Patient Family or Population Health Problem Solution

Patient Family or Population Health Problem Solution

Diabetes mellitus impacts the quality of care and treatment costs. This paper discusses the impact of leadership and change management on addressing type 2 diabetes mellitus (DM). Also, it discusses effective strategies for communication and collaboration. Furthermore, it identifies nursing standards and government policies that impact the management of type 2 DM and explores the use of healthcare technology to manage type 2 DM.

Leadership and Change Management

Leadership and change management strategies impact the management of type 2 diabetes mellitus. To begin with, relevant leadership strategies include open communication, effective delegation of tasks, decisiveness, and shared decision-making (UAGC.edu, 2022). Open communication enables leaders to share information with team members. For instance, open communication will enable leaders to share the goals and objectives of DM management with members of the interdisciplinary team. By so doing, the teams will work harmoniously to achieve these goals (Zainol et al., 2021). Also, open communication will enable the interdisciplinary team to establish a therapeutic relationship with patients and their families. This will optimize the management of DM by allowing patients to take part in the treatment process. Effective delegation of tasks and shared decision-making promote interdisciplinary collaboration in the management of type 2 DM (Zainol et al., 2021). Decisiveness enables team members to select and implement the best interventions to manage type 2 DM.

Krakoff (n.d.) reports that change management embraces strategies such as planning, upholding transparency and truthfulness, effective communication, regular training, and evaluation. These strategies are key to the management of DM. Adequate planning enables the interdisciplinary team to select the best intervention to address each patient’s unique needs. Also, it facilitates the delegation of tasks among team members. Transparency and truthfulness enable the interdisciplinary team to involve patients and their families in the selection of their interventions (Krakoff, n.d.). This acknowledges that patients are autonomous stakeholders in the treatment process. As stated earlier, effective communication enables the team to share their goals and establish therapeutic relationships with patients. Consistently, training will ensure that all team members demonstrate adequate competency, whereas evaluation will assess the impact of the intervention on the patient’s well-being.

Nursing ethics guided the implementation of my intervention. To begin with, I acknowledged and respected the preferences of the patient and her family. This is harmonious with the ethical principle of autonomy (Varkey, 2021). Also, I minimized potential risks emanating from my intervention. In this context, the intervention adopts evidence-based pharmacological and non-pharmacological interventions that improve patient outcomes. This is consistent with the ethical principles of beneficence and non-maleficence (Varkey, 2021). Furthermore, I upheld fairness and justice when formulating the intervention.

Communication and Collaboration Strategies

The patient is a seventy-year-old American Indian female. She is a known diabetic patient diagnosed with the disease three decades ago. The patient is brought by her spouse and daughter. 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.

I selected type 2 diabetes mellitus as the focus of my capstone project because the disease is the most common type of diabetes mellitus. For instance, it accounts for about 90 percent of all cases of DM (CDC.gov, 2022). Also, the disease has a significant economic impact. The USA spends more than $320 annually to manage the disease (CDC.gov, 2022). Type 2 DM is relevant to nursing practice. Nursing training equips them with relevant knowledge and skills to facilitate screening, diagnosis, formulation of a care plan, and patient education.

Patient and family engagement optimizes the management of diabetes mellitus. It enables healthcare providers to understand the preferences, needs, and beliefs of their patients. By so doing, holistic care and patient-centeredness are achieved (AHRQ.gov, n.d.-a). Furthermore, it provides an opportunity for patient education and increases the likelihood of adherence to the treatment plan (AHRQ.gov, n.d.-a). Adherence to the treatment plan improves patient outcomes. Improved patient outcomes lower treatment costs associated with frequent hospitalizations.

The interdisciplinary team can use therapeutic communication to optimize communication and collaboration with the patient and their families. Therapeutic communication embraces techniques aimed at establishing a therapeutic relationship between healthcare providers and patients (Gaylle, 2019). These techniques enable healthcare providers to remain objective and avoid discriminatory or stereotypical practices. For example, empathy allows healthcare providers to share the feelings of patients and their families. Also, paraphrasing and summarizing make the patient acknowledge that they have been understood (Gaylle, 2019). The other strategies of therapeutic communication include reflection, active listening, and confronting.

Nursing Practice Standards and Organizational or Governmental Policies

The American Nurses Association’s standards guided the formulation of this capstone project. According to these standards, the nurse should uphold professional competency when assessing, diagnosing, formulating, and initiating care plans and during follow-ups (MO.gov, n.d.). Also, nurses should embrace interdisciplinary collaboration and uphold healthcare ethics in their routine (MO.gov, n.d.). Furthermore, nurses should uphold the provisions of various standard treatment guidelines when managing different patient populations. These provisions enabled me to develop evidence-based interventions to manage the patients with type 2 DM. In addition, they enabled me to include various members of the interdisciplinary team in the management of the disease.

The Health Insurance Portability and Accountability Act of 1996 enabled me to leverage healthcare technology in patent management. This Act advocates for the privacy, security, and confidentiality of electronic patient information (Edemekong et al., 2022). The Act directs healthcare providers and other covered entities to prevent unauthorized access to personal health information unless when permitted by law (Edemekong et al., 2022). These provisions enabled me to protect and explore strategies for protecting personal health information when using telemedicine.

Proposed Intervention and the Quality of Care, Patient Safety, Costs

The intervention embraces pharmacological approaches and lifestyle changes. The pharmacological interventions are based on the American Diabetes Association’s guidelines. The pharmacological intervention aims to adequately control plasma glucose levels (Chung et al., 2020). Tight glycemic control improves patients’ safety by lowering the incidence of diabetic complications (Chung et al., 2020). Furthermore, tight glycemic control lowers the incidence of emergency department visits and minimizes hospitalization (Chung et al., 2020). This helps to lower healthcare costs incurred in the management of diabetes mellitus. This intervention acknowledges the need for patient education on medication adherence.

Notably, lifestyle changes are also based on the American Diabetes Association’s guidelines. To begin with, the Mediterranean-style diet promotes weight loss and improves glycemic control (Chung et al., 2020). This diet embraces fresh fruits and vegetables, carbohydrates with a low glycemic index, olive oil, and seafood (Chung et al., 2020). Additionally, aerobic exercises optimize insulin sensitivity and improve glycemic control (Chung et al., 2020). Furthermore, physical activity reduces the risk of other comorbidities, such as hypertension, that would worsen the prognosis of the disease (Chung et al., 2020). As such, lifestyle modification improves patient safety, minimizes hospitalizations, and lowers healthcare costs.

The Agency for Healthcare Research and Quality provides benchmark data on the quality of care and safety of patients with diabetes mellitus in the USA. The quality and disparity report targets all states. They report on thematic areas such as patient safety, holistic care, quality of care, and public access to healthcare (AHRQ.gov, n.d.-b). Also, the report focuses on ethnicities, poverty levels, and other social determinants of health (AHRQ.gov, n.d.-b). This data forms the basis of quality improvement plans. In this context, healthcare facilities gauge the performance of their metrics versus other healthcare facilities.

Technology, Care Coordination, and Community Resources

Telemedicine is an example of healthcare technology used in the management of type 2 diabetes mellitus. It promotes continuous patient monitoring, improves medication adherence, and promotes the timely initiation of interventions (Aberer et al., 2021). Continuous glucose monitoring systems and tele-retinal screening are examples of telemedicine technologies that promote remote patient monitoring (Aberer et al., 2021). They allow patients to gain control over their disease. Also, they eliminate the need for in-person visits. Smart pens, glucose diaries, mobile reminders, and alarms are examples of telemedicine technologies that optimize medication adherence (Aberer et al., 2021). Video conferencing and audio calls are examples of technologies that promote timely interventions (Aberer et al., 2021).

The interdisciplinary team accomplishes care coordination for patients with type 2 DM. This team comprises nurses, physicians, pharmacists, dieticians, and laboratory technicians; the team performs roles such as screening, formulation of evidence-based care plans, and patient education. Furthermore, the team is involved in availing accurate laboratory diagnostic results. This collaboration increases the quality of care and patient safety.

Patients with type 2 DM benefit from various community resources. The Association of Diabetes Care and Education Specialists provides support groups to patients and their families. It eliminates language barriers by allowing patients to select their language of choice when accessing support groups (DiabetesEducator.org, n.d.). Also, the American Diabetes Association supports community-based organizations involved in patient and family care (ADA, 2022).

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

AHRQ.gov. (n.d.-a). How Patient and Family Engagement Benefits Your Hospital. https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/howtogetstarted/How_PFE_Benefits_Hosp_508.pdf

AHRQ.gov. (n.d.-b). National Healthcare Quality and Disparities Reports (NHQDR). https://datatools.ahrq.gov/nhqdr

American Diabetes Association. (2022). The Diabetes Reality is Frightening. https://diabetes.org/

CDC.gov. (2022). Prevalence of Diagnosed Diabetes. https://www.cdc.gov/diabetes/data/statistics-report/diagnosed-diabetes.html

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

DiabetesEducator.org. (n.d.). Association of Diabetes Care & Education Specialists. https://www.diabeteseducator.org/practice/practice-tools

Edemekong, F. P., Annamaraju, P., & Hayde, J. M. (2022). Health Insurance Portability and Accountability Act. https://www.ncbi.nlm.nih.gov/books/NBK500019/

Gaylle, D. (2019). In-simulation Debriefing Increases Therapeutic Communication Skills. Nurse Educator, 44(6), 295–299. https://doi.org/10.1097/NNE.0000000000000643

Krakoff, S. (n.d.). The 10 Best Organizational Change Management Strategies. https://online.champlain.edu/blog/best-organizational-change-management-strategies

MO.gov. (n.d.). Standards of Nursing Practice. https://health.mo.gov/living/lpha/phnursing/standards.php.

UAGC.edu. (2022). 4 Leadership Styles in Business: Leadership Style Quiz. https://www.uagc.edu/blog/4-leadership-styles-in-business

Varkey, B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical Principles and Practice, 30(1), 17–28. https://doi.org/10.1159/000509119

Zainol, N. Z., Kowang, T. O., Hee, O. C., Fei, G. C., & Kadir, B. Bin. (2021). Managing Organizational Change through Effective Leadership: A Review from Literature. International Journal of Academic Research in Business and Social Sciences, 11(1). https://doi.org/10.6007/ijarbss/v11-i1/8370

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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:

Patient Family or Population Health Problem Solution

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 three direct practicum hours working with the same patient, family, or group.