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NURS-FPX 4900 Assessment 1 Assessing the Problem – Leadership, Collaboration, Communication, Change Management, and Policy Considerations

NURS-FPX 4900 Assessment 1 Assessing the Problem – Leadership, Collaboration, Communication, Change Management, and Policy Considerations

NURS-FPX 4900 Assessment 1 Assessing the Problem – Leadership, Collaboration, Communication, Change Management, and Policy Considerations

The Health Problem and the Population

Type two diabetes is one of the leading lifestyle medical conditions in the world. Type two diabetes is a health problem common in adults above the age of 45 years (Bellou et al., 2018). Men are at high risk of being diagnosed with type two diabetes than females. The risk factors of type two diabetes include being overweight or obese, having a family history of diabetes, physical inactivity, high cholesterol levels, race, smoking, and drinking alcohol (Bellou et al., 2018). Age is also a risk factor, with people above 45 at high risk of developing diabetes. In the USA, diabetes mellitus is the 7th leading cause of death and affects approximately 29.1 million people (Bellou et al., 2018).

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The prevalence rate of type two diabetes is high in males above the age of 45 years. Therefore, type two diabetes mellitus in older male adults is the chosen health problem to be assessed. In this case, the patient is Mr Paul, a 65-year-old African-American male diagnosed with type two diabetes mellitus three years ago. After being diagnosed with the medical condition, Mr Paul claims he was taught how to use his medication and the importance of adhering to the drugs. He, however, claims that he was not educated on lifestyle modification. Despite being diagnosed with diabetes, the patient claimed that he continued his sedentary lifestyle where he could smoke daily, take alcohol and eat food with fats. He also claims that he does not perform any exercise.

Evidence from Peer-Reviewed Literature

Enough evidence shows the relationship between lifestyle and type 2 diabetes mellitus. Zhang et al. (2020) investigated the association of at least three lifestyle factors with diabetes and the health outcome of the factors among diabetes patients. The researchers found that participants who adopted a healthy lifestyle had a reduced risk of type two diabetes (Zhang et al., 2020). The participants with the healthiest lifestyle had a 75% lower risk of diabetes incidence (Zhang et al., 2020). According to Zhang et al., more than 14 studies with more than one million participants showed more evidence that a healthy lifestyle was associated with decreased incidence of type two diabetes. Therefore, the work of Zhang and colleagues and the 14 studies proves that adopting a healthy lifestyle reduces the risk of type 2 diabetes (Zhang et al., 2020). As Zhang et al. found, beneficial exercise. It also reduces the adverse effects of type 2 diabetes. The study by Zhang et al. insisted on dealing with all risk factors associated with type two diabetes instead of concentrating only on lifestyle modification (Zhang et al., 2020). Effective management of diabetes requires nurses to focus on all aspects, such as nutrition and other risk factors.

In their work, Zhang, Du, and Ma (2017) reported current lifestyle factors that increase the risk of type 2 diabetes. According to the researchers, factors such as food consumption, economic factors, people’s behaviours, and lifestyle factors played an essential role in the increase in type two diabetes cases (Zhang, Du, and Ma, 2017). Eating food with many fats and feeding on many cereals was associated with increased type two diabetes. Other factors Zhang, Du, and Ma identified that increase the adverse effect of type two diabetes included smoking, high quantities of sugar-sweetened food and beverage, and omitting meals such as breakfast (Zhang, Du, and Ma, 2017). Zhang, Du, and Ma also highlighted insufficient physical inactivity and poor sleep patterns as causes of increasing type 2 diabetes and complications. Zhang, Du, and Ma (2017) support the existing evidence that an unhealthy lifestyle increases the adverse effects of type two diabetes. The unhealthy lifestyle stated by Zhang, Du, and Ma includes a high intake of carbohydrates and fats, a sedentary lifestyle, and obesity (Zhang, Du, and Ma, 2017). Effective prevention and management of diabetes should therefore include lifestyle management.

Studies have also been conducted on the nursing management of patients with type two diabetes. Valenzuela-Suazo, Guerrero-Núñez, and Cid-Henríquez (2018) in their study described the features of nursing care of patients with type two diabetes. The focus of the research was based on primary nursing care and the theory of bureaucratic caring. According to Valenzuela-Suazo et al. (2018), nursing care of patients with type two diabetes should include education of the patient, the physical aspect of patient, the legal aspect, the economic aspects, and the social-cultural aspects of the patient (Valenzuela-Suazo, Guerrero-Núñez, and Cid-Henríquez, 2018). Focusing on all these factors improves the outcomes when caring for a patient with diabetes. Evidence also indicates a need to consistently implement clinical interventions to improve the results of patients with type 2 diabetes. Kitsiou, Paré, Jaana, and Gerber (2017) suggested that with modern technology, telemonitoring and the use of mHealth interventions are some of the best ways of type 2 management self–management (Kitsiou, Paré, Jaana & Gerber, 2017). Patient education is essential in ensuring self-management of type two diabetes. The evidence from the research shows that teaching diabetic patients is one of the management components. Patient education should focus on nutrition and lifestyle modification.

NURS-FPX 4900 Assessment 1 Assessing the Problem – Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Nursing Practice Standards

The nursing practice standards may slightly differ from one state to another, but most states have similar means. Every state has its Nursing Practice Act that guides the nurses working there. The Nursing Act in each state ensures that only competent and qualified nurses are employed to provide nursing services. In Texas, for example, the mission of the nursing board is to “protect and promote the welfare of the people of Texas by ensuring that each person holding a license as a nurse in the state is competent to practice safely” (Texas Board of Nursing, 2019). Ideally, nurses in each state should be aware of their Nurse Practice Act and ensure they work within their scope of practice.

Enforcement of the practice standards in nursing improves the quality of nursing care. Qualified and competent nurses are employed, which enhances the quality of care. The nurses also practice within their scope of practice, ensuring efficiency and improving patient outcomes. The practice standards are created considering ethical principles, protecting the patient’s rights. Implementing the practice standards in each state enhances the quality of care given to diabetic patients since there will be no gaps in the management of diabetes (Texas Board of Nursing, 2019). Patient outcomes will improve, and medical errors will also be reduced. Well-developed standards and policies improve the nursing care process, critical in managing type two diabetes, especially in lifestyle modification.

Leadership Strategies to Improve Patient Outcomes

Diabetes is common, and a lot of patients in hospitals suffer from the condition. The condition is chronic, so practical and long-term leadership strategies are best for ensuring the state is managed. A multidisciplinary approach is one of the best leadership strategies to improve the outcomes of patients with type two diabetes. The process involves the collaboration of nurses, physicians, pharmacists, nutritionists, physiotherapists, and social workers in caring for and managing patients with diabetes (Buggy & Moore, 2017). Many aspects, such as adherence to medication, nutrition, physical exercise, counselling on smoking, and taking alcohol, are all used in managing patients. Nurses alone cannot provide services to diabetic patients, and their collaboration with other health workers improves patient outcomes (Buggy & Moore, 2017).

The other strategy is adapting the use of mHealth and electronic health records (EHR). Type 2 diabetes is a chronic disease; therefore, using EHR and mHealth will help monitor the patient’s progress for extended periods (Lyles ET AL., 2017). This included medication effectiveness and improvement based on interventions that focus on lifestyle factors. MHealth also helps in patient self-management. With EHR and MHealth, there will be efficiency and effectiveness in managing patients with type 2 diabetes (Lyles ET AL., 2017).

NURS-FPX 4900 Assessment 1 Assessing the Problem – Leadership, Collaboration, Communication, Change Management, and Policy Considerations

Part 2: Assessment of the Problem

Mr Paul, a 65-year-old African-American male, was diagnosed with type two diabetes mellitus three years ago. The patient has struggled to maintain his blood glucose level within the normal range for the past three years. The patient noted that his blood glucose levels have been increasing despite adhering to his medication. Mr Paul has increased his weight and still smokes and takes alcohol because he claims he was not told to stop. He also does not perform any physical activity. On assessment, the patient was aware of his condition but lacked knowledge of lifestyle modification to manage his condition.

An essential aspect of managing Mr Paul is patient education to help him manage his condition. Diabetes is a chronic condition, so patients should have continuous education on living with their needs. Continued education on adherence to medication and lifestyle modification reduces the adverse effects of type two diabetes. The complication of the disease is also reduced since the patient can manage himself. Based on middle-range theory, effective patient communication is essential in managing diabetes. Nurses should communicate effectively when educating patients and relatives on their conditions. During nurse-patient education, the nurse should prioritize lifestyle modification as the best strategy for managing type two diabetes. In this case, Mr Paul should accept modifying his lifestyle, such as performing physical activity daily and stopping smoking, to improve the outcomes. Mr Paul should also stick to his medication and plan of care.

Barriers that may arise include the patient’s not cooperating, the high cost of management due to the lack of health insurance by the patient, and stress resulting from racial abuse of the patient. Collaboration of health care providers in providing care helps in dealing with some challenges, such as stress, and ensuring cooperation. Allowing the patient to express his feelings also helps deal with barriers to improve patient outcomes. Collaborating with social workers ensures that the patient’s financial issues are solved and ensures the patient gets the right quality of care. The change management strategy creates a sense of urgency supported by the scope of practice standards and evidence in nursing.

 Other Related Posts: Nurs-fpx 4040 Assessment 1 – Nursing Informatics in Health Care


Bellou, V., Belbasis, L., Tzoulaki, I., & Evangelou, E. (2018). Risk factors for type 2 diabetes mellitus: an exposure-wide umbrella review of meta-analyses. PloS one13(3), e0194127.

Buggy, A., & Moore, Z. (2017). The impact of the multidisciplinary team in managing individuals with diabetic foot ulcers: a systematic review. Journal of wound care26(6), 324-339.

Kitsiou, S., Paré, G., Jaana, M., & Gerber, B. (2017). Effectiveness of mHealth interventions for patients with diabetes: an overview of systematic reviews. PloS one12(3), e0173160.

Lyles, C. R., Ratanawongsa, N., Bolen, S. D., & Samal, L. (2017). mHealth and health information technology tools for diverse patients with diabetes.

Texas Board of Nursing. (2019). Nurse Practice Act. Retrieved from http://www.bon.texas.govYang, M. H., Kang, S. Y., Lee, J. A., Kim, Y. S., Sung, E. J., Lee, K.

Valenzuela-Suazo, S., Guerrero-Núñez, S., & Cid-Henríquez, P. (2018). Nursing Care for Persons with Diabetes Mellitus Type 2, According to the Theory of Bureaucratic Care. Aquichan18(1), 20-31. 

Zhang, N., Du, S. M., & Ma, G. S. (2017). Current lifestyle factors that increase the risk of T2DM in China. European Journal of clinical nutrition71(7), 832-838.

Zhang, Y., Pan, X. F., Chen, J., Xia, L., Cao, A., Zhang, Y. & Pan, A. (2020). Combined lifestyle factors and risk of incident type 2 diabetes and prognosis among individuals with type 2 diabetes: a systematic review and meta-analysis of prospective cohort studies. Diabetologia63(1), 21-33.


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In a 5-7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Assess the situation from a leadership, collaboration, communication, change management, and policy perspective. Plan to spend approximately two direct practicum hours meeting with a patient, family, or group of your choice to explore the problem and, if desired, consult with the subject matter and industry experts.

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