NURS-FPX4900 Assessment 4 Patient Family or Population Health Problem Solution

NURS-FPX4900 Assessment 4 Patient Family or Population Health Problem Solution

NURS-FPX4900 Assessment 4 Patient Family or Population Health Problem Solution

Data gathered throughout the capstone project highlights how diabetes mellitus as a problem can be approached from the perspective of leadership, collaboration, communication, and change management to develop a solution for the problem.

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Capella NURS-FPX4900 Assessment 5

Data gathered from literature and studies gave an insight into the effects of policies, quality of care, safety, costs, technology, care coordination, and community resources on diabetes mellitus and the approach to solving diabetes type 2 as a problem to the population. One of the problems associated with diabetes mellitus type 2 is poor glycemic control, which mainly results from under-testing of HbA1c, which is used as an indicator of chronic blood sugar control (CDC, 2021).

This study included patients with poor glycemic control and HbA1c levels >9%. A PowerPoint presentation highlighting how the issue of HbA1c under testing could be solved to ensure that diabetic patients can test their HbA1c levels within the recommended parameters by the American Diabetes Association (ADA) was presented to these patients (Albarrak et al., 2018). They were also educated on the factors contributing to poor blood sugar control, associated complications, solutions to the complication, and how to prevent HbA1c under testing.

Leadership and Change Management in Diabetes Management

In its essence, leadership involves influencing, motivating, and guiding a specific group of people toward a specific goal or objectives (Adams, 2018). To guide a specific group of individuals to their goals, leaders must establish clear guidelines, structures, relationships and involve the group in the activities that drive them to these goals (Adams, 2018). Therefore, communication plays a critical role in driving the vision of a given group or individual toward achieving the set goal.

Being mindful of others, being team-oriented, and encouraging the participation of others are qualities of leaders that are essential in driving a team to achieve its goals. Educating this group of patients on diabetes mellitus and how to control their blood sugar levels was critical to promoting a better health outcome. Involving them in the process of care and allowing them to set their own goals was important in ensuring the success of the interventions (Adams, 2018).

NURS-FPX4900 Assessment 4 Patient Family or Population Health Problem Solution

According to the Great Man Theory of leadership, interpersonal skills are the best ingredient for interacting, working, and effectively communicating with individuals and team members (Adams, 2018). This theory guided the intervention development in addressing the problem of diabetes type 2 and adherence to the recommended HbA1c testing frequency and treatment. The harmful consequences of not keeping their blood sugar levels within normal ranges were explained to the selected 13 diabetic patients in an interactive group session. This was done in a simple language that the members could easily understand.     

We eventually came to a consensus on how we could collaborate to attain personal and group objectives. In creating these goals and objectives, we used the SMART criterion, which stands for Specific, Measurable, Attainable, Relevant, and Time-bound (Aghera et al., 2018). This model has proven effective in fueling individuals toward achieving their goals and visions. We then held meetings between intervention times to assess whether each group member was meeting their objectives.

Throughout the intervention, individuals were allowed to make decisions and decide on possible objectives. Autonomy played an essential role in enabling each group member to achieve intrinsic goals in addition to the group goals. By explaining the importance of long-term glycemic control and testing their HbA1c within the recommended frequency, each diabetic patient was able to set their own goal that they thought was within their grasp.

Strategies for Communicating and Collaborating with the Patient

The selected patients were of the age group of 40-62 years. They had poor blood sugar control over the last year and recorded HbA1c greater than 9% in the previous HbA1c testing done. Seven of the members had manifested diabetes complications ranging from acute to chronic complications. The body mass index was also from overweight to obese. All of them had already enrolled in initiatives meant to reduce their weight, including gym sessions for exercise and dietary changes.                     

After interacting with them and understanding their state, complications, and progress made, we came up with three group goals: weight reduction through a healthy lifestyle and exercise, self-management to control their long-term blood sugar levels, and HbA1c testing after every six months. On exercising, we specified at least 30 minutes of moderate to intense exercise per day, five days a week, for the next three months before evaluation.

Those who could do more we also encouraged. On dietary, we advised them to maintain a 1,900 calorie diet a day. This, however, was flexible depending on their daily blood glucose levels. Additionally, diabetics who are overweight or obese have an increased risk of developing insulin resistance and, thus, poor response to medication. Weight loss, therefore, plays a vital role in reducing the risks of suffering complications associated with diabetes, such as the cardiovascular and renal effects that may result due to poorly controlled blood glucose levels (CDC, 2021).

Communication played a crucial role in effecting the intervention (Chichirez & Purcărea, 2018). Group communication and individual meetings effectively came up with the group and individual goals, respectively. The complications of poor glycemic control and its effect on the individual’s social and economic life were communicated to the group.

The group members were allowed to keep the brochures with them for future reference. Non-verbal and other kinds of verbal communication, such as visual aids, were also employed throughout the presentation and in passing the intended message over, in addition to textual communication in the form of presentations and brochures (Chichirez & Purcărea, 2018). Highlighting the parameters that need modification enables the patients to work on them effectively.

Understanding that working together and communicating is vital for achieving their goals, the patients were motivated to control their sugar levels and weight to achieve better health outcomes. According to Lander et al. (2019), actively involving patients in their care promote adherence to treatment plans, tracking their health records, and understanding their condition. Through effective communication and collaboration, we were able to develop SMART goals and strategies to control their blood sugar levels and their state of weight depending on what they view as achievable.

Policy Effects on the Development of Intervention for the Diabetic Patients

According to Oyeleye (2021), the interaction between patients and health professionals should always be guided and governed by policies. My interaction with the selected group of patients was no exception. Privacy and confidentiality are emphasized in the Health Insurance Portability and Accountability Act (HIPAA) of 1996 (Oyeleye, 2021). This federal policy is meant to keep sensitive patient information from being shared without their permission or knowledge.

This policy influenced how I interacted with the patients and other team members during the project. The essence of individual meetings was to promote privacy and ensure that the patients could share information about their health without fear of them being disclosed to unauthorized individuals.

The Minnesota state board of nursing has rules and policies that regulate the scope of practice for registered nurses in addition to federal guidelines. The state policy allows registered nurses (RNs) to diagnose and treat patients through services like case studies, health counseling, and care provision (Lander et al., 2019). My interactions with all the patients were governed by the scope of my practice, including how I cared for them, health counseling, and diabetes patient education.

The selected patients were counseled to ensure they were emotionally and psychologically knowledgeable and stable. As per my scope, I also provided education on the necessity and methods for controlling their blood sugar levels. Finally, the proposed intervention for managing their blood sugar levels and HbA1c testing followed nursing evidence-based guidelines.

Interventions Effect on Quality of Care, Patient Safety, and Costs

Weight loss and blood sugar control are critical in the long-term management of diabetes (Shan et al., 2019). Implementing the outlined interventions, including exercising and dietary changes, is essential in weight loss for the patients. Effective long-term control of blood sugar and monitoring through testing HbA1c plays an important role in mitigating the renal, cardiovascular, and other complications associated with poor blood sugar control in diabetes (Shan et al., 2019).

Five of the selected patients had hypertension. Exercising and weight loss play an essential role in the management of hypertension. According to Albarrak et al. (2018), losing weight by even 10% improves blood pressure and body cholesterol, which is significant in managing hypertension. By removing these health issues, these individuals can live a healthier lifestyle and enhance the safety and quality of their life.

According to the (CDC, 2021), the average cost of caring for diabetic patients in the USA is about $327 billion as of 2017. The average cost per individual is about $16,752 per year (Riddle & Herman, 2018). The expense of treating diabetes-related complications is not included in this estimate. Patient welfare is conserved, and the cost of controlling diabetes is reduced dramatically per person by applying the intervention and perhaps reducing the risk of severe consequences.

Technology, Care Coordination, and Community Resources

Technology, care coordination, and community resources play a significant role in providing care (Shan et al., 2019). In the management of diabetes, there have been significant technological advancements. These advancements include insulin pumps, continuous glucose monitors, and systems that combine a pump and a monitor for algorithm-driven insulin delivery automation (Shan et al., 2019). These tools make it easy for people with diabetes to control their blood sugar levels, reducing complications associated with uncontrolled diabetes.

During health counseling of the selected patients, they were advised on the importance of these tools in controlling their blood sugar levels. Additional tools developed include monitors for caloric intake, physical activity, and software applications to identify restaurants with specified calories for consumption as required by their bodies (Shan et al., 2019).

Care coordination and community resources are essential in the management of diabetes (Whittemore et al., 2019). The use of community resources helps reduce the expensive costs incurred in the management of diabetes. They include community-based organizations, health workers, and other organizations actively aiding diabetic patients and their families (Whittemore et al., 2019). Diabetic patients are also educated on the causes, self-management, and care by community health workers (Williams et al., 2020).

Physicians and physical therapists are crucial in managing complications associated with diabetes type 2 (Shan et al., 2019).  Physical therapists are also vital in keeping the population fit and diabetes patients from becoming physically unfit.  Spiritual counseling should be provided to diabetics through associated religious groups and their leaders to help them become closer to their deity and live healthy emotional and spiritual life. During the intervention, I suggested the patients seek these services, which some of the patients utilized and aided in implementing the interventions.

Conclusion

Effective communication during the intervention was ensured by combining verbal and non-verbal forms of communication. Collaboration with the patients was also provided to ensure that SMART goals were set. Furthermore, the intervention was developed by carefully applying effective leadership, communication, and change management. Finally, the application of technology ensured that the patients could easily control their blood sugar levels and weight to achieve their goals.

References

Adams, D. (2018). Mastering theories of Educational Leadership and Management. University of Malaya Press. https://books.google.at/books?id=ho5xDwAAQBAJ

Aghera, A., Emery, M., Bounds, R., Bush, C., Stansfield, R. B., Gillett, B., & Santen, S. A. (2018). A randomized trial of SMART Goal Enhanced Debriefing after simulation to promote educational actions. The Western Journal of Emergency Medicine, 19(1), 112–120. https://doi.org/10.5811/westjem.2017.11.36524

Albarrak, A. I., Mohammed, R., Assery, B., Allam, D., Morit, S. A., Saleh, R. A., & Zare’a, R. (2018). Evaluation of diabetes care management in primary clinics based on the guidelines of American Diabetes Association. International Journal of Health Sciences, 12(1), 40–44. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC5870309/

CDC. (2021, December 29). Type 2 diabetes. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/basics/type2.html

Chichirez, C. M., & Purcărea, V. L. (2018). Interpersonal communication in healthcare. Journal of Medicine and Life, 11(2), 119–122. https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6101690/

Lander, J., Langhof, H., & Dierks, M.-L. (2019). Involving patients and the public in medical and health care research studies: An exploratory survey on participant recruiting and representativeness from the perspective of study authors. PloS One, 14(1), e0204187. https://doi.org/10.1371/journal.pone.0204187

Oyeleye, O. A. (2021). The HIPAA Privacy Rule, COVID-19, and nurses’ privacy rights. Nursing, 51(2), 11–14. https://doi.org/10.1097/01.NURSE.0000731892.59941.a9

Riddle, M. C., & Herman, W. H. (2018). The cost of diabetes care-an elephant in the room. Diabetes Care, 41(5), 929–932. https://doi.org/10.2337/dci18-0012

Shan, R., Sarkar, S., & Martin, S. S. (2019). Digital health technology and mobile devices for the management of diabetes mellitus: state of the art. Diabetologia, 62(6), 877–887. https://doi.org/10.1007/s00125-019-4864-7

Whittemore, R., Vilar-Compte, M., De La Cerda, S., Marron, D., Conover, R., Delvy, R., Lozano-Marrufo, A., & Pérez-Escamilla, R. (2019). Challenges to diabetes self-management for adults with type 2 diabetes in low-resource settings in Mexico City: a qualitative descriptive study. International Journal for Equity in Health, 18(1), 133. https://doi.org/10.1186/s12939-019-1035-x

Williams, J. S., Walker, R. J., & Egede, L. E. (2020). The role of family and peer support in diabetes. In Behavioral Diabetes (pp. 391–401). Springer International Publishing. https://doi.org/10.1007/978-3-030-33286-0_25

NURS-FPX4900 Assessment 4 Instructions: Patient, Family, or Population Health Problem Solution

  • Develop an intervention (your capstone project), as a solution to the patient, family, or population problem you’ve defined. Submit the proposed intervention to the faculty for review and approval. This solution needs to be implemented (shared) with your patient, family, or group. You are not to share your intervention with your patient, family, or group or move on to Assessment 5 before your faculty reviews/approves the solution you submit in Assessment 4. In a separate written deliverable, write a 5-7 page analysis of your intervention.

Please submit both your solution/intervention and the 5-7 page analysis to complete Assessment 4.

Introduction

In your first three assessments, you applied new knowledge and insight gleaned from the literature, from organizational data, and from direct consultation with the patient, family, or group (and perhaps with subject matter and industry experts) to your assessment of the problem. You’ve examined the problem from the perspectives of leadership, collaboration, communication, change management, policy, quality of care, patient safety, costs to the system and individual, technology, care coordination, and community resources. Now it’s time to turn your attention to proposing an intervention (your capstone project), as a solution to the problem.

Preparation

In this assessment, you’ll develop an intervention as a solution to the health problem you’ve defined. To prepare for the assessment, think about an appropriate intervention, based on your work in the preceding assessments, that will produce tangible, measurable results for the patient, family, or group. In addition, you might consider using a root cause analysis to explore the underlying reasons for a problem and as the basis for developing and implementing an action plan to address the problem. Some appropriate interventions include the following:

    • Creating an educational brochure.
    • Producing an educational voice-over PowerPoint presentation or video focusing on your topic.
    • Creating a teaching plan for your patient, family, or group.
    • Recommending work process or workflow changes addressing your topic.

Plan to spend at least 3 direct practicum hours working with the same patient, family, or group.

In addition, you may wish to complete the following:

    • Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
    • Conduct sufficient research of the scholarly and professional literature to inform your work and meet scholarly expectations for supporting evidence.

Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Supportpage.

Instructions

Complete this assessment in two parts: (a) develop an intervention as a solution to the problem and (b) submit your proposed intervention, with a written analysis, to your faculty for review and approval.

Part 1

Develop an intervention, as a solution to the problem, based on your assessment and supported by data and scholarly, evidence-based sources.

Incorporate relevant aspects of the following considerations that shaped your understanding of the problem:

    • Leadership.
    • Collaboration.
    • Communication.
    • Change management.
    • Policy.
    • Quality of care.
    • Patient safety.
    • Costs to the system and individual.
    • Technology.
    • Care coordination.
    • Community resources.

Part 2

Submit your proposed intervention to your faculty for review and approval.

In a separate written deliverable, write a 5–7 page analysis of your intervention.

    • Summarize the patient, family, or population problem.
    • Explain why you selected this problem as the focus of your project.
    • Explain why the problem is relevant to your professional practice and to the patient, family, or group.

In addition, address the requirements outlined below. These requirements correspond to the scoring guide criteria for this assessment, 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, note the additional requirements for document format and length and for supporting evidence.

    • Define the role of leadership and change management in addressing the problem.
      • Explain how leadership and change management strategies influenced the development of your proposed intervention.
      • Explain how nursing ethics informed the development of your proposed intervention.
      • Include a copy of the intervention/solution/professional product.
    • Propose strategies for communicating and collaborating with the patient, family, or group to improve outcomes associated with the problem.
      • Identify the patient, family, or group.
      • Discuss the benefits of gathering their input to improve care associated with the problem.
      • Identify best-practice strategies from the literature for effective communication and collaboration to improve outcomes.
    • Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of your proposed intervention.
      • Cite the standards and/or policies that guided your work.
      • Describe research that has tested the effectiveness of these standards and/or policies in improving outcomes for this problem.
    • Explain how your proposed intervention will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
      • Cite evidence from the literature that supports your conclusions.
      • Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
    • Explain how technology, care coordination, and the utilization of community resources can be applied in addressing the problem.
      • Cite evidence from the literature that supports your conclusions.
    • Write concisely and directly, using active voice.
    • Apply APA formatting to in-text citations and references.

Additional Requirements

    • Format: Format the written analysis of your intervention using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
      • A title page and reference page. An abstract is not required.
      • Appropriate section headings.
    • Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
    • Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
    • Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.

Portfolio Prompt: Save your intervention to your ePortfolio. After you complete your program, you may want to consider leveraging your portfolio as part of a job search or other demonstration of your academic and professional competencies.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

    • Competency 1: Lead people and processes to improve patient, systems, and population outcomes.
      • Define the role of leadership and change management in addressing a patient, family, or population health problem.
    • Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
      • Explain how a proposed intervention to address a patient, family, or population health problem will improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
    • Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
      • Explain how technology, care coordination, and the utilization of community resources can be applied in addressing a patient, family, or population health problem.
    • Competency 5: Analyze the impact of health policy on quality and cost of care.
      • Explain how state board nursing practice standards and/or organizational or governmental policies guided the development of a proposed intervention.
    • Competency 6: Collaborate interprofessionally to improve patient and population outcomes.
      • Propose strategies for communicating and collaborating with a patient, family, or group to improve outcomes associated with a patient, family, or population health problem.
    • Competency 8: Integrate professional standards and values into practice.
      • Write concisely and directly, using active voice.
      • Apply APA formatting to in-text citations and references.

Assessment 5 Instructions: Intervention Presentation and Capstone Video Reflection

  • Present your approved intervention to the patient, family, or group and record a 10-15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Introduction

Baccalaureate-prepared nurses have many opportunities to reflect on their contributions to patient care outcomes during clinical experiences. Research suggests that creating and sharing video reflections may enhance learning (Speed, Lucarelli, & Macaulay, 2018).

For this assessment, you’ll present your approved intervention to the patient, family, or group and reflect on various aspects of your capstone practicum experience. Such reflection will give you a chance to discuss elements of the project of which you are most proud and aspects of the experience that will help you grow in your personal practice and nursing career.

Reference

Speed, C. J., Lucarelli, G. A., & Macaulay, J. O. (2018). Student produced videos—An innovative and creative approach to assessment. Sciedu International Journal of Higher Education, 7(4).

Instructions

Complete this assessment in two parts: (a) present your approved intervention to the patient, family, or group and (b) record a video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program.

Part 1

Present your approved intervention to the patient, family, or group. Plan to spend at least 3 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Be sure you’ve logged all of your practicum hours in Capella Academic Portal.

The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.

Use the Intervention Feedback Form: Assessment 5 [PDF] as a guide to capturing patient, family, or group feedback about your intervention. You’ll include the feedback as part of your capstone reflection video.

Part 2

Record a 10–15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. A transcript of your video is not required.

You’re welcome to use any tools and software with which you are comfortable, but make sure you’re able to submit the deliverable to your faculty. Capella offers Kaltura, a program that records audio and video. Refer to Using Kaltura for more information about this courseroom tool.

Note: If you require the use of assistive technology or alternative communication methods to participate in these activities, please contact DisabilityServices@Capella.edu to request accommodations. If you’re unable to record a video, please contact your faculty as soon as possible to explore options for completing the assessment.

Requirements

The assessment requirements, outlined below, correspond to the scoring guide criteria, so address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for supporting evidence.

    • Assess the contribution of your intervention to patient or family satisfaction and quality of life.
      • Describe feedback received from the patient, family, or group on your intervention as a solution to the problem.
      • Explain how your intervention enhances the patient, family, or group experience.
    • Describe your use of evidence and peer-reviewed literature to plan and implement your capstone project.
      • Explain how the principles of evidence-based practice informed this aspect of your project.
    • Assess the degree to which you successfully leveraged health care technology in your capstone project to improve outcomes or communication with the patient, family, or group.
      • Identify opportunities to improve health care technology use in future practice.
    • Explain how health policy influenced the planning and implementation of your capstone project, as well as any contributions your project made to policy development.
      • Note specific observations related to the baccalaureate-prepared nurse’s role in policy implementation and development.
    • Explain whether capstone project outcomes matched your initial predictions.
      • Discuss the aspects of the project that met, exceeded, or fell short of your expectations.
      • Discuss whether your intervention can, or will be, adopted as a best practice.
      • Describe the generalizability of your intervention outside this particular setting.
      • Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
    • Assess your personal and professional growth throughout your capstone project and the RN-to-BSN program.
      • Address your provision of ethical care and demonstration of professional standards.
      • Identify specific growth areas of which you are most proud or in which you have taken particular satisfaction.
    • Communicate professionally in a clear, audible, and well-organized video.

Additional Requirements

Cite at least three scholarly or authoritative sources to support your assertions. In addition to your reflection video, submit a separate APA-formatted reference list of your sources.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

    • Competency 2: Make clinical and operational decisions based upon the best available evidence.
      • Describe one’s use of evidence and peer-reviewed literature to plan and implement a capstone project.
    • Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
      • Explain whether capstone project outcomes matched one’s initial predictions and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
    • Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.
      • Assess the degree to which one successfully leveraged health care technology in a capstone project to improve outcomes or communication with a patient, family, or group.
    • Competency 5: Analyze the impact of health policy on quality and cost of care.
      • Explain how health policy influenced the planning and implementation of one’s capstone project, as well as any contributions the project made to policy development.
    • Competency 7: Implement patient-centered care to improve quality of care and the patient experience.
      • Assess the contribution of an intervention (capstone project) to patient, family, or group satisfaction and quality of life.
    • Competency 8: Integrate professional standards and values into practice.
      • Assess one’s personal and professional growth throughout a capstone project and the RN-to-BSN program.
      • Communicate professionally in a clear and well-organized video.