Improving Clinical Outcomes- Data Analysis, Goal Setting, and Change Plan for Enhanced Performance
According to Martinez et al. (2019), diabetes mellitus is a metabolic disorder characterized by the impaired metabolism of carbohydrates. Hyperglycemia occurs due to altered insulin secretion and can occur in the presence or absence of insulin resistance (Martinez et al., 2019). Type 2 diabetes mellitus can result from insulin resistance, inadequate secretion of insulin, or impaired glucagon secretion (Martinez et al., 2019). Early screening and close patient follow-up lead to a good prognosis of the disease (Martinez et al., 2019). Diminished screening and patient follow-up reflect poor management. Poorly managed diabetes mellitus can lead to acute diabetes emergencies and long-term macrovascular and microvascular complications (Peer et al., 2020). For that reason, evaluation of how early screening and patient follow-up can be used to decrease the incidence of diabetic emergencies and complications is essential. Our assignment writing help is at affordable prices to students of all academic levels and disciplines.
Data Table
| Current Outcomes | Change Strategies | Expected Outcomes |
| The hospital’s health care providers do not conduct regular diabetes screenings for visiting patients and the community. Furthermore, they do not conduct routine and dedicated patient follow-ups. These issues have resulted in undesirable clinical outcomes among diabetic patients. The documented outcomes include:
1. An increase in the incidences of microvascular and macrovascular complications. 2. Increased incidences of diabetic emergencies, including hyperosmolar hyperglycemic state and hypoglycemia. |
Different strategies can be adopted to ensure that the burden of microvascular, macrovascular, and diabetic emergencies is reduced;
1. Healthcare professionals should uphold routine screening exercises (Martinez et al., 2019). Accordingly, annual screening will be conducted on people aged 45 years and above and younger patients with predisposing factors such as obesity (Peer et al., 2020). The screening will focus on the fasting plasma glucose (FPG) levels, HbA1C level, random plasma glucose (RBG) levels, and oral glucose tolerance test (OGTT). RBG of 200mg/dl or more, FPG of 126mg/dl or more, BbA1C of 6.5% or more, and OGTT with plasma glucose of 200mg/dl or more confirm the diagnosis (Martinez et al., 2019). The screening will be done in the outpatient and inpatient departments. It will be a collaborative effort among nurses, physicians, and laboratory technicians (Johnson & Carragher, 2018). 2. Healthcare professionals should also intensify follow-ups of diabetic patients 3. The healthcare system should embrace patient education during screening, regular visits, and follow-ups (Chen et al., 2020). |
1. The incidences of microvascular and macrovascular will decrease significantly compared to the current outcome. This is because routine screening and follow-ups lead to early diagnosis of diabetes mellitus, which facilitates prompt initiation of treatment and other management strategies exercises (Martinez et al., 2019). Consequently, this promotes tight glycemic control, which improves the prognosis of the disease by reducing the development of diabetic complications (Peer et al., 2020). Furthermore, patient education enables patients to adhere to medications and detect signs and symptoms of diabetic complications (Chen et al., 2020). This will make them seek timely healthcare services and avert the progress of complications (Chen et al., 2020).
2. Reduced incidences of diabetic emergencies. Patient education will focus on adherence to medications and lifestyle modification (Chen et al., 2020). This promotes good control of blood sugar levels and helps to avert diabetic emergencies (Chen et al., 2020). Routine screening and follow-ups will help identify patients with poorly controlled blood sugar levels based on laboratory results (Martinez et al., 2019). Such patients are at a high risk of experiencing diabetic emergencies. The patients will be evaluated for compliance, and treatment regimens will be modified accordingly (Martinez et al., 2019). This helps to choose the best plan that adequately controls blood sugar levels and reduces the probability of occurrence of diabetic emergencies (Martinez et al., 2019.
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Change Strategies and How They Achieve the Desired State
Diabetes emergencies and complications emanate from a poor disease management protocol. This can be addressed by the adoption of three strategies: routine screening, patient follow-ups, and patient education. Routine screening should be upheld. Screening facilitates index diagnosis of diabetes mellitus (Peer et al., 2020). It is important because early detection and initiation of treatment and management protocols improve the prognosis of the disease (Peer et al., 2020). Besides, screening can enable the detection of early-onset diabetic complications. An example is the early detection of diabetic retinopathy, which can lead to the initiation of laser photocoagulation therapy to improve the prognosis of the disease (Martinez et al., 2019). Routine screening forms the basis of diagnosis, patient education, tight glycemic control, and prompt management of complications. An example is routine eye examination for early signs and symptoms of diabetic retinopathy, such as microaneurysms (Wang & Lo, 2018). After this diagnosis, the patient should be informed that medication adherence promotes glucose control (Peer et al., 2020). This is important because it decreases the progress of the disease.
Dedicated patient follow-ups enable the health care providers to evaluate the level of compliance and response to therapy. During these follow-ups, the healthcare provider can check the pill count and the patient’s feedback on their progress and screen for the onset of diabetic complications (Martinez et al., 2019). Follow-ups can be achieved by booking routine diabetic clinics for patients or community-level follow-ups (Martinez et al., 2019). It enables the healthcare provider to modify the existing treatment plan and adopt the most beneficial one. It also enables patients to present their concerns and receive guidance and counseling from healthcare providers. Therefore, adopting routine follow-ups will decrease the incidence of diabetic complications and improve patients’ quality of life (Peer et al., 2020).
Patient education complements the treatment process. Thorough patient education equips the patient with sufficient information concerning diabetes mellitus. Accordingly, this includes the etiology, signs and symptoms, and management (Chen et al., 2020). Patients should be able to recognize signs of hypoglycemia and address them promptly. Compliance with medications should also be addressed. Compliance enables glycemic control, which improves the prognosis of the disease (Chen et al., 2020). Patients should know the importance of lifestyle modifications, including dietary and the need for aerobic exercise (Chen et al., 2020). This is important because non-pharmacological approaches are complementary to the pharmacological aspects. Just like routine follow-ups and screening, patient education is a key facilitator of a better prognosis for diabetes mellitus (Chen et al., 2020).
Quality Improvement of Safety and Equitable Care
The three strategies will ensure safety and equitable care. Routine screening and follow-ups will facilitate the early diagnosis and monitoring of response and compliance, respectively. Routine screening follow-ups ensure that the entire patient population has access to healthcare services without any discrimination (Martinez et al., 2019). The strategies ensure that patients know their disease state and its progress. As a result, this ensures their safety because they adopt healthy lifestyles and improve their medication adherence. Lifestyle modification and compliance improve the prognosis of the disease and the patient’s quality of life.
Patient education upholds safety in care by ensuring that patients make informed decisions. Patients recognize the impact of non-compliance and unhealthy lifestyles on the progress of their disease. They also learn to identify diabetic emergencies such as hypoglycemia and its management. Similarly, the potential side effects and contraindications of medications are identified (Chen et al., 2020). This is important for the safety of the patient. Patient education targets all patients attending the hospital and society. Therefore, patient education ensures knowledge transfer to the entire population without discrimination. Furthermore, patients receive health care services that fulfill their needs.
Interprofessional Considerations
The interprofessional team involved in the implementation of the strategies includes nurses, physicians, nutritionists, pharmacists, and social workers. Nutritionists should provide knowledge on appropriate nutritional practices (Szafran et al., 2019). This information includes the recommended daily calories and the quantity consumed per meal. Equally, nurses, pharmacists, and physicians should provide patient education on the importance of compliance and lifestyle modification. Nurses should ensure that the correct quantity of medication is administered at the right time (Johnson & Carragher, 2018). Pharmacists are involved in providing information about medications: the contraindications, potential interactions, and adverse effects. Physicians are involved in the prompt diagnosis of diabetes mellitus and early initiation of therapy (Johnson & Carragher, 2018). Lastly, social workers and other health care providers should take part in patient follow-ups.
References
Chen, S., Qian, D., Burström, K., & Burström, B. (2020). Impact of an Educational Intervention in Primary Care on Fasting Blood Glucose Levels and Diabetes Knowledge Among Patients with Type 2 Diabetes Mellitus in Rural China. Patient Education and Counseling, 103(9), 1767–1773. https://doi.org/10.1016/j.pec.2020.03.010
Johnson, J. M., & Carragher, R. (2018). Interprofessional Collaboration and the Care and Management of Type 2 Diabetic Patients in the Middle East: A Systematic Review. Journal of Interprofessional Care, 32(5), 621–628. https://doi.org/10.1080/13561820.2018.1471052
Martinez, L. C., Sherling, D., & Holley, A. (2019). The Screening and Prevention of Diabetes Mellitus. Primary Care – Clinics in Office Practice, 46(1), 41–52. https://doi.org/10.1016/j.pop.2018.10.006
Peer, N., Balakrishna, Y., & Durao, S. (2020). Screening for Type 2 Diabetes Mellitus. Cochrane Database Of Systematic Reviews, 2020(5). https://doi.org/10.1002/14651858.CD005266.pub2
Szafran, O., Kennett, S. L., Bell, N. R., & Torti, J. M. I. (2019). Interprofessional Collaboration in Diabetes Care: Perceptions of Family Physicians Practicing in or not in A Primary Health Care Team. BMC Family Practice, 20(1), 1–10. https://doi.org/10.1186/s12875-019-0932-9
Wang, W., & Lo, A. C. Y. (2018). Diabetic retinopathy: Pathophysiology and treatments. International Journal of Molecular Sciences, 19(6). https://doi.org/10.3390/
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Assessment 2 Instructions: Change Strategy and Implementation
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Develop a data table that illustrates one or more underperforming clinical outcomes in a care environment of your choice. Write an assessment (3-5 pages) in which you set one or more quantitative goals for the outcomes and propose a change plan to help you achieve the goals.
Improving Clinical Outcomes- Data Analysis, Goal Setting, and Change Plan for Enhanced Performance
Introduction
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, it is recommended that you complete the assessments in this course in the order in which they are presented.
Knowing the best practice for our patients is very important in providing safe and effective care. Understanding best practices can help nurses identify areas of care that need to be improved. To identify areas of need, nurses must use evidence from various sources, such as the literature, clinical practice guidelines (CPG), professional organization practice alerts or position papers, and protocols. These sources of evidence can also be used to set goals for improvement and best practices to improve the care experience or outcomes for patients.
The challenge facing many care environments and healthcare practitioners is how to plan for change and implement changes. If we cannot effectively implement changes in practice or procedure, then our goals of improving care will likely amount to nothing. This assessment focuses on allowing you to practice locating, assessing, analyzing, and implementing change strategies in order to improve patient outcomes related to one or more clinical goals.
This assessment will take the form of a data table to identify areas for improvement and to set one or more outcome goals, as well as a narrative describing a change plan that would help you to achieve the goals you have set.
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