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Capella 4900 Assessment 5

Capella 4900 Assessment 5 Intervention Presentation and Capstone Video Reflection

Student Name

Capella University

NURS-FPX 4900 Capstone Project for Nursing

Prof. Name

Date

Introduction 

Hello everyone, my name is ________, and I am a registered nurse at Southern California Hospital at Hollywood. Today, I would like to present to you all the reflections on the capstone project I did in collaboration with my patient Michael who was a 67-year-old male suffering from type 2 diabetes for the last four years. His unhealthy lifestyle, minimal knowledge about diabetes, and non-compliance to medication were the culprit behind her dangerously high blood glucose levels.

By spending various practicum hours discussing his condition and required goals, I was able to make an intervention plan consisting of a Diabetes Self-Management Education and Support (DSMES) program and remote monitoring of medication adherence for Michael. This intervention plan was based on the patient-centered approach. In this capstone video reflection, I will describe the contributions this plan made toward Michael’s health and the overall journey of this capstone project.

Contributions of Intervention to Patient’s Satisfaction & Quality of Life

DSMES education program and remote monitoring of medication adherence played a vital role in improving Michael’s diabetes. The education provided to Michael in DSMES enhanced his knowledge of diabetes, ways to cope with it, weight management, and self-blood glucose monitoring. This intervention contributed to patient satisfaction and improved quality of life as the main concern for Michael and his family was normal blood glucose levels which were lowered to the normal range for diabetes patients. Michael and his family reported in their feedback that this education program was a huge contribution to his healthy lifestyle now.

He further reported that knowing about the complications of diabetes through DSMES made him aware of making healthier choices for his life which made him implement a healthy lifestyle with regular physical activity and eating a healthy diet. He further described that he completely avoided using processed food and had healthy meals ever since he learned about the harms of diabetes. The remote monitoring of medication adherence was found to be fruitful for Michael as he struggled to take medication consistently.

Furthermore, he utilized the Affordable Care Act (ACA) provisions which he was unaware of before this capstone project. The ACA health policy covered his health insurance and helped him manage his medication expenses to a great extent. The remote monitoring by nurses helped him improve his compliance with medication which lowered his blood glucose levels to a normal range. Michael’s family was equally satisfied as his quality of life improved as a result of the proposed intervention plan for him.

Use of Evidence and Peer-Reviewed Literature to Plan and Implement Capstone Project

  Talking about the proposed intervention plan developed for Michael’s condition was solely derived from the evidence-based and peer-reviewed research literature. After exploring Michael’s condition and his preferences, I researched the best intervention plans for diabetes in older people and found several interventions such as continuous glucose monitoring, DSMES programs, and remote patient monitoring. In a study by Izquierdo and colleagues (2022), the effectiveness of educational programs like DSMES was shown which resulted in enhanced knowledge about diabetes leading to improved condition by self-managing strategies. Another study by Munshi and colleagues (2021) described the impact of remote monitoring on medication adherence in diabetes patients.

The study showed improvement in patient’s behaviors toward medication adherence as they were keenly observed by nurses and their support in medication management remotely greatly influenced the medication adherence attitude. These principles of evidence-based practice informed me about these aspects of my capstone project. I discussed these interventions and their potential benefits in diabetes with Michael and based on his preference and condition’s requirement, we were able to select DSMES and remote monitoring of medication adherence as planned intervention for him. Hence, evidence-based practices and peer-reviewed literature play an immense role in the planning and implementation of the capstone project.

Leveraged Healthcare Technology to Improve Outcomes/Communication with Patient

In this section, I will throw some light on the extent to which I successfully leveraged healthcare technology in this capstone project to improve outcomes and communication with Michael. Healthcare technologies facilitate better management of long-term diseases like diabetes where chronic care treatment requires to be delivered. For this purpose, healthcare technologies like EHR, telehealth, telemonitoring, and remote monitoring can be effective tools to monitor care treatments and improve communication with patients (Kim et al., 2022).

In my capstone project, I planned to implement remote monitoring of Michael to observe his medication adherence behavior. This technology has the potential to improve diabetes outcomes as medication therapy is equally important in patients who have high blood glucose levels to a dangerous level. Moreover, the apps with remote monitoring features also have the specialty to communicate with patients where health professionals can guide patients on medication management improving communication between patients and healthcare professionals.

The prospective improvements in healthcare technology use that can be made to enhance diabetes outcomes can include the use of continuous glucose monitoring technology which can provide continuous blood glucose level measurements digitally. This will help healthcare professionals manage diabetes effectively as the wide trends in blood glucose level fluctuations can be estimated through CGM. This can further improve diabetes management in patients with type-2 diabetes (Martens et al., 2021). 

Influence of Health Policy on Planning and Implementation of Capstone Project  

The HITCH Act of 2009 has established various provisions on the use of health information technologies. One of the provisions of this Act includes the adoption and implementation of health information technologies to improve the quality, safety, and efficiency of care treatment provided to patients (HIPAA Journal, 2023). Owing to this policy based on technology and its implementation, I planned to introduce remote monitoring, a technology-based intervention that could help manage Michael’s condition effectively. Furthermore, the American Nursing Association provided nursing practice standards that involved care coordination (Brunt & Russell, 2022).

The DSMES program involved the implementation of care coordination as the multidisciplinary team was included to provide Michael with education and support on self-management of diabetes in various aspects of his life. For example, diabetes educators, physical therapists, dieticians, nurses, and primary care physicians delivered coordinated care in the DSMES program. These health policies influenced profoundly on planning and implementation of this capstone project by providing an idea on the implementation of health technology and care coordination in clinical practices.

Furthermore, this capstone project contributed to the development of a policy in our hospital where patients with diabetes who live far from our hospital are enabled to acquire this intervention of remote monitoring. Health professionals will be able to monitor diabetics who need to travel from far distances. The baccalaureate-prepared nurse played a massive role in the development and implementation of the policy by implementing specific change management strategies that can convince healthcare authorities to add a particular health policy. The nurses are the primary caretakers of patients and know patients’ requirements and preferences by which they can estimate what care treatment and strategy can help them recover in a better way; therefore, through their insightful knowledge, they can play a role in policy development and implementation.

Analysis of Capstone Project Outcomes and Comparison with Initial Predictions

While planning for this capstone project of the proposed intervention, the initial predictions included lowered blood glucose levels from 315 mg/dL along with lower hospital visits. Moreover, it was predicted that Michael will attain a regulated blood glucose level due to proper medication adherence and consistent lifestyle modifications. The outcomes of this capstone project successfully matched the initial predictions as Michael’s blood glucose level lowered down from the initial measurement. The frequency of hospital revisits was reduced as a result of remote monitoring. Furthermore, through lifestyle modifications and medication adherence, Michael’s blood glucose levels became regular (< 180mg/dL).

The proposed interventions can be adopted as a best practice as they are evidence-based and derived from peer-reviewed literature. Moreover, as Michael’s blood glucose levels are regulated as a result of this intervention, they can be generally implemented for diabetes’ who have similar conditions or situations like him. The total nine practicum hours spent with Michael have been completed and documented in the Capella Academic Portal Experience Form. 

Personal and Professional Growth Throughout Capstone Project

Throughout this capstone and the RN-to-BSN program, I learned about the sufferings of diabetics and how they need to take multiple medications to keep their blood glucose levels regulate. Moreover, their struggle with lifestyle modification and implementing consistency influenced my personal growth. Michael’s struggles helped me make healthier choices to prevent obesity and hence, diabetes. Furthermore, my professional growth was deeply influenced by this capstone project.

I was more aware of ethical principles such as beneficence, empathy, and truthfulness and how my nursing practices can influence Michael and his care treatment of diabetes. Therefore, I became remotely available to Michael anytime he needed my assistance so his struggle could be alleviated and his condition could be improved. The specific areas of growth of which I am most proud and have taken particular satisfaction are the improved and healthy lifestyle that I attained while providing care treatment to Michael. 

Conclusion 

To conclude, Michael’s diabetes condition was the focal point of this capstone project for which two interventions were planned and implemented i.e. DSMES program and remote monitoring of medication adherence. In this video, we reflected on the contributions these interventions made toward Michael’s condition in terms of satisfaction and quality of life. From Michael’s feedback, it was observed that the proposed intervention plan enhanced his satisfaction due to improved quality of life.

Moreover, the proposed intervention plan was developed and implemented on the basis of evidence-based practice and peer-reviewed literature. The healthcare technology was successfully leveraged to improve the outcomes of Michael’s condition. Moreover, the health policies that influenced the planning and implementation of this capstone project were HITECH Act policies and ANA-provided standards of care coordination. Lastly, we evaluated the capstone project outcomes that matched the initial predictions and analyzed my personal and professional growth throughout this capstone project and the RN-to-BSN program.

References

Brunt, B. A., & Russell, J. (2022, September 20). Nursing professional development (NPD) standards. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK534784/ 

HIPAA Journal. (2023). What is the HITECH act. https://www.hipaajournal.com/what-is-the-hitech-act/ 

Izquierdo, V., Pazos-Couselo, M., González-Rodríguez, M., & Rodríguez-González, R. (2022). Educational programs in type 2 diabetes designed for community-dwelling older adults: A systematic review. Geriatric Nursing, 46, 157–165. https://doi.org/10.1016/j.gerinurse.2022.05.008

Kim, J., Park, T., & Kim, K. J. (2022). The clinical effects of type 2 diabetes patient management using digital healthcare technology: A systematic review and meta-analysis. Healthcare, 10(3), 522. https://doi.org/10.3390/healthcare1003052  

Martens, T., Beck, R. W., Bailey, R., Ruedy, K. J., Calhoun, P., Peters, A. L., Pop-Busui, R., Philis-Tsimikas, A., Bao, S., Umpierrez, G., Davis, G., Kruger, D., Bhargava, A., Young, L., McGill, J. B., Aleppo, G., Nguyen, Q. T., Orozco, I., Biggs, W., & Lucas, K. J. (2021). Effect of continuous glucose monitoring on glycemic control in patients with type 2 diabetes treated with basal insulin. JAMA, 325(22), 2262. https://doi.org/10.1001/jama.2021.7444

Munshi, K. D., Amelung, K., Carter, C. S., James, R., Shah, B. R., & Henderson, R. R. (2021). Impact of a diabetes remote monitoring program on medication adherence. Journal of Managed Care & Specialty Pharmacy, 27(6), 724–731. https://doi.org/10.18553/jmcp.2021.27.6.724 

Capella 4900 Assessment 5