Patient, Family, or Population Health Problem Solution

Patient, Family, or Population Health Problem Solution

Part 2

Diabetes mellitus is a chronic metabolic disease. It develops from either the body’s pancreas’ failure to produce sufficient amounts of insulin or the inability of the body to effectively use the produced insulin (WHO, 2021). Patients can be diagnosed with either Type 1 Diabetes Mellitus (T1DM), Type 2 Diabetes Mellitus (T2DM), Gestational Diabetes Mellitus (GDM), or prediabetes condition (Centers for Disease Control and Prevention, 2021).

Diabetes management aims to maintain blood glucose at the recommended healthy levels. It aims to support the recovery of existing cases and the prevention of future diabetes cases. Diabetes management also aims to reduce the cost of healthcare at the individual, community, and national levels. Therefore, it is important to develop and adopt prevention-focused approaches to improve health outcomes and reduce diabetes-related complications and associated costs (Bertram et al., 2018; Raghupathi & Raghupathi, 2018).

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The Role of Leadership and Change Management in Diabetes Management

Leadership is a critical element in healthcare. It is even more needed as healthcare shifts from disease-focused to patient-centered and prevention-focused systems. Leaders provide direction during change. They are essential for team effectiveness by facilitating communication across healthcare teams (Choi et al., 2018). Leadership in nursing directs actions within the nursing profession and directs best practices in nursing care (Maziero et al., 2020).

The long-term management and prevention of diabetes can be achieved through long-term dietary modifications and changes. The long-term dietary modification program is focused on developing long-term changes in eating and related habits to ensure that the patients and the community moderately consume healthy foods and develop a simple-to-follow meal plan. The program will lead to changes that affect the patients and the entire community. I will develop patient teaching sheets and flyers on diet and dietary modifications needed to better manage diabetes and distribute them among the patients and the target community populations.

The dietary modification and change program will require a leadership style that effectively applies change management strategies and considers nursing ethics to effectively manage these changes and achieve long-term diabetes management objectives. I will adopt a transformational leadership style in the implementation of the long-term and management of the changes during the diabetes management process. The leadership role will challenge the current eating habits and behaviors of food manufacturers and producers and the community. The long-term dietary modification program will include collaboration among various stakeholders, including healthcare professionals, community health and social workers, patients, caregivers, and other members of the community. The leadership role is expected to inspire, motivate, and direct the stakeholders to achieve the goals of the long-term dietary modification program.

Transformational leadership creates opportunities for team members to learn and grow and improves the emotional intelligence necessary for team relationships (Wang et al., 2018). It promotes innovativeness and creates an ethical environment, cooperation, and clear communication. As diabetes management majorly depends on self-care, transformational leadership will support mentoring of the patients in dietary modification while allowing them to decide on their diet and take responsibility for their health. Change management strategies will support the organization of the involved stakeholders and achieve a seamless modification and change of dietary habits.

Impact of Long-term Dietary Modification Program on Diabetes Prevention, and Enhancement of Quality of Care, Patient Safety, and Reduction of Care Costs

Diabetes is related to increased costs due to the cost of treating the disease. Uncontrolled diabetes damages multiple organs, leading to complications that increase care costs and reduce the quality of care received and overall quality of life. Diabetes-related complications include cardiovascular complications such as cardiac diseases and hypertension (Yamazaki et al., 2018) and stroke (Alam et al., 2021), neuropathy resulting in numbness and pain, nephropathy with a risk of total kidney failure, and retinopathy complications risking total blindness (WHO, 2021). Other conditions that affect the patient’s quality of life include foot and skin conditions, depression, and dementia (Chow et al., 2022). The World Health Organization (WHO, 2021) has identified diabetes as a leading cause of death, with over 1.5 million deaths directly caused by diabetes being reported in 2019.

A cure for diabetes mellitus, especially Type 1 and 2, is yet to be developed. However, research has proved that diabetes progression can be prevented and reversed (Hallberg et al., 2019). Diet changes and weight loss are linked to improved glycemic control in patients with Type 2 diabetes (Yu et al., 2020; Yuan et al., 2020). My dietary modification and change program will integrate holistic approaches in the diet modification and change program. Therefore, I will collaborate with and lead other specialists to develop individualized eating plans for patients that focus on organic foods rich in nutrients and low fat and calorie content. The program will promote reduced consumption of refined and processed foods and sweetened drinks and improved physical activity. The program will eliminate the use of expensive medications for diabetes management, eventually reducing the costs of diabetes care while eliminating the side effects associated with the use of diabetes medications. The elimination of the medications and associated side effects improves patient safety and care quality. Further reversing diabetes reduces the risk of diabetes-related complications with long-term effects on the cost and quality of care and improved patient quality. The progress of the intervention program and its health and economic impacts will be benchmarked against the Impact Toolkit provided by the CDC National Diabetes Prevention Program and the Medicare Diabetes Prevention Program (MDPP) Expanded Model.

I chose to focus on diabetes mellitus as it is a continuing healthcare problem of concern based on the current disease trends. Diabetes is also a risk factor for various complications that lower the quality of life of the patients and their caregivers and reduce their productivity. I expect this project to improve my understanding of evidence-based practices in addressing community health issues and improving the quality of care and health outcomes. It will be relevant to the patients and the community as it will create awareness of diabetes and promote the best healthy eating practices to improve diabetes care, manage the disease, and prevent it to avoid future cases.

Application of Health Information, Patient Care Technologies in Care Coordination, and Utilization of Community in Diabetes Management

I will use technology in my project, including patient management technologies and communication and social platforms to help with care coordination, information sharing, and creating awareness of the Dietary Modification and Change Program. I will specifically make use of Health Information Exchange (HIE) systems and electronic health record (EHR) functions to support the major coordination and collaboration of care efforts. The use of technology will support the coordination of care and community resources for the effective implementation of the dietary modification and change program. Technology has been associated with improved efficiency of care coordination, collaboration, and communication by easing the sharing of health information. For instance, healthcare technologies such as EHRs improve interoperability of care team information with an impact on care coordination for complex patients (Ranade-Kharkar et al., 2018). Technology has also been linked to better peer-to-peer communication and sharing of health information and education, resulting in improved disease literacy among peers (Peterson et al., 2020) and an impact on disease prevention behaviors with proven lowered chances of falling sick (Saran et al., 2018).

Care coordination and collaboration are essential in this project as they create a participative community that works towards the objectives of the program. Care coordination depends on bringing together community resources and aligning the available community resources, such as human resources and capital, to improve health outcomes (Ross & de Saxe Zerden, 2020). I will, therefore, use technology to effectively coordinate healthcare teams and community resources in the promotion of diet modifications for healthy eating.

Impact of Healthcare Policies on the Development of Proposed Dietary Modification and Change Plan

Healthcare policies and nursing standards are significant in the development of my diet modification and change program for diabetes prevention. The nursing standards are developed through a robust and evidence-based process that ensures the sustainability of nursing practice and the achievement of positive outcomes (Chamberlain et al., 2018). However, government policies on nutrition can be barriers or provide opportunities for the development of healthy eating programs (Mozaffarian et al., 2018). Therefore, the policies and standards affect the development of the program at various levels. They define the responsibilities of nurses and ensure adherence to nursing protocols.

The nursing standards provided by the American Nurses Association (ANA) will affect my plan as they define my scope of practice and may limit the practice scope of the healthcare professionals I will collaborate with in developing the diet modification and change program. The HIPAA will impact the program by ensuring that the ethics of practice and the privacy and patient information collected and utilized in the development of healthy eating plans are maintained. The policies provided by the Center for Nutrition Policy and Promotion (CNPP) provide the dietary guidelines for use in the US. I will consider these guidelines to ensure that my plan meets the recommended dietary levels for nutrition programs. Adherence to these provided nutritional guidelines will determine if my program will be accredited by related health bodies, such as The Joint Commission.

Communication and Collaboration Strategies to Improve Population Diabetes Outcomes

Communication and collaboration are essential in diabetes care. Collaboration brings together different activities, resources, and professionals to achieve better patient and community health outcomes. The efficiency of the collaborating teams in diabetes care and health promotion is determined by the effectiveness of the team’s communication strategies. I will adopt a bidirectional feedback process to ensure a complete dietary modification and change program and support self-management in the long term.

The bidirectional feedback loop will facilitate effective communication by including active listening, open dialogues, and the application of empathic values in communication. Research has shown that effective nursing communication determines the success of disease prevention, treatment, rehabilitation, education, and health promotion outcomes (Babaii et al., 2021). Further, active listening and empathic communication have been noted to improve clinical practice and health outcomes by considering patients’ emotions, experiences, and views (Diabetes UK, n.d.). Empathic communication has also been linked to achieving emotional calmness and reducing fear in patients (Babaii et al., 2021).

References

Babaii, A., Mohammadi, E., & Sadooghiasl, A. (2021). The Meaning of the Empathetic Nurse–Patient Communication: A Qualitative Study. https://doi.org/10.1177/23743735211056432

Bertram, M. Y., Sweeny, K., Lauer, J. A., Chisholm, D., Sheehan, P., Rasmussen, B., Upreti, S. R., Dixit, L. P., George, K., & Deane, S. (2018). Investing in non-communicable diseases: an estimation of the return on investment for prevention and treatment services. The Lancet, 391(10134), 2071–2078. https://doi.org/10.1016/S0140-6736(18)30665-2

Centers for Disease Control and Prevention. (2021). What is diabetes?. https://www.cdc.gov/diabetes/basics/diabetes.html

Chamberlain, D., Pollock, W., & Fulbrook, P. (2018). RCN Workforce Standards for Intensive Care Nursing: Systematic and evidence review, development, and appraisal. Australian Critical Care, 31(5), 292–302. https://doi.org/10.1016/J.AUCC.2017.08.007

Choi, E. H., Kim, E. K., & Kim, P. B. (2018). Effects of the Educational Leadership of Nursing Unit Managers on Team Effectiveness: Mediating Effects of Organizational Communication. Asian Nursing Research, 12(2), 99–105. https://doi.org/10.1016/J.ANR.2018.03.001

Diabetes UK. (n.d.). Chapter 1 – Communication and engagement | Diabetes UK. Retrieved June 23, 2022, from https://www.diabetes.org.uk/professionals/resources/shared-practice/psychological-care/emotional-health-professionals-guide/chapter-1-communication

Hallberg, S. J., Gershuni, V. M., & Athinarayanan, S. J. (2019). Reversing Type 2 Diabetes: A Narrative Review of the Evidence. Nutrients 2019, Vol. 11, Page 766, 11(4), 766. https://doi.org/10.3390/NU11040766

Maziero, V. G., Bernardes, A., Righetti, E. A. V., Spiri, W. C., & Gabriel, C. S. (2020). Positive aspects of authentic leadership in nursing work: integrative review. Revista Brasileira de Enfermagem, 73(6), e20190118. https://doi.org/10.1590/0034-7167-2019-0118

Mozaffarian, D., Angell, S. Y., Lang, T., & Rivera, J. A. (2018). Role of government policy in nutrition—barriers to and opportunities for healthier eating. BMJ, 361. https://doi.org/10.1136/BMJ.K2426

Peterson, E. B., Chou, W. Y. S., Rising, C., & Gaysynsky, A. (2020). The Role and Impact of Health Literacy on Peer-to-Peer Health Communication. Studies in Health Technology and Informatics, 269, 497–510. https://doi.org/10.3233/SHTI200058

Raghupathi, W., & Raghupathi, V. (2018). An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach to Public Health. International Journal of Environmental Research and Public Health 2018, Vol. 15, Page 431, 15(3), 431. https://doi.org/10.3390/IJERPH15030431

Ranade-Kharkar, P., Narus, S. P., Anderson, G. L., Conway, T., & del Fiol, G. (2018). Data standards for interoperability of care team information to support care coordination of complex pediatric patients. Journal of Biomedical Informatics, 85, 1–9. https://doi.org/10.1016/J.JBI.2018.07.009

Ross, A. M., & de Saxe Zerden, L. (2020). Prevention, health promotion, and social work: Aligning health and human service systems through a workforce for health. American Journal of Public Health, 110, S186–S190. https://doi.org/10.2105/AJPH.2020.305690

Saran, I., Fink, G., & McConnell, M. (2018). How does anonymous online peer communication affect prevention behavior? Evidence from a laboratory experiment. PLOS ONE, 13(11), e0207679. https://doi.org/10.1371/JOURNAL.PONE.0207679

Wang, L., Tao, H., Bowers, B. J., Brown, R., & Zhang, Y. (2018). When nurse emotional intelligence matters: How transformational leadership influences intent to stay. Journal of Nursing Management, 26(4), 358–365. https://doi.org/10.1111/JONM.12509

WHO. (2021, November 10). Diabetes. https://www.who.int/news-room/fact-sheets/detail/diabetes

Yu, Z., Nan, F., Wang, L. Y., Jiang, H., Chen, W., & Jiang, Y. (2020). Effects of high-protein diet on glycemic control, insulin resistance and blood pressure in type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. Clinical Nutrition, 39(6), 1724–1734. https://doi.org/10.1016/J.CLNU.2019.08.008

Yuan, X., Wang, J., Yang, S., Gao, M., Cao, L., Li, X., Hong, D., Tian, S., & Sun, C. (2020). Effect of the ketogenic diet on glycemic control, insulin resistance, and lipid metabolism in patients with T2DM: a systematic review and meta-analysis. Nutrition & Diabetes 2020 10:1, 10(1), 1–8. https://doi.org/10.1038/s41387-020-00142-z

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Assessment 4 for my Capstone Project for Nursing{ Last BSN course}. Please follow all information submitted.

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: Remember that you can submit all, or a portion of, your draft assessment to Smarthinking for feedback, before you submit the final version. If you plan on using this free service, be mindful of the turnaround time of 24-48 hours for receiving feedback.

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.