organizes content so clarity is enhanced and all ideas flow logically with smooth transitions. Use paraphrasing and summarizatio n to represent ideas from Incorporates plagiarized information. Paraphrasing or summarization is awkward, inaccurate, or borders on plagiarism. Uses paraphrasing and summarizatio n to represent ideas from Uses concise, paraphrasing or summarization to accurately represent ideas from external sources. CRITERIA DISTINGUISHE D CRITERIA external sources. NONPERFORMANCE BASIC PROFICIENT external sources. DISTINGUISHE D Exhibits an insightful interpretation and synthesis of credible sources. Running head: POLICY PROPOSAL 1 Policy Proposal 2019 Policy Proposal Despite being recognized as one of the region’s top choices for health care, Mercy Medical Center has areas for opportunity. Medication errors in the medical and surgery unit have seen a 50% increase from 4 in 2015 to 8 in 2016. Nute suggests that medication errors may result in longer hospital stays and higher rates of mortality and morbidity (as cited in Kavanagh, 2017). Diabetes Management Policy

According to Rafter, Hickey, Conroy, Condell, O’Connor, Vaughan, Walsh, and Williams, these errors may result in an increase in the cost of health care (as cited in Kavanagh, 2017). Incidents resulting from medication errors require additional resources and more care interventions, which leads to a decrease in the efficiency of health care services provided. Considering the expense medication errors can entail for patients and health care practitioners, there is a need for an organizational policy to address the shortfall in the reduction of medication errors. Strategies to Resolve Medication Errors Medication Error Analysis According to Zhan, Smith, Keyes, Hicks, Cousins, and Clancy, because of the fear of repercussions such as disciplinary action being taken, a large number of medication errors go unreported (as cited in Weant, Bailey, & Baker, 2014). However, learning from these errors will Copyright ©2018 Capella University. Copy and distribution of this document are prohibited. POLICY PROPOSAL 2 help reduce their recurrence and improve care interventions. Every reported error is an opportunity for the development of a countermeasure and will help avoid or reduce the impact of the same error in the future (Weant et al., 2014). A health care system that exposes patients to medical errors needs to be critically evaluated. Failure mode and effects analysis is a technique that can be used to analyze incidents related to medication errors. Under this method of analysis, the medical center can commission the formation of a multidisciplinary committee that will review processes susceptible to errors. Commented [A1]: Good introduction that meets the goal of “explaining the need for the organizational policy.” Copyright ©2018 Capella University. Copy and distribution of this document are prohibited. POLICY PROPOSAL 3 Based on the inadequacies observed, the committee can classify the medication errors according to the priority in which they need to be addressed (Weant et al., 2014). As part of the analysis, the committee will review the steps in the process, the things that could go wrong, the reasons behind them, and the possible repercussions (Institute for Healthcare Improvement, n.d.). Based on these factors, the committee can recommend actions to reduce the possible errors in the process. The analysis will end with an evaluation of the prescribed actions for improvement (Centers for Medicare and Medicaid Services, n.d.). Automated Dispensing Cabinets An automated dispensing cabinet is a computerized medication distribution system that is installed in patient care units. It stores, dispenses, and electronically tracks drugs at the point of care. Using these cabinets can help the medical center profile patients, reduce the time taken to retrieve medication, and track inventory on a real-time basis (Weant at al., 2014). These cabinets usually contain high-alert and controlled medications and can only be accessed using an ID and a password. With the use of these cabinets, nurses will not have to walk long distances to collect the required medication (Rochais, Atkinson, Guilbeault, & Bussières, 2014). The implementation of both these strategies can be affected by certain environmental factors. The efficacy of medication error analysis can be affected if error incidents are underreported or if errors are incorrectly documented. Barach and Small state that error incidents are usually reported verbally despite how frequently they occur. This can lead to an underreporting of errors (as cited in Elden & Ismail, 2016). Diabetes Management Policy

Moreover, verbally communicating errors can lead to errors in documenting data. According to Claudia, Sharon, DeVSP, Merrell, and Gail, the scope for the improvement of patient safety will be limited if errors are discussed verbally (as cited in Elden & Ismail, 2016). With regard to the use of automated dispensing cabinets, incorrect restocking is Copyright ©2018 Capella University. Copy and distribution of this document are prohibited. POLICY PROPOSAL 4 one of the problems that can arise, which can result in treatment delays. Apart from this, inaccurate documentation of doses retrieved from the automated cabinets can also affect timely treatment. This can lead to incorrect administration of medication (Hamilton-Griffin, 2016). Additionally, when care providers such as nurses are affected by heavy workloads and are preoccupied with various tasks at once, they are likely to get interrupted or distracted while collecting and administering medication from the cabinets. To ensure that these issues do not arise, the pharmacy can be asked to share an updated list of the stock on a daily basis. A staff member or nurse can be tasked to cross-check the cabinet stock against the list provided by the pharmacy. Further, reassessing the stock from time to time and using barcode technology for restocking medications can also reduce the possibility of such errors occurring (Pennsylvania Patient Safety Authority, n.d.). Clinicians need to be provided with continuous education on new drugs, procedures, and policies so that the proposed strategies are effectively implemented. Apart from that, creating simulation environments will also instill confidence in care providers about their competency in medication administration. It is necessary to create a culture of safety within the organization, which will allow care providers to freely report errors without the fear of negative consequences and coercion. Policy for Managing Medication Errors Policy Statement Medication errors pose a risk to patient safety and public health. This policy is a guide for health care practitioners to enable them to take appropriate action in the event of a medication error. The guidelines and recommendations will provide a framework to improve the practice of the two proposed evidence-based strategies. Diabetes Management Policy

Copyright ©2018 Capella University. Copy and distribution of this document are prohibited. POLICY PROPOSAL 5 Scope The policy applies to nursing staff, medical staff, emergency and allied care practitioners, and staff employed at the pharmacy. All concerned individuals are responsible for the prescription, dispensation, and administration of medicines. Guidelines for Implementing Evidence-Based Strategies The multidisciplinary local patient safety committee (which includes professionals from various disciplines such as nursing, pharmacy, and medicine) should regularly go over the existing action plan to improve health care outcomes. The committee must assess apprehensions and go over events that possibly endanger patient safety. It should also analyze trends in medication errors as well as address systemic weaknesses (Polnariev, 2016). According to Schlesselman, around half of all possible medication error events can be averted by patient education. Pharmacists can counsel patients when they are visited for consultations. Training sessions on counseling patients will aid the effectiveness of pharmacists’ consultations. These training sessions should include an emphasis on asking open-ended questions to patients (as cited in Polnariev, 2016) such as the following three prime questions: (1.) What did the physician tell you the medication is for?, (2.) How did the physician tell you to take the medication?, and (3.) What did the physician tell you to expect? The sessions should also emphasize listening to patients patiently, learning to identify inaccuracies in their responses, and demonstrating to them the use of medication devices (Lauster & Srivastava, 2013). Before the administration of any medication, a review of medication orders by a pharmacist will ensure the safety of the hospital’s medication system. Barcode verification should be put in place for the stocking of medications. Limited amounts of medication should be placed in the cabinets, and the cabinets should be refilled frequently (Hyland, Koczmara, Copyright ©2018 Capella University. Copy and distribution of this document are prohibited. Commented [A2]: I think the idea of the multidisciplinary team is good; the active involvement of all key stakeholders will be critical to success. POLICY PROPOSAL 6 Salsman, Musing, & Greenall, 2007). For the nursing staff, barcode verification will validate the 7 Stakeholder Involvement in Implementing Proposed Strategies rights of medication administration: right patient, right drug, right dose, right time, right route, Assistance can be sought from key right reason, and right documentation. These 7 rights will be verified while administering medication. Diabetes Management Policy

A nurse will scan the barcode on his or her identification badge, on the patient’s administrative personnel such as the chief executive officer, director of nursing, or chief wristband, and on the medication. Software will analyze the real-time data, and based on the operating officer. These individuals can form database, it will generate approvals or warnings (Shah, Lo, Babich, Tsao, & Bansback, 2016). a quality committee where they can share When choosing and placing medications within automated dispensing cabinets, products that look their expertise and monitor the effective alike should not be placed inside the same multiple-product drawer. Medications should be implementation of the proposed strategies. By retrieved from the cabinet for one patient at a time and administered without delay. Training establishing role accountability and sessions about the right practices related to the use of automated dispensing cabinets should be articulating the organization’s quality organized for the staff. The staff must be educated about unsafe practices that can affect patient improvement norms from time to time, the outcomes negatively such as retrieving medications in advance and retrieving medications for key administrative personnel can reinforce a multiple patients. They must also be educated about …Diabetes Management Policy