NURS 8114 Clarifying Connections: Practice Problem, Evidence, Changing Practice

NURS 8114 Clarifying Connections: Practice Problem, Evidence, Changing Practice

NURS 8114 Clarifying Connections: Practice Problem, Evidence, Changing Practice

In my module 4 assignment, I focused my attention on improving self-care practices for diabetes patients. I identified that there are challenges in management of diabetes at home setting with some elements of care being unclear to patients. From the readings and sources I reviewed, one clear element was that poor self-care management result to increased risk of diabetes complications and burden for patients (Abdulrhim et al., 2021). Additionally, these complications have negative outcomes on quality of life for patients and increase their financial burden to manage the complications. Some of the causes of poor self-care practices is inadequate education to patients and an education that does not meet the holistic literacy for patients to advance outcomes in self-care management (Conca et al., 2018). These challenges must be addressed by improving the manner that patients are educated, follow-up practices are conducted, and care is delivered to promote quality of life and clinical outcomes.

Again, the sources identified that use of an interdisciplinary a collaborative team that comprises of diabetes educators (nurses), APRNs or physicians, pharmacists, nutritionists or dieticians, social workers, psychiatrists could provide an effective framework for educating diabetes patients on self-care practices. A combined effort by these professionals can ensure patients, caregivers, families, and community is aware of best practices to manage diabetes (Wojciechowski et al., 2016; du Pon et al., 2019; Fals & Abraham-Pratt, 2019). A summary of the findings from all the 10 sources identified that integration of an interdisciplinary collaborative team could promote best outcomes for patients by ensuring that quality healthcare practices are identified for educating patients on diabetes self-care practices (Szafran et al., 2019). These practices enhancement is likely to promote effective control of blood glucose level (glycemic control) leading to an overall improvement in health outcomes and quality of life (Miller-Rosales & Rodriguez, 2021). The professionals working collaborative was established to be an effective approach that could enhance health outcomes and improve the self-care practices at home setting.

From the synthesis of the information contained in the articles, I identified that different professionals have different roles in collaborative efforts for patients with diabetes. For instance, nurses can be important educators working collaboratively with APRNs or physicians to educate patients on best approaches to advance health outcomes through effective glycemic control (Miller-Rosales & Rodriguez, 2021). If need be, the physicians or APRNs can also prescribe medications that could enhance attainment of normal glycemic control to prevent deterioration of complications and symptoms. Nurses also function best in educating patients desired lifestyle changes that should be adopted and various readings that have to be made at home setting for effective glycemic control (Lee et al., 2021). Nutritionist or dietician can work effectively in educating the patient on correct diet to take to enhance effective control of blood sugar level. Psychiatrists play an important role in providing emotional and psychological wellbeing for patients since change in lifestyle could induce stress and anxiety that may result to reduced quality of life. Social workers are in need when a patient has little or no social support to enhance social welfare support could be provided based on level of need (Fals & Abraham-Pratt, 2019). Pharmacists are in need to enhance the process of diabetes medication dispensing. All these professionals can work together to ensure effective glycemic control for patients to improve health outcomes.

In the implementation of change, Lewin Change Management model can be used to ensure that all necessary

NURS 8114 Clarifying Connections Practice Problem, Evidence, Changing Practice
NURS 8114 Clarifying Connections Practice Problem, Evidence, Changing Practice

processes of change are implemented to avoid possibilities of resistance to change (Fals & Abraham-Pratt, 2019). The involvement of management support is also critical to ensure additional resources, planning and changes in workflow is implemented to support the new approach (Fals & Abraham-Pratt, 2019). Other staff in the facility will require training to function within the new setting and enhance the outcomes of health. It is also recommended that community members, patients, their caregivers, and families should also be engaged to familiarize with the new approach. These changes are important to enhance effectiveness in glycemic control for patients and assurance of high standards of quality in delivery of healthcare services from an interdisciplinary collaborative team care for education of diabetes patients on self-care practices.

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References

Abdulrhim, S., Sankaralingam, S., Ibrahim, M. I. M., Diab, M. I., Hussain, M. A. M., Al Raey, H., & Awaisu, A. (2021). Collaborative care model for diabetes in primary care settings in Qatar: a qualitative exploration among healthcare professionals and patients who experienced the service. BMC health services research21(1), 1-12. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-021-06183-z 

Conca, T., Saint-Pierre, C., Herskovic, V., Sepúlveda, M., Capurro, D., Prieto, F., & Fernandez-Llatas, C. (2018). Multidisciplinary collaboration in the treatment of patients with type 2 diabetes in primary care: analysis using process mining. Journal of medical Internet research20(4), e8884. https://www.jmir.org/2018/4/e127 

du Pon, E., Kleefstra, N., Cleveringa, F., van Dooren, A., Heerdink, E. R., & van Dulmen, S. (2019). Effects of the Proactive interdisciplinary self-management (PRISMA) program on self-reported and clinical outcomes in type 2 diabetes: a pragmatic randomized controlled trial. BMC endocrine disorders19(1), 1-9. https://link.springer.com/article/10.1186/s12902-019-0466-0  

Fals, A. M., & Abraham-Pratt, I. (2019). An effective multidisciplinary approach to childhood obesity prevention and treatment: Integration of technology, health coaching of child, and fitness options. Pediatrics. 144 (2), 221. DOI: https://doi.org/10.1542/peds.144.2_MeetingAbstract.221

Lee, J. K., McCutcheon, L. R., Fazel, M. T., Cooley, J. H., & Slack, M. K. (2021). Assessment of interprofessional collaborative practices and outcomes in adults with diabetes and hypertension in primary care: a systematic review and meta-analysis. JAMA network open4(2), e2036725-e2036725. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2776302

Miller-Rosales, C., & Rodriguez, H. P. (2021). Interdisciplinary primary care team expertise and diabetes care management. The Journal of the American Board of Family Medicine34(1), 151-161. https://www.jabfm.org/content/34/1/151.abstract

Szafran, O., Kennett, S. L., Bell, N. R., & Torti, J. M. (2019). Interprofessional collaboration in diabetes care: perceptions of family physicians practicing in or not in a primary health care team. BMC family practice20(1), 1-10. https://bmcfampract.biomedcentral.com/articles/10.1186/s12875-019-0932-9

Wojciechowski, E., Pearsall, T., Murphy, P., & French, E. (2016). A case review: Integrating Lewin’s theory with lean’s system approach for change. Online journal of issues in nursing, 21(2). http://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-21-2016/No2-May-2016/Integrating-Lewins-Theory-with-Leans-System-Approach.html.

My literature review focuses on heart failure patient’s readmission rates and how to lower readmission rates. The literature focuses on transitional care. The patient transitioning form the hospital to the home. Education in a key component. The articles focus on disease process education, dietary education (low sodium and low cholesterol), medication, and daily VS/Wt. The articles connect to my practice problem of an increase readmission rate of heart failure patients.

My synthesis of evidence on which to base a practice change showed the need for a practice change initiative. Discharge education and instructions in my practice will benefit from being updated to include follow up sooner in 1 – 2 weeks of discharge and provide scale if the patient does not have one or can’t afford one. My practice could prescribe a complex treatment plan involving multiple medications and self-care practices to achieve optimal care. To summarize the goals of heart failure care, clinical practice guidelines clinical practice guidelines. The Heart Failure Society of America and the American College of Cardiology/American Heart Association will be a great resource (Laskey and Cox, 2015).  In addition to the importance of pharmaceuticals, guidelines have recognized the importance of patient self-care measures.

 

References

 

Gilstrap, LG, Stevenson, LW, Small, R., (2018). Reasons for guideline nonadherence at heart failure discharge. Journal of the American Heart Association. 2018;7:e008789.

Brisco‐Bacik, M., Maaten, J., Houser, S., Vedage, N., Rao, V., Ahmad, T., Wilson, P.,  and Testani , J. (2018). Outcomes Associated With a Strategy of Adjuvant Metolazone or High‐Dose Loop Diuretics in Acute Decompensated Heart Failure: A Propensity Analysis. Journal of the American Heart Association. 2018;7:e009149.

Laskey, W., Alomari, I., Cox, M., Schulte, P., Zhao, X., Hernandez, A., Heidenreich, P., Eapen, Z., Yancy, C., Bhatt, D., Fonarow, G. (2015). Heart Rate at Hospital Discharge in Patients With Heart Failure Is Associated With Mortality and Re-hospitalization. Journal of the American Heart Association. ;4:e001626

 

My literature review focuses on heart failure patient’s readmission rates and how to lower readmission rates. The literature focuses on transitional care. The patient transitioning form the hospital to the home. Education in a key component. The articles focus on disease process education, dietary education (low sodium and low cholesterol), medication, and daily VS/Wt. The articles connect to my practice problem of an increase readmission rate of heart failure patients.

My synthesis of evidence on which to base a practice change showed the need for a practice change initiative. Discharge education and instructions in my practice will benefit from being updated to include follow up sooner in 1 – 2 weeks of discharge and provide scale if the patient does not have one or can’t afford one. My practice could prescribe a complex treatment plan involving multiple medications and self-care practices to achieve optimal care. To summarize the goals of heart failure care, clinical practice guidelines clinical practice guidelines. The Heart Failure Society of America and the American College of Cardiology/American Heart Association will be a great resource (Laskey and Cox, 2015).  In addition to the importance of pharmaceuticals, guidelines have recognized the importance of patient self-care measures.

 

References

 

Gilstrap, LG, Stevenson, LW, Small, R., (2018). Reasons for guideline nonadherence at heart failure discharge. Journal of the American Heart Association. 2018;7:e008789.

Brisco‐Bacik, M., Maaten, J., Houser, S., Vedage, N., Rao, V., Ahmad, T., Wilson, P.,  and Testani , J. (2018). Outcomes Associated With a Strategy of Adjuvant Metolazone or High‐Dose Loop Diuretics in Acute Decompensated Heart Failure: A Propensity Analysis. Journal of the American Heart Association. 2018;7:e009149.

Laskey, W., Alomari, I., Cox, M., Schulte, P., Zhao, X., Hernandez, A., Heidenreich, P., Eapen, Z., Yancy, C., Bhatt, D., Fonarow, G. (2015). Heart Rate at Hospital Discharge in Patients With Heart Failure Is Associated With Mortality and Re-hospitalization. Journal of the American Heart Association. ;4:e001626