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Nhs Fp6004 Assessment 1

Paper Details

School: Capella University
Subject: Nursing
Assessment: Nhs Fp6004 Assessment 1
Course: NHS-FP6004
Referencing: APA
Pages: 7
Professor: Elizabeth Lopes


Policy Proposal
Student’s Name
Module Code



The scope of health care management includes making rational decisions aimed at improving the overall quality of care for the patients. The aim of any competitive healthcare entity is to improve the quality of healthcare offered to the patients and mitigate any negative unforeseen eventualities (Arabi, Fowler & Hayden, 2020). This implies that it’s prudential for our healthcare entity to assess their areas of underperformance to facilitate improvements and delivering high quality care. From the analysis of the dashboard metrics, it’s evident that there is a significant decline in HgbA1c testing. This aspect needs to be addressed by the entity to facilitate delivering evidence-based care. 

Therefore, this paper will propose a rational policy change that will lead to improvement in HgbA1c testing to enable meeting the benchmark. Besides, it will be critical for the entity to assess vital parameters that need to be addressed to formulate policies that will address this shortfall. The scope of this paper will also incorporate determining stakeholders to be incorporated in the policy formulation and recommending evidence-based practices towards this perspective. 

Need for creating a policy and practice guidelines to address HgbA1c shortfall

Assessment of the current benchmark for the stated metric illustrate that there is an overarching need to address this metric. The benchmark has been illustrated to perform at least once during the four quarters of 2019. The benchmark only performed during the first quarter of 2019 while significantly underperforming in the previous year with only 122 tests performed. This implies that the underperformance of this benchmark could be implicated for causing misdiagnosis or errors in clinical decisions for diabetic patients. As cited by Lau and Aw (2020), HgbA1c is a fundamental test in testing and managing patients with elevated sugar levels. This test indicates an individual’s average blood sugar level for the past three months. 

Nhs Fp6004 Assessment 1

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According to the American Diabetes Association (ADA) (2018), 34.2 million Americans had type 1 diabetes out of which 7.4 million were undiagnosed. These statistics point to the need to ensure that there is an accurate measurement of hemoglobin to address undiagnosed cases and avert negative consequences. The presence of HgbA1c as an underperforming benchmark can affect an entity’s operations and quality care. Besides, this can lead to poor sustainability. 

Schnell, Crocker and Weng (2017) note that diabetes impacts a significant financial burden on the patients, their families or the wider society. Statistics from ADA indicate that diabetes cost the United States $327 billion in 2017 alone (American Diabetes Association, 2020). This included $237 billion for direct medical attention and an additional $90 billion attributed to reduced productivity. These metrics highlight the need to address diabetes to achieve overall optimum care. Diabetes has also been cited to affect the elderly population and individuals with other comorbidities, therefore exacerbating their condition. 

The scope of diabetes management is not only critical on individual basis but also on the wider healthcare delivery system. For instance the implications of diabetes on pregnant mothers can have a lethal impact on the unborn child (Egan et al., 2017). Studies have shown that gestational diabetes can lead to prenatal injury and harm to the mother if not managed in due time. Besides, diabetes can lead to productivity loss due to absence of employees from workplaces. Therefore, there is a need for creating a policy and practice to address these shortfalls. 

Ethical, evidence-based practice guidelines to improve targeted benchmark performance

Healthcare professional are mandated to uphold legal, ethical and moral guidelines to facilitate attainment of quality care (Mathibe-Neke, 2020). In this perspective, it’s the prerogative of our entity to comply with accompanying regulations and laws in provision of care to our patients. Besides, the success of a healthcare entity is determined by the ability to deliver timely high quality care at all times. To address the shortfall in benchmark, the use of evidence-based practice and ethical guidelines is imperative. The use of A1C testing for diabetes is critical to ensure that patients with diabetes attain optimum care and quality recovery. This test is done after three months where a healthcare professional evaluated a patient’s blood sample to determine the metabolic performance. These measurements are done medically until an average metabolic rate has been attained. 

As cited by Advani (2020), conducting frequent assessments plays a key role in facilitating overall recovery for individuals with diabetes. For example, assessment after every two months is vital to monitor a patient’s improvement or recovery and therefore taking necessary steps. However, it’s vital to monitor the improvement of pregnant women every month to ensure that there are no inherent risks that could interfere with their pregnancy or overall health. First, training the staff on how to improve diabetes assessment will lead to improvement in baseline metrics. The ADA recommends timely decision making and collaborative engagements to facilitate improvement in diabetic patient’s outcomes. Therefore, this is an evidence-based intervention that will lead to improvement in the shortfall in baseline metric. 

Studies have shown that use of evidence-based data leads to overall improvements in diabetic outcomes (Kent, Steyerberg & van Klaveren, 2018). Therefore, the use of reliable data in the health entity will improve care delivery and enable for cost management. One of the evidence-based interventions in diabetes management is ability of a patient to adopt healthy lifestyle. It’s on this basis that adopting the chronic care model (CCM) will bear a plethora of advantages in improving deficiencies in delivery of care (Boehmer et al., 2018). The advantages of this model incorporate the ability to encourage individual, community and professional support in managing a chronic condition such as diabetes. 

Potential effects of environmental factors on recommended guidelines

Environmental factors will most likely affect the implementation of the recommended guidelines in our healthcare settings. To begin with, the successful implementation of the recommendations requires adequate staff and resources. According to Driscoll et al., (2018) a healthcare entity must have the optimum nurse-patient ratio to attain success in diabetes management. This implies that the healthcare administration must set aside adequate resources (human and capital) to achieve the benefits hypothesizes in the recommendations. For instance, it would be prudential to increase monitoring services for the patient’s outcomes. The implementation of the CCM implies that a primary care professional takes control of the process to achieve improvement in care. With adequate resources and staffing, there will be improved patient motoring and management of adverse events or exacerbations. Therefore, these environmental factors are likely to be imperative in dictating delivery of quality care. 

Stakeholders involved

 Implementation of these policies will require several stakeholders. First, the nursing professionals will be involved to help in developing the process recommendations, application of standard nursing procedures and maximizing every skill of a team member. One of the fundamental objectives in the proposed policy changes is to improve the shortfall in dashboard metric and give the patients overall quality care. Therefore, healthcare leaders will be involved in offering directives and resources required in this perspective. The nurses will also be mandated with ensuring collection of evidence-based data related to efficacy and overall outcomes of the proposed policy. 

The patients will form critical stakeholders considering that this policy impacts directly on their overall health. Besides, the care takers will be mandated with assessing the patients and taking vital parameters that will lead to improvements of the proposals. Therefore, inter-professional collaboration will be critical in facilitating success of this undertaking. This will strengthen the policy and lead to changes in the practice. 


Considering the negative effects of diabetes on patient’s health outcomes, it’s imperative to ensure that accurate data related to the condition is attained to enhance patient-centered care. Besides, there is need to adopt rational policies that will lead to attainment of optimum patient care and improve HgbA1c testing which is critical in managing diabetes. Implementing CCM, education and health promotion will enhance delivery of evidence-based care and incept policies that will enhance management of diabetes and other comorbidities associated thereto. 


Advani, A. (2020). Positioning time in range in diabetes management. Diabetologia, 63(2), 242-252.

American Diabetes Association. (2018). Economic costs of diabetes in the US in 2017. Diabetes care, 41(5), 917-928.

American Diabetes Association. (2020, Jan). Improving Care and Promoting Health in Populations: Standards of Medical Care in Diabetes—2020. Diabetes Care, pp. 7-13.

Arabi, Y. M., Fowler, R., & Hayden, F. G. (2020). Critical care management of adults with community-acquired severe respiratory viral infection. Intensive care medicine, 46(2), 315-328.

Boehmer, K. R., Abu Dabrh, A. M., Gionfriddo, M. R., Erwin, P., & Montori, V. M. (2018). Does the chronic care model meet the emerging needs of people living with multimorbidity? A systematic review and thematic synthesis. PloS one, 13(2), e0190852.

Driscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., … & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European Journal of Cardiovascular Nursing, 17(1), 6-22.

Egan, A. M., Vellinga, A., Harreiter, J., Simmons, D., Desoye, G., Corcoy, R., … & Dunne, F. P. (2017). Epidemiology of gestational diabetes mellitus according to IADPSG/WHO 2013 criteria among obese pregnant women in Europe. Diabetologia, 60(10), 1913-1921.

Kent, D. M., Steyerberg, E., & van Klaveren, D. (2018). Personalized evidence based medicine: predictive approaches to heterogeneous treatment effects. Bmj, 363.

Lau, C. S., & Aw, T. C. (2020). HbA1c in the diagnosis and management of diabetes mellitus: an update. Diabetes, 6, 1-4.

Mathibe-Neke, J. M. (2020). Ethical practice in the nursing profession: A normative analysis. South African Journal of Bioethics and Law, 13(1), 52-56.

Schnell, O., Crocker, J. B., & Weng, J. (2017). Impact of HbA1c testing at point of care on diabetes management. Journal of diabetes science and technology, 11(3), 611-617.


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