Intervention Presentation and Capstone Video Reflection

 Intervention Presentation and Capstone Video Reflection

Hello, and welcome to today’s presentation. Firstly, we will evaluate the impact of the intervention on patient care, satisfaction, and quality of life. Secondly, we will discuss the use of evidence. Thirdly, we will describe the use of healthcare technology. Fourthly, we will discuss the impact of health policies. Fifthly, we will explore project outcomes versus initial expectations. Lastly, we will assess professional and personal growth.

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Impact of the Intervention on Patient Satisfaction and Quality of Life

The patient is a seventy-year-old Indian American female. She is a known diabetic patient diagnosed with the disease three decades ago. The patient is brought in by her spouse and daughter, where a physical examination reveals a weak pulse, lethargy, confusion, and dry mucous membranes. Her respiratory rate is 28 breaths per minute. Further workup reveals plasma glucose levels of 37.0 mmol/L, bicarbonate levels of 17 mEq/L, and a serum osmolality of 335 mOsm/kg. These are manifestations of hyperosmolar hyperglycemic state (HHS). The patient is started on intravenous fluid resuscitation, and a plan for insulin therapy is initiated.

The intervention is based on the American Diabetes Association’s guidelines. Also, the intervention embraces telemedicine technology such as reminders, alarms, video conferencing, and glucose diaries. Writing in 2020, Chung, Erion, Florez, Hattersley, Hivert, Lee, McCarthy, Nolan, Norris, and Pearson report that examples of non-pharmacological approaches included in the intervention are adopting the Mediterranean-style diet and physical activity. Writing in 2020, Chung, Erion, Florez, Hattersley, Hivert, Lee, McCarthy, Nolan, Norris, and Pearson report that pharmacological approaches include oral hypoglycemic agents and injectables such as insulin. This intervention aims to provide tight glycemic control and improve patient outcomes. Telemedicine is leveraged to optimize treatment. Notably, reminders and alarms will be used to improve adherence to the treatment plan.

The patient and her family were excited about the non-pharmacological approaches included in the intervention. They reported that previous treatment plans focused on pharmacotherapy alone. They agreed to work in concert with the dietician to optimize the patient’s nutritional plan. Furthermore, the patient’s family agreed to enroll her in a local community resource to facilitate the patient’s physical activity sessions. They demonstrated low digital literacy and were unwilling to embrace telemedicine. However, after further engagements, they agreed to adopt alarms, reminders, and video conferencing. According to them, they would embrace these approaches to improve adherence to the treatment plan.

The intervention enhances the experience of the patients and their families. To begin with, Aberer, Hochfellner, and Mader, writing in 2021, report that telemedicine will optimize the patient experience by allowing remote patient monitoring (RPM) and minimizing forgetfulness to take medications. Aberer, Hochfellner, and Mader, in 2021, report that continuous glucose monitoring systems and tele-retinal screening will facilitate remote patient monitoring. Aberer, Hochfellner, and Mader, in writing in 2021, report that RPM will improve glycemic control by allowing patients to be involved in the treatment process and by facilitating timely feedback and interventions from healthcare providers. Secondly, the intervention will improve the patient experience by providing tight glycemic control, reducing visits to the emergency department, and minimizing healthcare costs. This will be achieved by both pharmacotherapy and lifestyle changes.

Evidence and Peer-Reviewed Literature

At this point, I would like to explore the use of evidence and peer-reviewed literature in my capstone project. I embraced the principles of evidence-based practice in my project. SCstatehouse.gov (n.d.) reports that the first principle is assessing needs. In this context, the problem is type 2 diabetes mellitus (DM). This population requires optimized care to achieve tight glycemic control and improve patient outcomes. SCstatehouse.gov (n.d.) reports that the second principle is enhancing intrinsic motivation. This enabled me to engage with and encourage the patient and her family to embrace my intervention to optimize disease management. Furthermore, it enabled me to engage other members of the interdisciplinary team to participate actively in the intervention. SCstatehouse.gov (n.d.) reports that the third principle is target intervention. I collaborated with the patient to formulate an evidence-based intervention to improve the management of type 2 DM. SCstatehouse.gov (n.d.) reports that the fourth principle is skill training. I educated the patient and her family to improve their digital and health literacy. Health literacy equipped them with key information about the management of diabetes mellitus and the available local community resources. On the other hand, digital literacy equipped them with key information about the relevance of telemedicine in the management of type 2 DM. SCstatehouse.gov (n.d.) reports that the fifth principle is positive reinforcement. This enabled me to identify and reinforce the enablers for patient adherence to the interventions. For instance, patient-centeredness promotes and improves adherence to the treatment plan. Finally, an evaluation will enable me to assess the impact of the intervention.

I sought peer-reviewed literature from online databases and government websites. The online databases enabled me to customize my searches to access the most recent evidence. In this scenario, I used PubMed, CINAHL, and Google Scholar. Furthermore, these online databases enabled me to use key search words to optimize the relevance of my search results. I used search terms such as “diabetes mellitus” and “lifestyle modification in diabetes mellitus.” I selected educational and government websites with domains such as .gov and .edu. I leveraged the CRAAP model to assess the credibility of my peer-reviewed articles.

Health Care Technology

I would now like to discuss how I leveraged healthcare technology in my capstone project. Telemedicine optimizes the management of diabetes mellitus by allowing continuous patient monitoring, facilitating timely initiation of interventions, and promoting medication adherence. To begin with, Aberer, Hochfellner, and Mader, in 2021, report that continuous patient monitoring (CPM) enables the healthcare provider to conduct close follow-ups and evaluate responses to therapy. CPM facilitates patient engagement because they are expected to upload their vitals continuously and transmit them to their healthcare provider. Aberer, Hochfellner, and Mader, in 2021, report that examples of technologies that promote CPM include continuous glucose monitoring systems (CGMS) and tele-retinal screening. CGMS measures and records plasma glucose levels periodically. Tele-retinal screening allows remote screening of retinopathy.

Also, smart pens, mobile health, and glucose diaries optimize medication adherence. Aberer, Hochfellner, and Mader, in 2021, report that smart pens promote patient engagement by recording the dosage of insulin administration. This acts as a reference point for patients to monitor medication adherence. Glucose diaries prompt patients to measure and record their glucose levels continuously. This is likely to improve adherence to medication because patients monitor their response to therapy. Aberer, Hochfellner, and Mader writings in 2021, report that mobile health technology, such as reminders, optimizes adherence to the treatment plan.

Telemedicine facilitates timely feedback and prompt modification of interventions. For instance, writing in 2021, Wong, Wang, and Manoharan reported that videoconferencing enables patients to access healthcare provided and seek real-time consultation—feedback from these interactive sessions from the basis of modifying treatment plans. Also, writings in 2021 by Wong, Wang, and Manoharan report that audio calls facilitate healthcare providers to address patients’ concerns promptly and explore the need for changing treatment plans.

Various strategies can be embraced to improve the future of health technology. Writing in 2020, Vargas, Eguiguren, Mogollón-Pérez, Bertolotto, Samico, López, De Paepe, and Vázquez report that all stakeholders in the healthcare setting should receive pertinent training to improve their digital literacy. Digital literacy will enhance user experience and improve their satisfaction levels. In addition, affordable quality broadband should be available to improve connectivity and optimize the use of healthcare technology. Also, writings in 2020 by Vargas, Eguiguren, Mogollón-Pérez, Bertolotto, Samico, López, De Paepe, and Vázquez suggest that all the public should be educated on the impact of healthcare technology in optimizing the quality of care. Public education will increase the acceptability of healthcare technology in practice.

Impact of Health Policy

At this point, I will discuss the health policies that impacted my capstone project. Firstly, the Health Insurance Portability and Accountability Act of 1996 impacted my project. Moore and Frye reported in 2019 that this policy directs all covered entities to protect electronic personal health information. This refers to information with unique identifiers that can be attributed to a patient. Examples include diagnosis, history of presenting complaint, medication, and past medical history. My capstone project leverages healthcare technology and involves electronic personal health information transmission. Strategies such as passwords and encryption will be used to maintain the privacy and confidentiality of patients’ data. Also, only authorized personnel will be allowed to access patients’ data.

Furthermore, the Medicare Diabetes Prevention Act of 2015 impacted my capstone project. Congress.gov (n.d.) reports that this policy provides insurance to those who fulfill the inclusion criteria for the diabetes prevention program. Additionally, Congress.gov (n.d.) reports that the program focuses on the use of telemedicine to improve care for patients with type 2 DM. Notably, it focuses on lifestyle modification, such as changing dietary habits and regular physical activity. My capstone project will embrace telemedicine to optimize the management of type 2 DM. Telemedicine will provide an opportunity for virtual sessions of physical exercise and nutritional advice.

Nurse practitioners play a key role in policy formulation and implementation. Firstly, they work in concert with other healthcare providers to formulate policies to improve the quality of healthcare at the organizational level. Secondly, they work in concert with elected leaders to influence policy formulation at the local, state, and national levels. Thirdly, they collaborate with nursing organizations to influence policy formulation at the national level.

Capstone Project Outcomes Versus Initial Predictions

As we wrap up, I will evaluate whether or not my capstone project fulfilled my initial predictions. To begin with, I expected to formulate a holistic care plan to optimize the management of the patient’s type 2 DM and minimize the incidence of complications. Furthermore, I intended to formulate a care plan that creates flexibility in accessing healthcare services. These two expectations were achieved. I used the principles of evidence-based practice to formulate a holistic intervention. I upheld autonomy to allow the patient and her family to participate in formulating the care plan and achieve patient-centeredness. This evidence-based intervention adopts pharmacotherapy and lifestyle modification. These approaches provide tight glycemic control and optimize the management of diabetes mellitus. I leveraged telemedicine to create flexibility and improve access to healthcare. This can be achieved via videoconferencing, audio calls, and mobile health. This intervention can be adopted as a best practice because it is evidence-based.

This intervention is generalizable. It can be used to optimize the quality of care for patients with type 2 DM in other healthcare settings, such as nursing homes or large hospitals. When applied to large healthcare settings, members of the interdisciplinary team should embrace care coordination. Also, these facilities should conduct comprehensive training to improve digital literacy among healthcare providers, patients, and their families. I spend four hours with the patient and her family. The patient demonstrated her willingness to adhere to the intervention to minimize incidences of diabetic emergencies. We agreed that they would seek timely clarification for any concerns that would arise during treatment.

Personal and Professional Growth

In conclusion, I will evaluate my personal and professional growth. The capstone project provided an opportunity for personal growth. Firstly, it enabled me to improve my research skills. For instance, I learned how to locate credible information from online databases and scholarly websites. Also, I learned how to assess the credibility of peer-reviewed articles. Secondly, the capstone project improved my interpersonal skills. In this context, I embraced therapeutic communication to establish a rapport and interact with the patient and her family. Also, I used open communication to interact with members of the interdisciplinary team.

The capstone project facilitated my professional growth and adherence to professional standards. To begin with, I applied the principles of healthcare ethics to my capstone project. Notably, I upheld beneficence, justice, autonomy, and non-maleficence. Beneficence and non-maleficence enabled me to develop an evidenced-based intervention that seeks to maximize benefits and minimize potential risks to the patient. Autonomy enabled me to develop a patient-centered intervention, whereas justice enabled me to refrain from stereotypes and discriminatory practices. Furthermore, the American Nurses Association’s standards enabled me to uphold professional standards.

References

Aberer, F., Hochfellner, D. A., & Mader, J. K. (2021). Application of Telemedicine in Diabetes Care: The Time is Now. Diabetes Therapy, 12(3), 629–639. https://doi.org/10.1007/s13300-020-00996-7

Chung, W. K., Erion, K., Florez, J. C., Hattersley, A. T., Hivert, M. F., Lee, C. G., McCarthy, M. I., Nolan, J. J., Norris, J. M., Pearson, E. R., Philipson, L., McElvaine, A. T., Cefalu, W. T., Rich, S. S., & Franks, P. W. (2020). Precision Medicine in Diabetes: A Consensus Report from the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care, 43(7), 1617–1635. https://doi.org/10.2337/dci20-0022

Congress.gov. (n.d.). H.R.2102 – Medicare Diabetes Prevention Act of 2015. https://www.congress.gov/bill/114th-congress/house-bill/2102

Moore, W., & Frye, S. (2019). Review of HIPAA, Part 1: History, protected health information, and privacy and security rules. Journal of Nuclear Medicine Technology, 47(4), 269–272. https://doi.org/10.2967/JNMT.119.227819

SCstatehouse.gov. (n.d.). Eight Evidence‐Based Principles. https://www.scstatehouse.gov/Archives/CitizensInterestPage/SentencingReformCommission/RetreatPresentations/HandoutonEBP_FinalVersion.pdf

Vargas, I., Eguiguren, P., Mogollón-Pérez, A. S., Bertolotto, F., Samico, I., López, J., De Paepe, P., & Vázquez, M. L. (2020). Understanding the factors influencing the implementation of participatory interventions to improve care coordination. An analytical framework based on an evaluation in Latin America. Health Policy and Planning, 35(8), 962–972. https://doi.org/10.1093/heapol/czaa066

Wong, V. W., Wang, A., & Manoharan, M. (2021). Utilization of telehealth for outpatient diabetes management during the COVID-19 pandemic: how did the patients fare? Internal Medicine Journal, 51(12), 2021–2026. https://doi.org/10.1111/

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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 groups in the Capella Academic Portal Volunteer Experience Form.

Interpersonal Communication and Dynamics

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 the Capella Academic Portal.