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Care Pathways and Strategies for Diabetes and Coronary Heart Disease Patients

Info: 4741 words (19 pages) Nursing Essay
Published: 11th Feb 2020

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Tagged: heart disease

Discuss how the practitioner and agencies involved in the care pathways for one of the chosen physiological disorders


A professional that will help with individuals who have diabetes is their optometrists as they are trained to be able to examine the eye and see defects in individuals vision, and are able to identify problems with their general health, for example, high blood pressure and diabetes, if an individual with diabetic retinopathy.However, if they require surgery they will then go see ophthalmologists are a surgical medical specialist who is able to perform surgeries on the eye. They went to medical school whereas optometrist when to optometry school. Ophthalmologist is able to examine the eye thoroughly and are able to diagnose many diseases and infection for example cataracts, glaucoma, macular degeneration and diabetic retinopathy’s use many different tools in order to examine the eye for example medical history indicates if there is any in the family who has diabetes or is they have been any recent changes in vision. A slit-lamp microscope it I device which shines light into the eyes and can examine the inside of the eyelid and the inner eye and the front surface if the eye.

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Another professional that is a podiatrist they are health care professional who has been trained to diagnose and treat an abnormal condition of the feet and lower limbs. They can prevent and correct deformities and help to keep people on their fee and moving, they also help people relieve pains and treat their infections. Day to day foot problems such as ingrown toenail, fungal nail, calluses, blister and verrucae. the orthotics are a tailor-made insoles, padding which supports your arch and relives and heel pain., its placed in your show and takes the pressure off vulnerable places in your feet.

Furthermore, professionals that help with someone who suffers from diabetes can be a nurse. Diabetes management is an essential part of keeping healthy with the support of nursing staff it can be managed and prevent future complication DNS (diabetes specialist nurses) they are a crucial part patient care and promoting self-care management. DNS provides training for other health care professional for example school nurses and public health nurses. Practice nurses play a particular role when it comes to managing diabetes as they are often the one who maintain screening and support people with diabetes. For example, they do this by monitoring the blood glucose, identify and treat hyperglycaemia and hypoglycaemia and also assessing and meeting their nutritional needs.

Coronary heart disease:

A cardiologist is a healthcare professional in which an individual who suffers from coronary heart disease would see regularly. They work in order to prevent the disease from progressing further. They used cutting edge technology and therapy; emergency treatment is frequently required to treat individuals with CHD. They also do palliative care, at the end of someone’s life due to their heart disease. There are many different sub-specialities for cardiologist, and one is adult congenital heart disease as CHD falls under this sub-speciality. As women who suffer from heart attacks their symptoms tend to be different from the men’s they some places have women’s heart program which specialises in the care need to prevent and treat the heart disease’s a symptom is a heart attack.

Another professional in which plays a role in cardiovascular care is a dentist. It may seem they play a minor role however when they treat patients, they are able to see warning signs for a range of diseases including those of the heart. they must make to be more vigilant so that as they are the first in line to detect any potential problems during their oral health treatment. If an emergency is detected they must refer the patients to the general practitioner or the or hospital department. As there is a link between periodontitis and coronary heart disease as it is commonly known as gum disease. As our oral health is commonly spread through the spread of bacteria and other germs to various parts of your body through the bloodstreams. When they reach the heart, the bacteria will then attach themselves to damage the area of the heart and this will then cause inflammation. This can result in illness such as endocarditis etc. This is how periodontal; disease will release toxins into bloodstreams which will then help to form fatty plaques within the arteries. This can lead to serious issues such as blood this will block the blood flow to the heart which can lead to someone dying.

Lastly, another professional which can be involved in the care pathway for individuals with coronary heart disease is a nutritional therapist are qualified professionals who provide services which help to improve prevent any problems with individual care. It is a complementary therapy which works to helps chronic conditions such as coronary heart disease. As nutritional therapy will identify where a nutritional status is and use this information, so they are able to produce resources to help better the individuals diet. There are several factors which can be associated with the of the fatty tissues within the coronary heart, for example, most commonly linked to a diet and lifestyle. Obesity is one as those who are overweight will tend to have a diet which is high in saturated fats Cholesterol levels, as will produce cholesterol in our liver after we have eaten food. LDL which is lipoprotein cholesterol can lead to plaque forming in the arteries. Saturated and unsaturated fats can increase LDL cholesterol in the blood. (Betterhealth.vic.gov.au.2019)

Discuss the care strategy that can be used to support individuals with each physiological disorder



A care strategy which can help someone who suffers from diabetes is an aid for living. This is a useful service as it provides individuals with help in their everyday life when there is no one there to support them. An induvial with diabetes can go onto to suffer many problems with their health, for example, they can develop foot problems know as ‘diabetic foot’, also they can start to lose their eyesight and malnourishment. Aid for living will help them manage these condition with their diabetes so they are able to live at home as being mobile is hard if someone is not able to see and has not learned how to do everyday task also if their feet were hurting and they unable to stand no long enough to make some food this could lead to why they could become malnourished. It is possible for this to be a short-term care plan for the individuals as it helps them to stay at home, for an elderly, this can be preferred rather than moving to a care home. A reason in which aid for a living may not benefit an individual with diabetes is that it is not a permanent solution for especially an elderly who suffers from diabetes their health may start to decline and it is possible they would need 24-hour help, therefore, aid for a living may not be the best solution.

Nutritional therapy is a complementary therapy which helps people who suffer from conditions such as diabetes. It helps induvial with diabetes as they as the nutritional therapist will identify the status in which this person is at and will then go onto creating a meal plan for them to follow, it has everything that they need in their body. They use commercial dietary supplement (not approved by the NHS) such as mega disease of vitamins and minerals in order to help the induvial. As they believe that our body has a nutritional and biochemical imbalance which leads to poor health (Bda.uk.com. (2019). This is a long-term care plan as this will help them increase their nutritional health as they have identified which area needs improvement and this will help them in the future as they are healthier which means they will become less tired and weak. (Bda.uk.com. 2019) Nutritional therapy may not be good for someone who is suffering from diabetes, for example, they are using alternative medicine and are non-regulated by law such as dietician, they do not work alongside other health care professionals therefore for each induvial it is a risk as the treatment they offer may not be the best as they do not have a degree.

A podiatrist is a health care professional who helps with foot problems. They help individuals to manage foot pain by providing individuals with orthotics this is a tailored made insole which helps to relieve heel pain for individuals. Also, they advise patients on footwear to help with feet pain. This is a short-term care plan as their recommendation and all they try to do help may be exhausted and not for some people. It may not be best to use this care strategy for those who suffer from diabetes is that if you are classified as low-risk patient as your mobility is yet affected then the NHS won’t cover for individuals to see a podiatrist meaning that individuals may have to go see them privately which can vary from up to 25 to 40 pound per session and regular sessions monthly can be very expensive, also this can deter people as they may not have the financial capability of paying for this treatment leading them to have server problems with their feet.

Lastly managing the disorder is an important part of someone’s health when they suffer from a chronic condition such as diabetes. It provides patients with the confidence, skills and knowledge to be able to love with this disorder. It will help take of themselves, for example, teaching individuals how to administer their own insulin, check the levels of their blood glucose and learn the way to help reduce or increase it. This is a long-term care strategy as it will help individuals for the rest of their lives being able to take care of oneself. It may not be wise to when the induvial is diagnosed between the ages 9-14 with type one diabetes at that age they may find it difficult to remember to take their medication also find it overwhelming to administer their own insulin so managing the disorder is better for individuals later on in their life rather than when they are first diagnosed.


Coronary heart disease

Mobility aid is a care strategy which can help to support individuals, who are suffering from coronary heart disease. This is because individuals who suffer from CHD also suffer from a stroke which can cause them mobility issues. This can come either as a helping hand by career or methods placed around the individuals home. For example, they may need the use if a wheelchair placing ramps around the house so that it is easy for them to move around. This can be a short-term solution to help an induvial life to be much easier. However having a wheelchair and making the necessary adjustments to their environment can be very costly and therefore not all individuals are able to us access this service which can cause restriction as they are then confined to one space which can cause problems for their mental health as they are not going out and seeing others, therefore the may start to withdraw. Also, the lack of independence can make them feel uncapable of looking after oneself.

Moreover, another care strategy which can help to support individuals who are suffering from coronary heart disease can be a lifestyle change. This can be very useful as many professionals can provide the necessary resources which the individuals will need to lead a better and healthier lifestyle. As cholesterol plays a role I the build-up incapable is important that individuals are aware and eat less saturated and non-saturated fats. Eating food such as sardines, tuna and fruits and vegetables are better for them. This is long-term solutions and can be very effective as it helps not to worsen the individual’s condition and can even contribute to their healing. Having healthier foods can be very costly compared to frozen and ready-made meals which tend to be high in saturated fats. Many people may feel as buying all the fruit and vegetables to be a financial burden. (nhs.uk, 2019)

Furthermore, another care strategy which can help to support individuals who are suffering from coronary heart disease can be medicine. There are many different drugs that can be used to treat coronary heart disease, for example, aspirin or other blood thinners as it can reduce your blood from clotting which helps to prevent construction to your coronary arteries, beta blockers is a medication used to help slow your heart and decrease the blood pressure ,it decreases the demand for oxygen in ones heart so if an individual has suffered a heart attack beta blocker will help reduce the risk of forthcoming attacks. Also, the use nitro-glycerine can come in forms of a tablet, spray or patches and it helps to control one’s chest pain, this is done by temporality dilating the coronary arteries which will reduce the heart demand for blood (Mayoclinic.org. 2019). This is a short-term solution as medication can not cure coronary heart disease however can help to prevent future complications. The right medication will help them to manage their symptoms effectively. There are many side effects to CHD medication for example beta blocker can cause to suffer a slow heartbeat, diarrhoea and nausea, blurred vision and sleep disturbance (insomnia) (nhs.uk. 2017). Therefore, this can cause problems for individuals wanting to go about their everyday life.

Lastly, another care strategy which can help to support individuals who are suffering from coronary heart disease can be an exercise program where they have daily or weekly exercise sessions. This can be as simple of walking at least half an hour a day or two and half hours a week, research shows people who fit reasonable active like walking burn more energy than those who go to the gym. People who exercise tend to have a better blood pressure than those who do not. As those with high blood pressure are at a higher risk of developing CHD as high blood pressure puts added force against the arty walls. Exercise helps to reduce the risk of heart attack and will help improve their quality of life. This is a long-term fix as it helps to prevent future problems with individuals health. Exercise for all CHD patients may not help us some may have suffered from mobility issues due to the disease, therefore, making it more difficult or unlikely. (Exerciseismedicine.com.au. 2019)

Evaluate the effectiveness of health and social care practitioners and agencies working together to deliver the care pathways for one of the chosen physiological disorders.

Coronary heart diseases involve many different agencies working tither to provide care for individuals who suffer from it.


A strength of multiagency working can be early identification, which leads to earlier intervention. As individuals will disclose information to their professionals and when diagnosing an issue, the other professionals may be able to identify something which either the other professional hadn’t yet noticed, or the patient had to disclose crucial information to them which can be relevant however seemingly insignificant. This can happen when an individual start to show symptoms of coronary heart disease, for example, an individual who has a history of ingestion their GP doctor may not be able to identify the problem at first as the individual may not notice it either, however after a systems such as a heart attack doctors a cardiologist will be able to diagnose the CHD and prevent other systems from progressing such as heart failure which can lead to death with no transplant.

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Another strength of multiagency working is a Better quality of services, as they will often be quicker rather than your GP requesting a specialist to come on your case each time they need a cardiologist, it is better if your GP work alongside them to better your holistic health. Also working in a team with a variety of resources help to solve issues which may arise faster, which means that your recovery time and the extent of the damage that has caused is minimal. They can work together to come up with the best possible way to treat your conditions, and different perspectives help to see a different way to approach it.

Another strength of multi-agency work is different professional will combine their skills and expertise to provide the best holistic care. They all play a vital role in individual health care; if they work together they can come up with the best solutions to keep the induvial healthy and comfortable for example cardiologist may advise the nutritionist to provide less saturated unsaturated fats in their meal plan. If your nurses which you see every day may notice that your struggling, after surgery, or diagnoses they will disclose this information to a psychologist who may be able to help them through it. Also when you work as a team, they are all able to maintain that individuals in all areas of their life, as they may be feeling down when the other professionals see them, it is essential that they are encouraging and aware of how their patient is feeling.


A disadvantage of multi-agency work, issues that may arise for example when more than two or more professionals are working together is lack of communication.Poor communication in healthcare can lead to horrible results for the health of the patient, this can be due to the lack of respect they each have for one another’s professions. Coronary heart disease has many professional working tother to provide the best holistic care for their patients. For example, a cardiologist may feel as their opinion matters more than a dentist who is qualified in medicine. Also, GP and dietician jobs overlapping this can cause unnecessary stress an inconveniences for the patient as they are providing them with the same information again and even asking the same questions and running the same test.

Moreover, another issue which may arise when two or more professionals work together is neglect; this is due to professionals not identifying clear roles and responsibilities between one and another. The lack of clarity will confuse them, and they will feel uneasy about the quality of their healthcare, as they are unable o identity, which is doing what for them. This can happen when a health care professional, for example, cardiologist and GP doctor order the same test this is because they are not working tother properly, which means they are wasting resources and time — also neglecting how the patient feels which will indirectly slow their recovery. (Scie.org.uk. 2019)

Furthermore, conflict and animosity between health care, which are providing holistic care for an individual, is a problem. This is because they are unable to work side by side and will often not value the other professional’s skills and expertise when dealing with their patient which will lead to delay in treatment and they will be may be unable to prevent heart intervention. This can cause their condition to worsen for example an individual who see her doctor at the GP due to chest pains, fatigue and nausea; which are signs which indicate to heat attack conflict between the health professional. However, they will request second opinions or other health care professionals, which may be better for them; however, the patient needs them to stay focus and refrain from involving their feelings.


Evaluate the care strategies that can be used to support individuals with one of your chosen physiological disorders


Complementary therapy is a strategy that is used to support individuals who suffer from coronary heart disease. Nutritional therapy is very useful services which aim to provide patients with information and resources that are needed in order for them to stay healthy and well. This will help them manage their condition as they are able to eat the right food which their body needs and stay away from food groups which will make them weak so for example if an induvial with coronary heart disease eats food that is high in salts and unprocessed foods and fried food this is not benefiting them however can worsen their condition. However, if they eat foods such as salmon, tuna and vegetables and fruits and whole grain bread this is better for their body. Nevertheless, nutritional therapy is a lifestyle change that must be made by the patient themselves. It is great that we provide them with the meal plans however it is there job to follow to and a dietitian or GP do not have any power over them to make sure they change as they can only advise.                

Moreover, care strategy which aims to help individuals who suffer from coronary heart disease can be the use of medication. A very useful medication that is provided to individuals is blood thinners this will lessen the chance of your blood clotting, this will help to prevent obstruction of the arteries if left untreated this can lead to someone’s death. Nitro-glycerine this is a tablet, spray or even patch that can help control an individuals chest pain by dilating your coronary artery, this will help to reduce your hearts demand for blood. Though this might help the individual if they stay on top of all their medication it is very possible when an individual reaches old age for their memory to become disorientated and therefore they may not remember to take their medication, therefore, this treatment plan that they are on may not be as effective as it could have been.(Mayoclinic.org. 2019)

Additionally, care strategy that aims to help individuals is being able to learn about their disorder so they are better equipped to manage the small things on their own. As they will have all the necessary tools and skills to better manage the disorder, for example, someone who suffers from coronary heart diseases may be taught about better dieting option available which will benefit them. Learning and implementing this will help them understand why it may not benefit them to eat and what can happen to them if they do therefore acting as a deterrent. The weakness of managing the disorder is teaching individuals how to may prove difficult as there may be barriers if communication between the patient and the health care professionals. For example language barriers finding an interpreter, when patients aren’t able to voice they will start to feel frustrated and helpless.

Furthermore, care strategy which aims to help individuals who suffer from coronary heart disease is rehabilitation strategy this can be with a psychologist who will assess the needs of the individuals and create a care plan which is best suited from them. It aims to help people overcome mental and emotional disorders that individuals may be facing due to the disorder the was diagnosed. For example, some individuals who are diagnosed with coronary heart disease can fall into depression and start to become withdrawn from those around them. This is bad for both their physical and mental health and therefore by providing a care strategy we are able to support them to be better and this can be done by prescribing anti-depressants. However, a weakness is not all areas may have the faculties needed for that individual, therefore, meaning they may have to travel far, this is can cause that induvial not seek help as they don’t believe that it is not worth it.




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         Exerciseismedicine.com.au. (2019). [online] Available at: http://exerciseismedicine.com.au/wp-content/uploads/2016/11/2014-CHD-FULL.pdf [Accessed 3 Jun. 2019].


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Coronary heart disease, which is often also called heart disease is the main form of heart disease. It is a disorder of the blood vessels within the heart that can lead to heart attack. When a heart attack occurs, the artery becomes blocked which prevents nutrients and oxygen from getting to the heart.

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