Written assignment that critically examines the effectiveness of policy, frameworks and assessment tools in public health disease management. Discuss the role of the community nurse and multidisciplinary team in empowering individuals and populations in r
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Public health is concerned with, reducing health inequality minimising health risks and improving the health status of populations' (Brocklehurst, 2004). Wanless (2004, p23), defines public health as, 'The Science and art of preventing disease, prolonging life and promoting health through organised efforts and informed choice of society, organisations public and private, communities and individuals". Throughout this paper the author will critically discuss the effectiveness of policies frameworks and assessment tools, used in public health disease management; in relation to the prevention and management of adults at risk of or with type two Diabetes Mellitus (DM) in the United Kingdom (UK). The Author will consider how environmental, epidemiological and demographic data can be used to highlight the underlying social determinants of a population's health, influencing policy making, and public health frameworks. Key issues to arise at local level following strategic plans to reflect government policy will be identified, and the role of the nurse and Multi Disciplinary Team (MDT) in implementing such policies will be examined. Within this strategy's employed in the authors' local area will be identified. The focus will then turn to empowerment, and the effectiveness of nursing frameworks and assessment tool, used to enable individuals and groups to become responsible for their own health. Type 2 DM occurs when the body ceases to produce adequate levels of insulin, and or when the action of the insulin that is produced becomes less affective; this is termed insulin resistant (Becker, 2003). It is most prevalent in ethnic minorities and older age however, there is a growing number of younger people and children developing DM (Roberts, 2007). Another factor that may increase an individual's susceptibility to DM is mental illness, in particular depression and schizophrenia (Holt, 2005). There are numerous underlying reasons for the growing prevalence of DM in the UK including, industrialisation and urbanisation leading to changes in lifestyle and eating habits (Helms, et al 2003). The results of these changes can be seen in the escalating level of obesity within the UK. ...read more.
Alongside this the department of health published The National Child Measurement Program in 2005, which requires school nurses to weigh and measure all four to five year olds and ten to eleven year olds annually, facilitating the evaluation of obesity reduction strategies and monitor prevalence (DoH, 2005). The big blue bus mobile healthy living centre, a collaboration that started in 2003 between Derbyshire County Primary Care Trust (PCT) and sure start provided a range of services including health promotion, smoking cessation, blood pressure monitoring and health screening at the point of need in the eight most deprived wards of the area. However, as of March 2008 this scheme was discontinued due to lack of funding. Although the PCT is assessing how these services may be provided in other community settings, no replacement services have currently been implemented (Derbyshire County PCT 2008 b). Other scheme that have been adopted locally include the expert patient program, enabling people to become more involved in self management of long term conditions such as diabetes and Rapid response nursing service, available to people with diabetes on a twenty-four hour basis to support people in their own home and reduce the number of hospital admissions (Derbyshire County PCT, 2007). All of which has seen community nurses becoming more involved in providing health education, information and support outside of the traditional setting. Meeting the need of the community and reducing health inequalities by empowering people to become responsible for their own health. Standard three of the NSF for diabetes relates to empowerment the author will now focus on role of the community nurse and MDT in implementing this standard; exploring strategies that may be employed to empower individuals and groups to be responsible for their own health. Empowerment is the process of supporting individuals to gain the skills, knowledge and confidence they need to make informed decisions regarding the treatment and management of their condition, allowing the patient to take grater control of their health (Nadoo & Wills, 2005). ...read more.
Community profiling as part of a health needs assessment. Nursing Standard. 22, 18, 51-56. Masterson, A. (2007). Community Matrons Person Centred Care Planning (Part One). Nursing Older People. 19, 4, 23-26. Mold, F. et al. (2008). The challenge of managing type 2 diabetes in primary care. Nursing Times. 104, 7, 32-33. Naidoo, J. & Wills, J. (2005). Public Health and Health Promotion Developing practice second edition. Oxford; Baillière Tindall. National Institute of Clinical Excellence. (2007). Behaviour change at Population, Community and Individual levels. London; NICE. National Institute of Clinical Excellence. (2003). Guidance on the use of patient-education models for diabetes: Technology Appraisal 60. London; NICE. National statistics. (2007) News release inequalities in life expectancy at 65 in the UK. London; Office for National Statistics. National Statistics. (2008). Statistics on Obesity, Physical Activity and Diet: England. London; Office for National Statistics. Nursing & Midwifery Council. (2004). Code of Professional Conduct. London; NMC. Prochaska, J. & DiClemente, C. (1984). The Transtheoretical approach: Crossing traditional boundaries of therapy. Homewood, Ill; Dow Jones-Irwin. QOF Database. (2005/6). Derbyshire County PCT. London. NHS. [Online]. Available from: <http://www.gpcontract.co.uk/> [Accessed 23rd March 2008]. Roberts, S. (2007). Working together for better diabetes care. London; Department of Health. Selby, M. (2004). Clinical general practice. Edinburgh; Butterworth-Heinemann. Singleton, C. (2006). Improving life for local people The Health of Derbyshire Report, director of public health report. Derbyshire; Derbyshire County Council. Stone, M. et al. (2005). Empowering patients with diabetes: a qualitative primary care study focusing on South Asians in Leicester, UK. Family Practice 22, 647-652. Tones, K. & Green, J. (2004). Health promotion planning and strategies. London; Sage Publications. Vile, C. (2004). Patient care at diagnosis: a planned education approach. Nursing Standard. 18, 28, 40-44. Wanless, D. (2004). Securing good health for the whole population: Final report. London; H.M.S.O. World Health Organisation, Regional Office for Europe. (1989). Saint Vincent Declaration. Diabetes Mellitus in Europe: a Problem at All Ages in All Countries, a Model for Prevention and Self-care. Italy; WHO ?? ?? ?? ?? 1 ...read more.
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