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.
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).
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.
NURS-FPX4900 Assessment 4 Patient Family or Population Health Problem Solution 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.
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:
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- 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.
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- 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.
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- 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.
- Define the role of leadership and change management in addressing the problem.
Also Read: Quality Safety and Cost Considerations NURS-FPX4900