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Evidence-Based Patient-Centered Concept Map Analysis

Evidence-Based Patient-Centered Concept Map Analysis

Summary Brief of the Patient

            JB is a 54-year-old Black American male with type 2 diabetes who has lived with the condition for 24 years. He had a right leg amputation below the knee five years ago due to wet gangrene and now uses crutches to walk. He was recently brought to the hospital with symptoms of altered consciousness, severe dehydration, and hyperglycemia.

Upon laboratory testing, it was found that JB had hyperglycemia of 32 mmol/L, a high hemoglobin A1c level of 7.9%, and deranged urea and electrolyte levels. He was diagnosed with a diabetic hyperosmolar hyperglycemic state and admitted to the intensive care unit for controlled insulin therapy.

JB was previously a truck driver but lost his job following the amputation and is now unable to work. He is married with one child, who is studying water engineering on a scholarship. JB does not have medical insurance, and his wife works as a supermarket attendant, which does not provide enough income to afford JB’s antidiabetic medications consistently.

As a result, JB has a history of not taking his medications as prescribed due to cost concerns and does not regularly monitor his blood sugar levels. Despite being told that uncontrolled blood sugar and poor diabetes self-care led to the development of wet gangrene in his right leg, JB has not sufficiently improved his knowledge and self-care practices.

Patient Needs Analysis

To ensure that the interventions in the concept map are relevant and appropriate for JB’s beliefs, values, and lifestyle, it is important to consider his health, economic, and cultural needs. JB’s medical needs include diabetes care, physical therapy and rehabilitation to enhance mobility, and mental health assistance to address the psychological burden of amputation and unemployment.

His economic needs may include financial aid to pay medical treatment and prescription expenses, a steady income to support the family’s basic necessities, and assistance in seeking work or training possibilities. Respect for JB’s personal beliefs and values, consideration of his cultural background as a Black American man, support for maintaining cultural traditions and connections, recognition of any cultural barriers or challenges, and provision of interpreters or other language support services as needed are all examples of cultural needs.

Addressing these demands allows the concept map interventions to be tailored to JB’s individual needs, assisting him and his family in managing his health condition and enhancing their general well-being.

To incorporate the patient’s culture, identity, abilities, and beliefs into the plan of care, it is important to consider the specific needs and preferences of the patient and his family. Since lack of knowledge on efficient diabetes self-care led to the complication of wet gangrene causing the subsequent amputation, part of the plan of care involves providing information and education about diabetes management in a culturally sensitive and appropriate manner.

This could involve using culturally relevant materials and resources and incorporating any cultural beliefs or practices that may affect JB’s self-management behaviors, such as his diet, physical activity, and medication adherence. Furthermore, the information will be provided in the patient’s native language (English) to aid understanding.

As a Black American, JB faces significant discrimination in healthcare. According to a review of socioeconomic disparities in lower extremity amputations by Girijala and Bush (2018), comparing amputees to non-amputees, the African American race was more common in amputees (25.1% vs. 12.6%).

In addition, Black American amputees often have limited access to healthcare services due to higher rates of medical non-insurance and difficulty with transportation (Connell et al., 2019). To address these barriers, the care plan for JB includes connecting him to various healthcare providers, including physical therapists and mental healthcare providers, to facilitate access to care and promote a holistic approach. This will allow JB to easily access and utilize these services, improving his overall care and health outcomes.

Communication Strategies

It is important to follow a few key strategies to communicate with JB and his family in an ethical, culturally sensitive, and inclusive way. First, it is critical to establish open and honest communication with JB and his family. This may include seeking their permission to share health information, explaining the aim of any tests or treatments, and being open about any risks and benefits (Roodbeen et al., 2020).

It is also crucial to provide a secure and inviting atmosphere for JB and his family, as well as actively listen to their worries and questions to foster honest conversation. In addition to encouraging open communication, it is critical to guarantee that only authorized information is exchanged in compliance with data protection regulations. This may involve explaining the limits of confidentiality and obtaining consent from JB or his family before sharing any personal health information.

Finally, it is crucial to make complex medical terms and concepts understandable to JB and his family, regardless of language, abilities, or educational level. This may include utilizing basic and plain language, giving written materials in JB’s native language or a language that he and his family can comprehend, and using visual aids or other types of communication to assist in communicating information.

It may also be beneficial to ask JB and his family if they have any questions or concerns and to carefully explain any information they may not comprehend. Following these principles will allow healthcare personnel to interact with JB and his family in an ethical, culturally sensitive, and inclusive manner.

Value and Relevance of the Resources

            A variety of resources were employed to develop a meaningful concept map for JB, as well as a critical analysis of his needs. Connell et al. (2019), Girijala and Bush (2018), and Lewis and Van Dyke (2018), for example, discuss the challenges African Americans face in healthcare access and utilization.

The three articles are relevant to JB’s case because he is a Black American amputee without medical insurance who is at a high risk of having difficulty accessing and utilizing healthcare services. Furthermore, the studies are current (published within the last five years), written by medical experts in various health fields, and give accurate findings supported by a variety of research studies.

On the other hand, Demir and Aydemir (2020) provide a comprehensive lower extremity amputation protocol, part of which includes physical mobility and strengthening exercises. This information is useful in caring for JB, an amputee who needs physical mobility and strengthening exercises to keep his joints functioning properly.

A large array of research papers supports the information in the article, and it is current (published within the past five years). Furthermore, Demir and Aydemir (2020) have specialist backgrounds in physical medicine and rehabilitation, which gives them the competence to write about lower extremity amputation protocol.

Furthermore, whereas Roodbeen et al. (2020) investigate the communication and collaborative decision-making during patient care, Silbert et al. (2018) address hypoglycemia in type 2 diabetes patients. The results of Roodbeen et al. (2020) may be valuable in assisting healthcare personnel in efficiently communicating with JB, who has little health literacy, and including him in decision-making about his treatment.

Moreover, Silbert et al. (2018)’s findings on risk factors and preventative measures may be valuable in assisting JB and his healthcare professionals in identifying ways to regulate his blood sugar levels and lower his risk of hypoglycemia. The two studies were written and published within the last five years by medical professionals and communication specialists, and they are supported by a large body of evidence from various research studies, boosting their credibility.

Conclusion

             The patient at the center of the concept map is a 54-year-old Black American man with type 2 diabetes who has lived with the condition for 24 years. He is an amputee, uses crutches to walk, and has recently been admitted to the intensive care unit (ICU) to manage a diabetic hyperosmolar hyperglycemic coma.

As a Black American amputee without medical insurance, he faces significant discrimination in accessing healthcare. Therefore, it is important to develop a comprehensive care plan that takes into account the patient’s culture, identity, abilities, and beliefs.

Additionally, the patient will need a strong social support system to help him cope with his physical debilitation and prevent any psychiatric consequences of his condition. The care plan should also address the patient’s economic and cultural needs, which may require extending beyond the hospital to his home. Although healthcare providers may have limited ability to address the patient’s financial needs directly, they can help educate the patient and his family on potential solutions and link them with relevant social and community resources to provide further support.

References

Connell, C. L., Wang, S. C., Crook, L., & Yadrick, K. (2019). Barriers to healthcare seeking and provision among African American adults in the rural Mississippi Delta region: Community and provider perspectives. Journal of Community Health, 44(4), 636–645. https://doi.org/10.1007/s10900-019-00620-1

Demir, Y., & Aydemir, K. (2020). Gülhane lower extremity amputee rehabilitation protocol: A nationwide, 123-year experience. Turkish Journal of Physical Medicine and Rehabilitation, 66(4), 373–382. https://doi.org/10.5606/tftrd.2020.7637

Girijala, R. L., & Bush, R. L. (2018). Review of socioeconomic disparities in lower extremity amputations: A continuing healthcare problem in the United States. Cureus, 10(10), e3418. https://doi.org/10.7759/cureus.3418

Lewis, T. T., & Van Dyke, M. E. (2018). Discrimination and the health of African Americans: The potential importance of intersectionalities. Current Directions in Psychological Science, 27(3), 176–182. https://doi.org/10.1177/0963721418770442

Roodbeen, R., Vreke, A., Boland, G., Rademakers, J., van den Muijsenbergh, M., Noordman, J., & van Dulmen, S. (2020). Communication and shared decision-making with patients with limited health literacy; helpful strategies, barriers, and suggestions for improvement reported by hospital-based palliative care providers. PloS One, 15(6), e0234926. https://doi.org/10.1371/journal.pone.0234926

Silbert, R., Salcido-Montenegro, A., Rodriguez-Gutierrez, R., Katabi, A., & McCoy, R. G. (2018). Hypoglycemia among patients with type 2 diabetes: Epidemiology, risk factors, and prevention strategies. Current Diabetes Reports, 18(8), 53. https://doi.org/10.1007/s11892-018-1018-0

Assessment 1 Instructions: Evidence-Based Patient-Centered Concept Map

Create a patient-centered concept map and write a 3-5 page narrative in which you explain the process and considerations that went into creating your concept map.

Introduction

Evidence-based practice is a key skill in the tool kit of the master’s-prepared nurse. Its goal is to ensure that health care practitioners are using the best available evidence to ensure that patients are receiving the best care possible (Godshall, 2020). In essence, evidence-based practice is all about ensuring quality care.

In this assessment, you will apply evidence-based practice and personalized care concepts to ensure quality care and improve the health of a single patient. The concept map that you will create is an example of a visual tool that you can use for patient and family education.

Reference

Godshall, M. (2020). Fast facts for evidence-based practice in nursing (3rd ed.). Springer Publishing Company.

Professional Context

Concept maps are widely used in nursing care. They can be effective tools for organizing workload, prioritizing patient care strategies, and developing personalized care approaches. In addition to organizing care, they can aid in ensuring that the patient’s care is individualized to not only their health conditions, but also their familial, cultural, and environmental situations.

Scenario

The purpose of a concept map is to visualize connections between ideas, connect new ideas to previous ideas, and to organize ideas logically. Concept maps can be an extremely useful tool to help organize and plan care decisions. By utilizing a concept map, a nurse can simplify the connection between disease pathways and emotional, cultural, socioeconomic, and personality considerations that impact a patient’s health.

Instructions

Develop a patient-centered concept map for a chosen condition. This could be a disease, or a disorder based upon the best available evidence that has been individualized to treat your patient’s health, economic, and cultural needs. Write a brief 3–5 page narrative that explains why the resources cited in the concept map and narrative are valuable and relevant. Describe how you incorporated the patient’s individual culture, identity, abilities, and beliefs into the plan of care. Also, be clear about your specific communication strategies for relating information to the patient and their family.

The bullet points below correspond to grading criteria in the scoring guide. Be sure that your map and narrative address all of the bullets below, at minimum.

Part 1: Concept Map

Visit Healthy People 2030’s Browse Objectives page and select a topic.

  • Design a patient-centered concept map based upon the best available evidence for treating a patient’s specific health, economic, and cultural needs.
  • Include objective and subjective assessment findings to support three nursing diagnoses.
  • Include interventions that will meet your patient’s individual needs.
  • Include measurable outcomes for each nursing diagnosis using SMART goals: (S)pecific, (M)easurable, (A)chievable, (R)elevant, and (T)ime-bound.
Part 2: Supporting the Concept Map
  • Analyze the needs of a patient, and those of their family, to ensure that the interventions in the concept map will be relevant and appropriate for their beliefs, values, and lifestyle.
  • Explain how you incorporated the patient’s individual culture, identity, abilities, and beliefs into the plan of care.
  • Consider how your patient’s economic situation and relevant environmental factors may have contributed to your patient’s current condition or could affect future health.
  • Consider how your patient’s culture or family should inform your concept map.
  • Apply strategies for communicating with the patient and their family in an ethical, culturally sensitive, and inclusive way.
  • Explain how you will communicate the proposed interventions and evaluation plan in an ethical, culturally sensitive, and inclusive way. Ensure that your strategies:
  • Promote honest communications.
  • Facilitate sharing only the information you are required and permitted to share.
  • Enable you to make complex medical terms and concepts understandable to your patient and their family regardless of language, abilities, or educational level.
  • Explain the value and relevance of the resources you used as the basis for your patient-centered concept map.
  • Explain why your evidence is valuable and relevant to your patient’s case.
  • Include a critique of the resources you used and specify the level of evidence.
  • Explain why each piece of evidence is appropriate for the health issue you are addressing and for the unique situation of your patient and the family.
  • Include how the evidence was used to plan your interventions.
  • Convey purpose of the assessment narrative in an appropriate tone and style, incorporating supporting evidence and adhering to organizational, professional, and scholarly communication standards.
  • Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.

The suggested headings for your paper are:

  • Patient Needs Analysis.
  • Communication Strategies.
  • Value and Relevance of Resources.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Submission Requirements

  • Length of narrative: 3–5 double-spaced, typed pages. Your narrative should be succinct yet substantive.
  • Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that support your evaluation, recommendations, and plans. Current source material is defined as no older than five years unless it is a seminal work. Be sure you are citing evidence in both parts.
  • APA formatting: Resources and citations are formatted according to current APA style.
  • Please submit both your concept map and your narrative as separate documents in the assessment submissions area.
  • You must submit both documents at the same time. Make sure both documents are attached before submitting your assessment.

Competencies Measured

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

  • Competency 1: Apply evidence-based practice to plan patient-centered care.
  • Design an individualized, patient-centered concept map, based upon the best available evidence for treating a patient’s specific health, economic, and cultural needs.
  • Analyze the needs of a patient, and those of their family, to ensure that the intervention in the concept map will be relevant and appropriate for their beliefs, values, and lifestyle.
  • Competency 4: Evaluate the value and relative weight of available evidence upon which to make a clinical decision.
  • Explain the value and relevance of the resources used as the basis for a patient-centered concept map.
  • Competency 5: Synthesize evidence-based practice and academic research to communicate effective solutions.
  • Apply strategies for communicating with the patient and their family in an ethical, culturally sensitive, and inclusive way.
  • Convey purpose of the assessment narrative in an appropriate tone and style, incorporating supporting evidence, and adhering to organizational, professional, and scholarly communication standards.