NURS FPX 4900 Assessment 3 Assessing the Problem Technology Care Coordination and Community Resources Considerations
Student Name Capella University NURS FPX 4900 Capstone Project for Nursing Prof. Name Date Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations Introduction Type II Diabetes Mellitus (DM) is one of the chronic health diseases that are common worldwide. There are various complications of this disease, which may lead to several challenges for the patients. One such patient has been observed in my healthcare facility, as discussed in Assessment 1. John, a 50-year-old, male patient, has been receiving DM treatment and care for a long period of time at our hospital. Recently, he has been suffering from extreme fatigue and blurry vision which are some of the complications of diabetes. Multiple lifestyle and medicinal changes have been implemented on John but his blood sugar levels remain high as he has acquired the disease hereditary from his parents. This assessment is another part of the previous one where I will be discussing some of the healthcare technologies that John has been using for the management of his disease and we will further dig into how coordination of care and community resources can be useful for improving John’s health. Impact of Healthcare Technologies on Type II DM Recently, several technologies have become a part of the healthcare industry, and healthcare providers, as well as patients, are benefitted from their use. Technological advancements have proven to have multiple benefits improving patient safety by programming risks and it eases the process of diagnosis and consultation. Moreover, it facilitates information sharing, assists in deriving clinical decisions, reduces medical errors, improves healthcare practices, and most importantly manages human shortages (Astier et al., 2020). Similarly, there are some of the technologies that have been innovated for the monitoring and management of diabetes. These are; glucose monitoring devices and insulin administration machines (pens and pumps). John used a blood glucose monitoring device previously when a new technology which is a Continous Glucose monitoring device has been introduced for better management of his condition. Although the plan of action for both CGM and blood glucose monitoring is the same, CGM has various other benefits as it provides both immediate as well as predictive glycemic data. This information will enable healthcare providers and John to monitor his glucose trends, identify hypo/hyperglycemia events with no symptoms, and review inconsistency over a period (Miller, 2020). Food and Drug Administration (FDA) have approved eight CGM systems worldwide and many of them are planned for future approval in years ahead (Aleppo & Webb, 2018). Despite having several benefits, CGM has certain disadvantages too. One of the basic drawbacks is the alarm system in the device. John has been recently introduced to this so he hasn’t shown any complaints however research finds various negative reports of CGM. Some patients have reported that these alarms can be disturbing while they are at work or school. Additionally, these alarms have resulted in increased anxiety and stress for various users. NURS FPX 4900 Assessment 3 Assessing the Problem An example of such a case is excessive night-time alarms which might cause anxiety-induced seizures and sleep deprivation in individuals (Alcántara-Aragón, 2019). This issue can be resolved by programming individualized alarms. Another disadvantage of CGM is it can sense the glucose present in interstitial fluid. There is always a difference between the glucose in the blood and interstitial spaces. Thus, the machines should be manually calibrated as BGM and patients must be educated about expected differences and should be instructed about performing BGM as needed (Alcántara-Aragón, 2019). Continuous Glucose Monitoring Devices (CGM) in professional practices impose positive impacts on diabetic patients’ health but also have some potential barriers to implementation. Cost and coverage by healthcare systems are two basic challenges faced by hospitals in terms of CGM implementation. With the advancements in technologies, cost-effectiveness has been an important aspect that most hospitals consider before introducing any digital devices in practice. Similarly, a study on the cost-effectiveness of CGM applications recommended that cost-benefit analysis is an important tool for decision-makers to have healthy gains and minimize the negative impact on the healthcare budget (Jiao et al., 2022). Another challenge is professional and personal education about CGM. Appropriate training of providers and patients is essential to the successful use of CGM in clinical practice. This training requires extensive development of curriculum and evidence-based practices which is a challenge for hospitals under this global burden of diseases (Aleppo & Webb, 2018). NURS FPX 4900 Assessment 3 Assessing the Problem Lastly, accessibility and health disparities are further challenges of using advanced technologies. To combat this challenge, telehealth and the use of mobile apps can be a beneficial option in managing diabetes for chronic patients. Advances in digital technologies, especially the evolution of smartphone apps have largely impacted patients’ self-management skills related to diabetes, assist in improvising lifestyle and bringing modifications, enhance patient-provider connection through telemedicine, and motivates patients to be compliant with their medication regimen. In terms of managing type II diabetes, as our concerned patient, John, it will enable him to effectively manage his type II DM by recording his glucose trends, medicine intake, carbohydrate intake, physical activity, and hypoglycemia events. Moreover, through smartphone apps he can be given direct coaching and nursing care through telecommunication. Research shows that these technologies have proven to improve patients’ health and reduce the risk of complications (Doupis et al., 2020). Use of Care Coordination and Community Resources The Agency for Healthcare Research and Quality (AHRQ) explains care coordination as the methodical planning of patients’ care activities and sharing of protected information only among required healthcare providers. This process results in effective, safe, and useful care according to patients’ needs and preferences (AHRQ, 2018). Management of diabetes can be costly, time-consuming, and is a complex process. Appropriate coordination of care by healthcare providers impacts positively these aspects of diabetes management thus improving patients’ outcomes. Since John is a chronic type II diabetes patient, he has been receiving various home health care services like home nursing, physical rehabilitation, and nutrition and dietary management. These services
NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations
Student Name Capella University NURS FPX 4900 Capstone Project for Nursing Prof. Name Date Assessing the Problem; Patient, Family, or Population Health Problem Solution The purpose of this assessment is to explore the impact of poorly managed Type 2 diabetes and obesity regarding the standard of care, patient well-being, and financial burden on the healthcare system and individuals. The analysis is based on two practicum hours spent with John, the patient, and consultations with subject matter experts, including diabetes nurse specialists, nutritionists, and other healthcare professionals. In addition, the assessment investigates the influence of nursing practice standards, organizational policies, and governmental regulations on the issue and recommends evidence-based strategies to tackle these concerns. The report also emphasizes the essential role of collaboration, communication, and leadership in the management of Type 2 diabetes and obesity, stressing the significance of a multidisciplinary approach to enhance patient outcomes. Finally, the conclusion highlights the importance of implementing evidence-based strategies to improve patient care, safety, and outcomes while minimizing healthcare costs. Practicum Hours Experience During the practicum hours, I interacted with John, his family, a diabetes nurse specialist, and a nutritionist. These meetings provided insights into the challenges John and his family face in managing his diabetes, the importance of patient education and self-care, and the need for a multidisciplinary approach to improve his condition. A review of evidence-based practice documents and websites further informed the best practices for diabetes management and the significance of patient-centered care. Impact on Quality of Care, Patient Safety, and Costs The management of Type 2 diabetes and obesity plays a crucial role in the quality of care and patient safety. When diabetes is poorly managed, patients are at an increased risk of developing complications such as kidney disease, nerve damage, and cardiovascular problems (Li et al., 2020). Obesity aggravates these issues, further elevating the risk of comorbidities (Zhou et al., 2020). In John’s case, inadequate management of his diabetes and obesity not only impacts his overall quality of care but also poses a threat to his safety. For instance, uncontrolled blood sugar levels can lead to hypoglycemia, which might cause sudden loss of consciousness, posing a significant risk to patient safety. The economic burden of Type 2 diabetes and obesity on both the healthcare system and individuals is substantial. It has been estimated that the direct medical costs of diabetes are around $327 billion annually in the United States (Li et al., 2020). These costs include expenses for medications, medical services, and productivity losses caused by diabetes-related morbidity and mortality. Moreover, obesity-related medical costs are estimated to be around $147 billion per year (Burd et al., 2020). In John’s case, the financial burden of managing his diabetes and obesity might lead to difficulties in affording medications and adhering to a healthy diet. This lack of resources can result in poorer health outcomes and increased healthcare utilization, placing an additional strain on the healthcare system. It is essential to address these challenges through effective management strategies, patient education, and multidisciplinary care to improve health outcomes and minimize healthcare costs. Impact of State Board Nursing Practice Standards and Policies on Type 2 Diabetes Management State Board Nursing Practice Standards State board nursing practice standards are critical in the management of Type 2 diabetes and obesity, as they guide nurses to provide evidence-based care to patients. These standards ensure that nurses assess, plan, and deliver diabetes management effectively, promoting patient safety and optimal health outcomes (Seaton et al., 2020). For example, the standards emphasize the importance of nursing assessment, care planning, individualized patient education, and regular monitoring of patients with diabetes. By adhering to these practice standards, nurses can effectively manage diabetes, reducing the risk of complications and associated healthcare costs. In addition, a coherent synthesis of literature supports these standards. A study found that a multidisciplinary approach to diabetes management led to improved outcomes for patients (Zhou et al., 2020). The American Diabetes Association (ADA) has also developed the Standards of Medical Care in Diabetes, which provide comprehensive guidelines on diabetes management, including diagnosis, treatment, and prevention (Li et al., 2020). These guidelines serve as a basis for healthcare organizations to develop their policies and protocols, ensuring the delivery of high-quality, evidence-based care to patients with diabetes. Organizational and Governmental Policies Policies at both the organizational and governmental levels play a critical role in managing Type 2 diabetes and obesity. The Affordable Care Act (ACA) and the 21st Century Cures Act are two examples of governmental policies that have implications for diabetes management. The ACA provides funding for programs aimed at preventing and managing chronic conditions such as diabetes, while the 21st Century Cures Act includes provisions related to the use of digital health technologies in healthcare (Zhou et al., 2020). One organizational policy that impacts diabetes management is the use of electronic health records (EHRs). EHRs allow for more efficient and coordinated care, as healthcare professionals can easily access and share patient information. Additionally, EHRs can facilitate population health management, allowing organizations to identify patients at risk for diabetes and implement interventions to prevent or manage the condition (Hohman et al., 2023). NURS FPX 4900 Assessment 2 Assessing the Problem Quality Safety and Cost Considerations Moreover, the “American Diabetes Association (ADA)” has established the Standards of Medical Care in Diabetes, a comprehensive set of guidelines that cover various aspects of diabetes management, such as diagnosis, treatment, and prevention (Li et al., 2020). These guidelines serve as a foundation for healthcare organizations to develop policies and protocols to provide high-quality, evidence-based care to diabetes patients. By incorporating up-to-date evidence-based guidelines from the ADA and other sources, healthcare organizations can ensure that they are providing the most effective interventions for managing diabetes and obesity. Policy Effects on Nursing Scope of Practice and Intervention The policies and standards associated with Type 2 diabetes management play a crucial role in determining the scope of nursing practice, influencing how nurses assess, plan, and provide care to patients with diabetes. For example, the nursing practice