Capstone Project

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Capstone Project: Assignment 4 (Part B: Analysis of the Intervention)

Juan Luis Cespedes Laplace

Capella University

NURS-FPX 4900

Instructor: Dr. Eunice Rosas

February 2022

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Analysis of the Intervention (Diabetic Self-Management Education)

Summary of the problem, the reason for its selection, and the reasons why it is essential in

the professional practice.

According to the World Health Organization (WHO), diabetes is considered the most

persistent and severe illness that affects the present population. The cause of diabetes is linked to

environmental and genetic factors. Its prevalence in the world is becoming a significant concern

since it affects the quality of life (Cunningham t al., 2018). The WHO reports that type 2 diabetes

affects about 90 percent of the individuals diagnosed with diabetes.

The reason for selecting this issue is the rise in the reported cases of morbidity and

mortality despite being a preventable and manageable condition. This is a preventable and

manageable condition through early screening and adherence to the providers' instructions in terms

of medication, healthy nutrition, and active involvement in physical exercise. The problem is

relevant to my practice since it gives an opportunity of improving how the condition is addressed

from the perspective of the population and healthcare providers (Cunningham t al., 2018). In this

case, the problem involves the community members and healthcare providers through a

collaborative approach and coordinated healthcare delivery so that the issues are addressed.

The implementation of the self-management education program assists in ensuring that the

community's role in reducing the incidence of diabetes incidence is supported and promoted. Such

education is important in promoting self-care since it ensures that the population is knowledgeable

about the causes of the condition, the risk factors, the importance of the early screening process,

the impacts of adherence to the medication and other guidelines provided by the physicians, and

how healthy behaviors increases the risk of the condition (Cunningham t al., 2018). Therefore, the

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education provided in this case assists in improving the self-management process especially for the

individuals who are under diabetes care.

The role of the leadership and change management in addressing the problem.

The leadership and the management of the changes are important in addressing the issue of

type 2 diabetes. Leadership plays an important role in creating different programs that assist in the

reduction and management of diabetes conditions. For example, nursing leadership helps introduce

the aspects of the screening and the control program by introducing the new programs that are

added and evaluated periodically (Guo et al., 2019). To ensure successful outcomes in managing

and controlling type 2 diabetes, acknowledgment of the benefits of controlling blood glucose needs

to become part of the organizational change and culture.

For the proposed intervention of self-management education, leadership and change

management help in ensuring a successful implementation of the intervention. The leadership

ensures that there is availability of healthcare providers who can train the population and offer

them the necessary skills and knowledge required to successfully prevent and manage type 2

diabetes. The nurses' leaders help in making sure that the trainees are provided with the skills that

can be later used to inform the population and facilitate the successful process of self-management

of diabetes conditions (Guo et al., 2019). The nurse leadership ensures that they form a partnership

with local leaders to ensure that majority of the population is reached and the information on

diabetes prevention and management reaches them. The nurse leaders also help in ensuring that

some of the barriers that can affect the successful education on diabetes self-management are

addressed, for example, economic, social, and culture.

The promotion of well-being and health requires the participation of both client and

provider. Patient-centeredness is helping in attaining active involvement of the patients in the

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caring process. This is important in the reduction of the risks and improvement in healthy

behaviors, thus promoting the safety of the population. Diabetes self-management education is a

program for the population with diabetes and those at risk of getting diabetes to acquire knowledge

and skills to make the behavior changes and excellent control of their diabetes and the associated

conditions. According to the four ethical principles, these practices can be considered to be

supporting the aspect of beneficence and non-maleficence (Guo et al., 2019). The reduction of the

risks to type 2 diabetes and skills for the self-management of the disease assists in reducing the

harm associated with complications.

The strategies for communicating and collaborating with patient, family, or the group for

improving the outcomes associated with type 2 diabetes.

The selected patient is the grandfather who is under medication for type 2 diabetes. The

successful caring process for these patients requires the collection of health information before

designing the care plan. The collection of information helps in understanding the history of the

disease, the history of medication, understanding whether there are other illnesses apart from

diabetes, understanding the allergic history, understanding the types of medications that have been

used by the patients, and whether the medications have assisted in reducing the symptoms

associated with the diagnosed condition (Gomez-Velasco et al., 2019). The information collected

from the patient also helps in understanding whether the patient is effectively managing his

condition and finding out the existing gap in the successful management of the patient's condition.

Collaboration is an essential healthcare system since it helps in promoting collaborative

teamwork. A well-coordinated collaboration within the healthcare profession gives an opportunity

of developing inclusive, population-based, cost-effective patient care, and increase in focusing on

health promotion and prevention of illnesses. Various strategies can be adopted to help in the

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promotion of effective collaboration and communication with the patient during healthcare service

delivery (Lie et al., 2019). Effective communication is achieved through designing a digital filing

system, having regular scheduled meetings, and involvement of the patient in discussing their

condition and informing them about the improvement that has been achieved.

The communication process is also supported using the strategies such as increasing the

interaction much easier, provision of simple written instruction when the need arises, giving the

patient time to give an opportunity of responding to the questions, and provision of simple written

instructions through using the language that is understandable (Lie et al., 2019). These strategies

are important in making sure that the potential complications and challenges are addressed.

Collaborative healthcare is important in designing collaborative healthcare plans. Dealing

with type 2 diabetes illness requires a collaborative effort from both healthcare providers, patients,

and family members. Therefore, there is a need to ensure that there is an existence of effective

strategies to help in promoting collaborative care. The collaboration strategies involve the

identification of ways of ensuring that there is an increase in the level of confidence. It is also

important to consider the existing barriers that might affect the collaboration process. The

identification of the barriers is important in making sure that the client can plan, increasing the

feasibility, and the possibility for success. The other approach is to ensure that there is an increase

in the level of commitment from both parties involved in the caring process (Davidson et al.,

2018). It is also important to ensure that the parties involved share similar values and focus on

promoting the health and well-being of the patient.

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How the state board nursing practice standards and/or organizational or governmental

policies guided the development of the proposed intervention.

The New York State Board of Nursing (NYSBN) is playing an important role in the

regulation of professional practice. This is done to ensure that the general population is provided

with safe services and protect them from the potential harms caused by the non-standardized

practices. Therefore, the development of the intervention of self-management education as a

strategy is based on promoting the safety of the population and prevention of the harms caused by

type 2 diabetes and potential complications. The focus of the intervention is to ensure that there is

a reduction in the morbidity and mortality incidences associated with type 2 diabetes. Self-

management education program helps in ensuring that patients are engaging in healthy behaviors

and adherence to the instructions provided by the physician and medication (Davidson et al.,

2018). This is an important strategy that reduces the risk of exposure to type 2 diabetes since there

is early screening and health education on the disease.

How the proposed intervention will help improve quality of care, patient safety, and ensure

that there is a reduction in the cost to the individuals and the system.

The use of self-management is based on the principles that primary care has the potential to

positively impact the healthcare and healthcare outcomes of individuals diagnosed with chronic

conditions. It also has a positive effect on physician and patient satisfaction. Self-management

helps in supporting the clients' health-associated behaviors and leads to an improvement in the

clinical outcomes (Oronsaye, 2019). The program teaching self-management skills are considered

to be more important compared to information-only. The self-management education improves the

healthcare outcomes and assists in the reduction of the cost for the treatment and the management

of type 2 diabetes. The self-management is helping in bringing together patients with type 2

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diabetes, thus assisting in the enhancement of the healthcare outcomes and reduction in the medical

costs (Maneze et al., 2019). The process of learning how to incorporate self-management support

principles into the healthcare practice hence supporting clients in building the skills and the

confidence required to live a healthy life.

How technology, care coordination, and the use of community resources can be used in

addressing the problem.

The healthcare technologies such as telecare telemonitoring are assisting in the successful

delivery of healthcare services to the patient. It promotes a coordinated healthcare process whereby

both patients and healthcare providers are involved in the healthcare process (Hughes et al., 2020).

In this case, the data on the blood sugar level is sent by the caregiver, family member, or the

patient to the physician to aid the process of making some changes to improve the condition of the

patient.

The community resources also play an essential role in promoting effective service delivery

to diabetic patients. Some of the community resources such as the gym clubs and the food market

help in the adherence to the guidelines provided by the physician. This resource allows a patient to

participate in physical exercise and consumption of healthy foods, respectively (Hughes et al.,

2020). The collaboration between the physicians and the community local leaders ensures a

successful coordination process towards successful management of the patient's condition.

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References

Cunningham, A. T., Crittendon, D. R., White, N., Mills, G. D., Diaz, V., & LaNoue, M. D. (2018).

The effect of diabetes self-management education on HbA1c and quality of life in African-

Americans: a systematic review and meta-analysis. BMC Health Services Research, 18(1),

1-13.

Davidson, P., Ross, T., & Castor, C. (2018). Academy of Nutrition and Dietetics: Revised 2017

standards of practice and standards of professional performance for registered dietitian

nutritionists (competent, proficient, and expert) in diabetes care. Journal of the Academy of

Nutrition and Dietetics, 118(5), 932-946.

Gómez-Velasco, D. V., Almeda-Valdes, P., Martagón, A. J., Galán-Ramírez, G. A., & Aguilar-

Salinas, C. A. (2019). Empowerment of patients with type 2 diabetes: current

perspectives. Diabetes, metabolic syndrome and obesity: targets and therapy, 12, 1311.

Hughes, G., Shaw, S. E., & Greenhalgh, T. (2020). Rethinking integrated care: a systematic

hermeneutic review of the literature on integrated care strategies and concepts. The

Milbank Quarterly, 98(2), 446-492.

Guo, Z., Liu, J., Zeng, H., He, G., Ren, X., & Guo, J. (2019). Feasibility and efficacy of nurse-led

team management intervention for improving the self-management of type 2 diabetes

patients in a Chinese community: a randomized controlled trial. Patient preference and

adherence, 13, 1353.

Lie, S. S., Karlsen, B., Graue, M., & Oftedal, B. (2019). The influence of an eHealth intervention

for adults with type 2 diabetes on the patient-nurse relationship: a qualitative

study. Scandinavian journal of caring sciences, 33(3), 741-749.

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Maneze, D., Weaver, R., Kovai, V., Salamonson, Y., Astorga, C., Yogendran, D., & Everett, B.

(2019). “Some say no, some say yes”: Receiving inconsistent or insufficient information

from healthcare professionals and consequences for diabetes self-management: A

qualitative study in patients with type 2 diabetes. Diabetes research and clinical

practice, 156, 107830.

Oronsaye, C. G. (2019). The Effectiveness of Nurse-Led Diabetes Self-Management Education

among Adults with Uncontrolled Type 2 Diabetes Mellitus (Doctoral dissertation, Grand

Canyon University).

Watson, N., Acuna, D. G., Wardian, J. L., Cobb, E. C., Beavers, D., & Sauerwein, T. J. (2018).

Diabetes self-management education via telemedicine in the United States Air

Force. Diabetes, 67(Supplement_1).