Technology Care Coordination, and Community Resources Considerations

Technology Care Coordination and Community Resources Considerations

Diabetes mellitus is adequately managed by an interdisciplinary team comprised of nurses, physicians, pharmacists, and dieticians. This paper explores the impact of health technology on the management of diabetes mellitus. Also, it explains care coordination and community resources used to address diabetes mellitus. In addition, it describes policies and standards that impact the management of diabetes mellitus and the applications of nursing ethics in diabetes management.

Part 1

Impact of Health Care Technology

Healthcare technology impacts the management of type 2 diabetes mellitus (DM). Telemedicine is an example of healthcare technology used in the management of DM. This is accomplished via various strategies. Firstly, telemedicine facilitates continuous patient monitoring. For instance, continuous glucose monitoring systems (CGMS) allow perpetual monitoring of plasma glucose levels (Aberer et al., 2021). These systems have sensors that measure and display plasma glucose values (Aberer et al., 2021). Thereafter, patients transmit these values to their clinicians. CGMS optimizes the management of DM by allowing patients and their clinicians to monitor glucose levels continuously (Aberer et al., 2021). This enables them to determine their response to treatment and the necessity for modifying the plans to improve glycemic control. Also, tele-retinal screening facilitates remote screening of diabetic retinopathy (Aberer et al., 2021). This is beneficial because it enables patients to complete their annual screening and eliminates the need for in-person visits (Aberer et al., 2021). Based on the results, clinicians make timely referrals to an ophthalmologist for specialized care.

Secondly, telemedicine optimizes medication adherence and documentation. For instance, smart pens record insulin dose and dosing frequency (Aberer et al., 2021). This information is transmitted to mobile applications to allow continuous monitoring (Aberer et al., 2021). Patients and their families can monitor this data to determine their adherence to the treatment plan. Also, this data can be recorded in glucose diaries and transmitted to clinicians. By so doing, clinicians can monitor patients’ adherence to treatment plans (Aberer et al., 2021). Furthermore, mobile reminders and alarms optimize adherence to the treatment plan by allowing patients to receive predetermined notifications (Wong et al., 2021). Glucose diaries enable patients to record their activities. These entail aspects such as dietary habits and medication intake. The diaries promote accountability and improve adherence to treatment plans.

Thirdly, telemedicine enables clinicians to make timely interventions. This is accomplished via technologies such as video conferencing and audio calls (Wong et al., 2021). Video conferencing and audio calls facilitate real-time interactions between patients and their clinicians (Wong et al., 2021). As such, patients can make real-time specialty consultations remotely. For instance, videoconferencing can enable a clinician to provide feedback obtained from remote patient monitoring and modify the patient’s treatment plan (Wong et al., 2021). In addition, telemedicine facilitates lifestyle modification. This can be accomplished via periodic audio and video calls. For instance, physical exercise training sessions can be offered virtually.

These findings are consistent with the healthcare technology used at my workplace. My workplace has embraced telemedicine in the management of chronic diseases such as diabetes mellitus. We use mobile health technology, such as reminders, to optimize adherence to the treatment plan. Furthermore, we use video conferencing to provide real-time feedback on patients’ concerns. In addition, high-risk patients have wearable devices to facilitate continuous remote patient monitoring.

Potential Barriers and Costs

The use of telemedicine is impeded by various factors. To begin with, limited digital literacy among healthcare providers, patients, and their families reduces the acceptability of telemedicine (Drees, 2020). This can be addressed by training and education sessions aimed at improving stakeholders’ digital knowledge and skills. The second barrier is the lack of affordable quality broadband (Appuswamy & Desimone, 2020). This hinders connectivity between patients and healthcare providers. The third barrier is the lack of multistate licensure (Drees, 2020). This is likely to impede connectivity for patients and clinicians from different states. The fourth barrier is patients’ preferences for face-to-face interactions (Appuswamy & Desimone, 2020). Some patients are unwilling to embrace telemedicine because they believe that in-person visits result in better clinical judgment. This can be addressed by presenting evidence on the utility of telemedicine for managing similar conditions across different facilities.

Care Coordination and Community Resources

Care coordination involves the appropriate delegation of tasks among various stakeholders involved in patient care. It increases the quality of care by allowing the interdisciplinary team to collaborate. Care coordination applies to patients with type 2 DM. Nurses are key stakeholders involved in activities such as screening, patient education, formulation of nursing care plans, patient follow-ups, and safe medication administration (Szafran et al., 2019). These actions aim to improve the quality of care, enhance patient safety, and achieve better outcomes. Furthermore, their actions aim to lower healthcare costs by minimizing diabetic complications and frequent hospital visits. Physicians are involved in screening, patient education, formulation of treatment plans, and patient monitoring (Szafran et al., 2019). Physicians should ensure that current evidence-based practice is used to formulate treatment plans. The pharmacist provides expert knowledge on drugs (Szafran et al., 2019). They educate patients and their families on the appropriate use of medication. For instance, they should teach and demonstrate appropriate insulin administration techniques (Szafran et al., 2019). Also, they should educate the patients on potential drug interactions, toxicities, and when to seek immediate help. Dieticians enforce lifestyle modifications involving healthy dietary approaches for patients with DM (Szafran et al., 2019). Lastly, laboratory technicians work in concert with physicians and nurses to provide accurate and timely results that direct the formulation of care plans (Szafran et al., 2019).

Patients with type 2 DM can benefit from various community resources. The Association of Diabetes Care and Education Specialists is an example of a community resource that benefits diabetic patients and their families (DiabetesEducator.org, n.d.). This association enables patients and their families to find virtual and in-person support groups. These support groups provide key coping mechanisms for patients and their families (DiabetesEducator.org, n.d.). Notably, patients choose support groups based on their language preferences. The American Diabetes Association is the other community resource for patients and their families. It collaborates with community-based organizations to provide holistic services on the management of DM and how to cope with the disease (ADA, 2022).

Barriers to Care Coordination and Use of Community Resources

The application of care coordination to manage DM is impeded by various factors. Firstly, shortages of nurses and other clinicians hinder care coordination (Vargas et al., 2020). In this scenario, healthcare providers are likely to be overwhelmed with various tasks. This will limit their ability to collaborate effectively. This can be addressed by effective panning of shifts and recruiting more healthcare providers. Secondly, a lack of standardized operating procedures impedes care coordination (Vargas et al., 2020. In this context, there is likely to be role ambiguity that impedes the delegation of tasks involved in patient care. The absence of standard operating procedures and policies creates disharmony and impedes care coordination. Thirdly, an individualistic culture at a healthcare facility will impede care coordination (Vargas et al., 2020. This culture negates the teamwork that is needed to achieve effective coordination. Also, a culture that fails to uphold holistic care and cultural sensitivity impedes care coordination. The use of local community resources is impeded by inadequate resource allocation. In this scenario, resources include adequate funding and allocation of competent personnel.

State Board Nursing Practice Standards, Organizational or Governmental Policies

The use of healthcare technology is impacted by the Health Insurance Portability and Accountability Act of 1996. According to this Act, the privacy and confidentiality of electronic personal health information (PHI) should be upheld (Edemekong et al., 2022). This applies to healthcare providers and health plans. This Act provides instances in which personal health information can be disclosed. Examples include law enforcement and public health activities (Edemekong et al., 2022). This Act will guide my actions when dealing with electronic PHI. I will use passwords to uphold the security and privacy of this information. Furthermore, I will only disclose this information under the circumstances prescribed by the provisions of the Act.

Also, the American Nurses Association’s standards will impact care coordination and the quality of care provided to diabetic patients with DM. The American Nurses Association establishes standards of practice, professional performance, and specialty practice guidelines that impact nursing practice (MO.gov, n.d.). These provisions advocate for upholding the nursing process, holistic care, patient-centeredness, and evidence-based practice. Furthermore, it advocates for continuous medical education to create a competent nursing workforce and adherence to standard treatment guidelines (MO.gov, n.d.). I will uphold these provisions in my practice. The nursing process will enable me to create a comprehensive care plan for diabetic patients. Furthermore, patient-centeredness and holistic care will enable me to involve patients actively in the management of DM.

The Medicare Diabetes Prevention Act of 2015 is a policy that impacts the quality of care by availing insurance to people who qualify for the diabetes prevention program (DPP) (Congress.gov, n.d.). The DPP targets patients with type 2 DM and embraces telemedicine to optimize their care. For instance, the program uses virtual sessions to educate patients about dietary modification, provide real-time training sessions on cardiorespiratory and muscle-building exercises, and help people cope with the disease. (Congress.gov, n.d.). I will uphold these provisions at my workplace. I will embrace telemedicine to optimize patient management. I will collaborate with other stakeholders to provide virtual sessions aimed at optimizing the management of diabetes mellitus.

Nursing ethics will impact my interaction with patients. To begin with, I will demonstrate respect for people. In this context, I will acknowledge that patients are autonomous individuals. I will permit them to suggest and select approaches to be included in their treatment plan. Furthermore, I will obtain their consent before initiating any treatment plan or administering medication. Secondly, I will engage in actions that benefit patients. In this context, I will ensure that the benefits resulting from care plans exceed any risks. To achieve this, I will take a comprehensive medical history to avert medications that increase the risk of hypersensitivity reactions. Also, I will research and embrace evidence-based interventions that optimize patient outcomes. Thirdly, I will uphold fairness in my dealings. In this scenario, I will not discriminate against any patient regardless of their ethnicity, sociodemographic background, disability, or sexual orientation. All patients will have access to the best care plans that address DM and other unique underlying medical conditions.

Part 2

I interacted with a seventy-year-old Indian American 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 a hyperosmolar hyperglycemic state. The patient is started on intravenous fluid resuscitation, and a plan for insulin therapy is initiated.

I spent six hours with the patient and her family. I upheld open communication and observed proper turn-taking to optimize our interaction. During this interaction, I learned that the patient does not adhere to her treatment plan. Lack of family involvement in her disease management was a key factor contributing to low medication adherence. We explored various methods that can be used to optimize patient adherence to treatment plans. We agreed that they would embrace mobile health technology, such as reminders and alarms, to improve adherence to the treatment plan. Also, the patient’s family agreed to monitor medication administration. During my interaction, I realized that low digital literacy impeded the patient and her family’s acceptability of mobile health technology. However, after further discussions, they agreed to embrace this technology. I obtained evidence from online medical databases such as Google Scholar, PubMed, and government websites.

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

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

Appuswamy, A. V., & Desimone, M. E. (2020). Managing Diabetes in Hard to Reach Populations: A Review of Telehealth Interventions. Current Diabetes Reports, 20(7). https://doi.org/10.1007/s11892-020-01310-2

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

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

Drees, J. (2020). 9 Barriers for Patients Accessing Telehealth. https://www.beckershospitalreview.com/telehealth/9-barriers-for-patients-accessing- telehealth.html

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

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

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

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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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 two 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. Document the time spent (your practicum hours) with these individuals or groups in the Capella Academic Portal Volunteer Experience Form. Report on your experiences during the second 2 hours of your practicum.

Introduction
As a baccalaureate-prepared nurse, you’ll be positioned to maximize the use of technology to achieve positive patient outcomes and improve organizational effectiveness. Providing holistic coordination of patient care across the entire healthcare continuum and leveraging community resource services can lead both to positive patient outcomes and to organizational improvements.

Preparation
In this assessment, you’ll determine how healthcare technology, coordination of care, and community resources can be applied to address the health problem you’ve defined. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.

To prepare for the assessment:

Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
Conduct sufficient research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.
Review the Practicum Focus Sheet: Assessment 3 [PDF], which provides guidance for conducting this portion of your practicum.
Note: As you revise your writing, check out the resources listed on the Writing Center’s Writing Support page.

Instructions
Complete this assessment in two parts.

Part 1
Determine how healthcare technology, the coordination of care, and the use of community resources can be applied to address the patient, family, or population problem you’ve defined. Plan to spend at least 2 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. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 3 [PDF] provided for this assessment to guide your work and interpersonal interactions.

Part 2
Report on your experiences during the second 2 hours of your practicum.

Whom did you meet with?
What did you learn from them?
Comment on the evidence-based practice (EBP) documents or websites you reviewed.
What did you learn from that review?
Share the process and experience of exploring the effect of the problem on the quality of care, patient safety, and costs to the system and individual.
Did your plan to address the problem change, based upon your experiences?
What surprised you, or was of particular interest to you, and why?
Capella Academic Portal
Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in Capella Academic Portal.

The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the BSN Practicum Campus page for more information and instructions on how to log your hours.

Requirements
The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.

Analyze the impact of health care technology on the patient, family, or population problem.
Cite evidence from the literature that addresses the advantages and disadvantages of specific technologies, including research studies that present opposing views.
Determine whether the evidence is consistent with technology use you see in your nursing practice.
Identify potential barriers and costs associated with the use of specific technologies and how those technologies are applied within the context of this problem.
Explain how care coordination and the utilization of community resources can be used to address the patient, family, or population problem.
Cite evidence from the literature that addresses the benefits of care coordination and the utilization of community resources, including research studies that present opposing views.
Determine whether the evidence is consistent with how you see care coordination and community resources used in your nursing practice.
Identify barriers to the use of care coordination and community resources in the context of this problem.
Analyze state board nursing practice standards and/or organizational or governmental policies associated with health care technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Explain how these standards or policies will guide your actions in applying technology, care coordination, and community resources to address care quality, patient safety, and costs to the system and individual.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice within the context of technology, care coordination, and community resources.
Explain how nursing ethics will inform your approach to addressing the problem through the use of applied technology, care coordination, and community resources.
Document the time spent (your practicum hours) with these individuals or groups in the Capella Academic Portal Volunteer Experience Form.
Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Competencies Measured
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 4: Apply health information and patient care technology to improve patient and system outcomes.
Analyze the impact of health care technology on a patient, family, or population problem.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Analyze state board nursing practice standards and/or organizational or governmental policies associated with health technology, care coordination, and community resources and document the practicum hours spent with these individuals or groups in the Capella Academic Portal Volunteer Experience Form.
Competency 6: Collaborate interprofessionally to improve patient and population outcomes.
Explain how care coordination and the utilization of community resources can be used to address a patient, family, or population problem.
Competency 8: Integrate professional standards and values into practice.
Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence.
Apply APA style and formatting to scholarly writing.