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NURS-FPX 4900 Assessment 3 Assessing the Problem – Technology, Care Coordination, and community Resources Considerations

NURS-FPX 4900 Assessment 3 Assessing the Problem – Technology, Care Coordination, and Community Resources Considerations

Part One

The Impact of Healthcare Technology on Care Coordination for Patients with Type Two Diabetes

Type two diabetes is a chronic disease associated with lifestyle factors. The world population is increasing, and people with type two diabetes have also increased. As the population increases, people adopt sedentary lifestyles such as smoking, eating sugary foods, and avoiding physical exercises, increasing the risk of type two diabetes. Increased cases of diabetes are a burden to people and the healthcare system. The condition has increased mortality rates, morbidity, and the cost of healthcare. The ever-increasing burden and problem of type two diabetes has resulted in the need for new technologies to address the problem effectively and efficiently.

The latest technologies in type two diabetes fall under information systems, technologies for self-monitoring, technologies for delivering insulin, technologies that reduce information processing, and technologies that focus on patient education (Rehman et al., 2017). These new technologies coordinate care management between type 2 diabetes patients and healthcare professionals, which improves the quality of care, improves patient outcomes, increases safety, and reduces healthcare costs for the patient. Patients with type 2 diabetes present with multiple signs and symptoms that differ from patient to patient. The patients also have other infections, such as hypertension, that affect them. The technologies address multiple issues in diabetes accurately and improve interdisciplinary team collaboration in caring for diabetic patients (Rehman et al., 2017). Ideally, the technologies improve health outcomes, and therefore they should be ethically acceptable, affordable, and accessible.

NURS-FPX 4900 Assessment 3 Assessing the Problem – Technology, Care Coordination, and Community Resources Considerations

Technologies for type 2 Diabetes

Technologies dealing with type 2 diabetes revolve around self-monitoring, collecting data, administering insulin, and linking healthcare professionals. Mobile health is one of the advancements in health that has improved the health outcome of diabetic patients (Rehman et al., 2017). MHealth in diabetes involves using smartphones and computers to address issues related to diabetes (Kitsiou et al., 2017). Through MHealth, relevant data used in the diagnosis of diabetes is obtained (Rehman et al., 2017). There is also tracking of the diseases and providing timely data useful in the management of diabetes (Rehman et al., 2017). In terms of self-monitoring, there are self-monitoring blood glucose (SMBG) technologies where relevant data is collected from the patient, evaluated, and used to develop better treatment options and plans for the patient (Hannon et al., 2018).

The M-health technologies and the SMBG are beneficial in managing type two diabetes both to the patient and the healthcare professionals. Through the technologies, patients can access a lot of information on diabetes, which helps manage their conditions (Kitsiou et al., 2017). The technologies are also accurate and record previous data, which is used for evaluation. The technologies also ensure that patients manage themselves instead of relying on few healthcare professionals available (Hannon et al., 2018). Using M-health and SMBG in type 2 diabetes has solved issues regarding interdisciplinary coordination (Rehman et al., 2017). The technologies have encouraged the management of patient while in their homes, which reduces hospital visits and readmission. The technologies have also solved the burden of racial discrimination and medical errors hence improving the quality of care given to diabetes patients. On the side of the patient, healthcare costs, such as visiting hospitals and being monitored by professionals, are reduced.

The M-health and SMBG technologies have some disadvantages in healthcare. The technologies limit nurse-patient interaction. It is hard for nurses to develop their skills and provide quality care when the technologies are used. Nurses provide quality care to patients when they are in contact with their patients since they will be able to gather both objective and subjective data during the assessment. The other disadvantage of the technologies is the high cost of initiating, using, and maintaining them. Hardware and software are required for successful implementation. IT professionals also need to be employed to maintain the systems. Medical professionals and patients should be educated on how to use technologies that may be expensive (Kitsiou et al., 2017). M-health technologies may also raise patient privacy and confidentiality concerns since a breach of data may occur.

NURS-FPX 4900 Assessment 3 Assessing the Problem – Technology, Care Coordination, and Community Resources Considerations

Costs and barriers related to the use of the technologies

There are some barriers and cost issues encountered when using the technologies in managing patients with type 2 diabetes. M-health and SMBG involve the use of smartphones to record and send data. Most patients are required to have applications that help them to record and monitor their blood glucose levels. The use of the application and the new technologies is new and may be complex for most patients and some healthcare professionals. The complexity of the systems, software, and procedure may lead to resistance, where patients and medical professionals may resist the technologies (Kitsiou et al., 2017). The other barrier that may lead to resistance is the perception among healthcare professionals that the technologies reduce the quality of care since they reduce interaction with diabetes patients. Training and education of medical professionals and patients on how to use the technologies may be expensive. The cost of buying equipment, software and hiring professionals to install the technologies may also be too high. The emergence of many companies providing the technologies for managing diabetes brings confusion, which is the best version of M-health or SMBG technology, hence a barrier.

Care Coordination and the Utilization of Community Resources

Type two diabetes is a lifestyle disease and therefore is affected by resources in the community. Social and economic factors in the community affect diabetic patients; hence, proper utilization of community resources is essential in preventing and managing type 2 diabetes (McLendon, Wood & Stanley, 2019). There should be proper coordination and utilization of resources such as food, hospitals, and exercise fields (Moin et al., 2020). There should be proper infrastructure, such as roads, to ensure accessibility and delivery of services to diabetic patients and people in the community. Family and home-based care are essential in addressing diabetes (McLendon, Wood & Stanley, 2019). There should be a collaboration between community leaders, community members, and healthcare providers (Moin et al., 2020). A good relationship between community members, leaders, and medics helps in the mobilization and proper utilization of resources required to address the burden of type 2 diabetes in the community.

Healthcare professionals should take advantage of community meetings, events, and welfare groups to pass health messages about type 2 diabetes. During community events, meetings, and welfare group meetings, community members can be educated on modifying their diet, performing physical activities, stopping smoking, avoiding excessive consumption of alcohol, dealing with stress, and adhering to medication, among other issues related to diabetes (McLendon, Wood & Stanley, 2019). Churches, schools, homes, hospitals, and markets can be used to deliver health messages on diabetes (McLendon, Wood & Stanley, 2019). Ideally, care coordination and proper utilization of community resources lead to better health outcomes in the community.

NURS-FPX 4900 Assessment 3 Assessing the Problem – Technology, Care Coordination, and Community Resources Considerations

Barriers Associated with Care Coordination and Community Resources.

Inadequate funds or finance is one barrier that hinders care coordination and utilization of community resources in preventing and managing diabetes. Enough funds are required to hire, pay and motivate healthcare professionals in the community (McLendon, Wood & Stanley, 2019). Money is also required in traveling to reach community members in their homes. Mobilization of relevant resources required for the education and management of diabetes is also expensive. Medications are expensive to buy and distribute to people with diabetes (Moin et al., 2020). Therefore, inadequate funds are the major barrier to care coordination and utilization of community resources (Moin et al., 2020). The other barrier is the language barrier. Health professionals may not understand the language of community members, which may lead to misunderstanding hence affecting coordination. Cultural beliefs and practices in the community may also hinder care coordination (McLendon, Wood & Stanley, 2019). Community members may have cultural beliefs and practices that promote diabetes, such as eating foods with fats and not going to hospitals when sick. Other factors that may hinder care coordination are harsh weather, poor infrastructure, and physical barriers like mountains.

State Board Nursing Practice Standards and or Organizational or Governmental Policies

The state board, nursing practice standards, and government policies provide guidelines and standards related to the use of technologies in healthcare and care coordination and community resources. New healthcare technologies deployed, such as the use of computers and smartphones in the management of diabetes, should follow the laid down standards in healthcare. The technology should meet the standards related to ethical standards, educational standards, research principles, and leadership principles (Beck et al., 2017). Nursing standards require that the technologies should adhere to nursing ethics by being safe or doing no harm to the patient, being confidential, and ensuring better patient outcomes.

While interacting with community members to improve care coordination and utilizing community resources in managing diabetes, nurses are still guided by the nursing standards. The nurses should be qualified, licensed and observe nursing ethical principles. Doing justice, doing no harm ensuring the privacy and confidentiality of diabetic patients in the community improves care coordination (Beck et al., 2017). Government laws, especially healthcare laws, should be observed as nurses interact with community members to provide information on diabetes and improve coordination. Implementation of educational policies such as mandatory health subjects like biology in schools and health education in schools improves health outcomes related to diabetes and other conditions (Beck et al., 2017). Laws on interaction and access to certain resources in the community ensure the peaceful interaction of nurses, leaders, and community members, which improves care coordination and community resources in the management of diabetes.

NURS-FPX 4900 Assessment 3 Assessing the Problem – Technology, Care Coordination, and Community Resources Considerations

Part two

During the two practicum hours, I met with a diabetic patient named Paul, who is 62 years. I also met an expert in diabetes by the name of Dr. Bill Albert. During the interaction with Mr. Paul, I learned that a sedentary lifestyle is the major risk factor for type two diabetes. People are busy in communities, and therefore care should be brought to their homes. I also learned that people find it hard to go to hospitals unless when their condition worsens. Therefore, there is a need to come up with a technology that manages diabetic patients in their homes. In the meeting with Dr. Bill Alberts, I learned that diabetic patient could monitor their conditions and send relevant data to healthcare professionals. I also learned that care coordination and proper utilization of community resources improve health outcomes. Modifying and using community resources is the best way of preventing and managing diabetes.

I reviewed the American Diabetes Association website https://www.diabetes.org/, which gave some evidence-based practices for managing diabetes. I learned from the website that the best way of managing diabetes is trying to address all the risk factors. The focus should be on modifying diet, performing exercises, and adhering to medication, among other factors. Education on diabetes through diabetic programs is essential in managing the condition. Therefore people should seek diabetic education programs.

Diabetes incidences are increasing, and people are suffering from the condition. People are not able to perform their daily activities. It is also costly to manage diabetes hence a burden to people. The quality of care for patients is poor, and therefore need for better modalities to address the burden of diabetes. The plan to address the problem change was based on my experiences, where I realized some information was not taught to the patient. What surprised me is that most patients and healthcare professionals are not aware of MHealth technologies. This is because there is an increased use of smartphones and computers in health, but most patients and medics cannot use them due to the complexity of the technologies, yet they are important.

References

Agency for Healthcare Research and Quality. (2019). Health information technology research: 2018 year in review. Retrieved from https://digital.ahrq.gov/2018-year-review

Beck, J., Greenwood, D. A., Blanton, L., Bollinger, S. T., Butcher, M. K., Condon, J. E., … & Wang, J. (2018). 2017 National Standards for diabetes self-management Education and Support. The Diabetes Educator44(1), 35-50.

Hannon, T. S., Yazel‐Smith, L. G., Hatton, A. S., Stanton, J. L., Moser, E. A., Li, X., & Carroll, A. E. (2018). Advancing diabetes management in adolescents: comparative effectiveness of mobile self‐monitoring blood glucose technology and family‐centered goal setting. Pediatric diabetes19(4), 776-781. https://doi.org/10.1111/pedi.12648

Health IT Buzz. (n.d.). Consumer engagement. https://www.healthit.gov/buzz-blog/category/consumer

HealthIT.gov. (2020). National health IT priorities for research: A policy and development agenda. https://www.healthit.gov/topic/scientific-initiatives/national-health-it-priorities-research-policy-anddevelopment-agenda https://doi.org/10.1111/phn.12601

Khanna, G. (2020). AHRQ advances new frontiers in digital healthcare. https://www.ahrq.gov/news/blog/ahrqviews/digital-healthcare.html

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. https://doi.org/10.1371/journal.pone.0173160

McLendon, S. F., Wood, F. G., & Stanley, N. (2019). Enhancing diabetes care through care coordination, telemedicine, and education: Evaluation of a rural pilot program. Public Health Nursing36(3), 310-320.

Moin, T., Harwood, J. M., Mangione, C. M., Jackson, N., Ho, S., Ettner, S. L., & Duru, O. K. (2020). Trends in costs of care and utilization for Medicaid patients with diabetes in Accountable Care Communities. Medical care58, S40-S45. doi: 10.1097/MLR.0000000000001318

Pazinski, S., Karras, P., Caban, T. Z., & Chaney, K. (2020). Mapping the path forward in health IT. https://www.healthit.gov/buzz-blog/health-it/mapping-the-path-forward-in-health-it

Rehman, H., Kamal, A. K., Sayani, S., Morris, P. B., Merchant, A. T., & Virani, S. S. (2017). Using mobile health (mHealth) technology in the management of diabetes mellitus physical inactivity, and smoking. Current atherosclerosis reports19(4), 16. https://doi.org/10.1007/s11883-017-0650-5

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Question 


In a 5-7 page written assessment, determine how healthcare technology, coordination of care, and community resources can be applied to address the patient, family, or population problem you’ve defined. In addition, plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with and, if desired, consulting with the subject matter and industry experts. Report on your experiences during the second 2 hours of your practicum.

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