Policy provisions based on government legislation may affect care coordination, especially when they raise ethical questions and necessitate dilemmas. Ethical questions arise when the policies have loopholes that hinder providers and organizations like the American Diabetes Association from executing their activities based on their goals (Fang et al., 2022). For instance, the privacy rule provision under HIPAA may hinder the effective sharing of patient information despite their acuity for immediate care provision. As demonstrated by the CDC (2022), policies like Preventive Drug Lists have essential medicines used in the management of diabetes and heart disease. These lists make the cost of care for diabetes patients high and reduce overall accessibility.
The Diabetes Caucus in the House of Representatives has listed critical bills that if enacted will have a profound impact on the management of the condition where over 1.2 million Americans get diagnosed each year (Diabetes Caucus, 2023). The policy provisions are essential in eliminating disparities in diabetes care provision. The privacy rule under HIPAA also raises ethical questions and dilemmas as providers may not access critical information to aid in their care provision. Diabetes patients requiring emergency care during exacerbation may be required to share information with their providers. Delays in such information provision may raise ethical dilemmas for providers to make better decisions.
The American Nurses Association (ANA) (2023) developed the Code of Ethics with Interpretive Statements (the Code) to guide nurses in carrying out their responsibilities in a consistent way that guarantees quality care and ethical obligations. The code comprises nine provisions that focus on the ethical conduct of nurses as an essential component of care coordination and attainment of the care continuum. For instance, the first provision entails respect for human dignity, discusses the nature of health, relationships between nurses and patients, the right to self-determination, and the interactions between nurses. These provisions are critical because they inform the kind of relationships that nurses develop with their patients and colleagues, the professional boundaries that they should have, and ethical aspects like respect for human dignity, self-determination, and protection of rights of privacy and confidentiality. As such, nurses working with diabetic patients and populations must offer care based on ethical provisions. The code encourages collaboration among nurses and other healthcare professionals for effective and quality care provision (American Nurses Association, 2023). The code affects coordination as it implores nurses to be accountable and make decisions in the best interest of patients for a better continuum of care.
As such, through the code, nurses must identify factors like income, health insurance, and cultural practices that influence health, lead to health disparities, and reduce or improve access to services, especially for diabetic patients and populations. The social determinants of health as advanced by Healthy People 2030 are critical to the attainment of effective services for providers dealing with diabetic populations. Aspects like living conditions and neighborhood, education, and overall health accessibility are critical in the care continuum. Therefore, based on the provisions of the code of ethics by ANA, nurses have a critical role in improving access to health care services through effective coordination across the different areas of care provision.
Nurses should know that health is a universal right and requires effective collaboration through consideration of human rights and health diplomacy as well as adhering to their overall obligation to advance health and human rights. Nurses should make efforts to address and reduce health disparities, even for individuals having diabetes through entities like the American Diabetes Association. As the code espouses, collaboration for human rights in complex, extreme, and extraordinary practice settings is challenging and has profound effects on care delivery (Hartmann-Boyce et al., 2020). However, nurses should rise to the occasion and offer evidence-based practice approaches to address such challenges, including possible disparities in healthcare.
As I conclude, it is evident that different policy and ethical factors impact care coordination for organizations and even individuals, especially nurses caring for diabetic patients and populations. The developed care coordination presentation shows that nurses must adhere to policy factors like HIPAA and ACA to increase access
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