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NURS FPX 4900 Assessment 5 Intervention Presentation and Capstone Video Reflection

nurs fpx 4900 assessment 5 intervention presentation and capstone video reflection

Student Name

Capella University

NURS 4900 Capstone Project for Nursing

Prof. Name

Date

Intervention Presentation and Capstone Video Reflection

Hi, my name is Cindy and I am a Baccalaureate nurse. Today I am presenting a capstone reflection video on the management of type II diabetes for chronic diabetics. Type II diabetes is one of the chronic diseases which is characterized by persistent uncontrolled blood sugar levels especially hyperglycemia or raised blood sugar levels after the intake of carbohydrates. This is non-insulin-dependent diabetes because hyperglycemia persists despite high insulin levels in the body, which is termed insulin resistance (Westman, 2021). According to CDC’s statistics, more than 37 million Americans are diagnosed with diabetes and about 95% of these people have type II DM (CDC, 2022).

This statistic develops room for bringing reforms in the population related to the management of diabetes. These reforms involve the education and reinforcement of behavioral changes in the patients who are diagnosed with the condition. Healthy People 2030 defines health behavioral modification as a key objective in terms of decreasing the global burden of diseases (U.S. Department of Health and Human Services, n.d.).  Some of the non-pharmacological interventions for the management of diabetes include lifestyle modification (dietary changes, stress management, and physical activity) and self-management of diabetes through blood glucose monitoring and tracking the records.

NURS FPX 4900 Assessment 5 Intervention Presentation and Capstone Video Reflection 

For this capstone project, I have been working with a patient, John, who has been a chronic type II diabetes patient. He is also suffering from obesity, blurred vision, and extreme fatigue. He has a family history of the same condition and his uncle and father have been suffering from the disease already. John has certainly been trying various lifestyle modification techniques and medicinal treatments to control his blood sugar levels. Despite his efforts, he still encounters uncontrolled sugar levels. In this capstone project, I have developed several interventions for John which included the introduction of Continuous Glucose Monitoring (CGM) devices for self-management and record keeping, a smartphone app for live coaching, some pharmacological advancements, and consultation with a multidisciplinary team through telehealth.  

Contribution of the Interventions to the Patient’s Satisfaction and Quality of Life

Next, I will present the contribution of these interventions to John’s quality of life and satisfaction. Evidence-based interventions are proven to be effective in improving patients’ satisfaction levels and quality of life. Self-management of diabetes has been considered an effective intervention for chronic diabetics. This includes self-monitoring of blood glucose levels, ensuring a healthy diet, engaging in physical activities, complying with medication, and preventing further complications (Adhikari & Santosh, 2021).

The successful ways of performing these actions are through monitoring blood glucose levels, keeping track of the readings, medicines, eating a healthy diet, and exercising, and consulting with the healthcare team for effective management. For this purpose, a CGM device was introduced for John. The CGM is a device that provides continuous glucose readings for patients and healthcare providers, which helps in the identification of hypo/hyperglycemia events with no symptoms and tracking the record (Miller, 2020). He was given complete training about the use of this device and how to report his blood glucose levels to healthcare providers.

This device was connected to his smartphone app, where as soon as he entered the glucose reading, he received live health coaching from the providers. This coaching included immediate actions (medicine and rest) if needed, short-term actions (coping from stress, physical activity, and diet changes), and/or long-term actions (medicine modifications, nutritional consultation, physical rehabilitation, doctors’ visit, etc.).  Moreover, on his appointments with doctors, his medicines were also changed so that effective results can be checked. For monitoring and evaluation of these outcomes, telehealth was used for constant updates, and for healthcare providers to ensure that interventions introduced for John are effective and successful. 

NURS FPX 4900 Assessment 5 Intervention Presentation and Capstone Video Reflection

These interventions were presented to the patient in person while providing the CGM device, the use of the device was demonstrated to John, and a re-demonstration was asked at the end. I developed an individualized smartphone app for him which was set up for immediate coaching and I also came prepared with some posters related to diet and exercise for his self-awareness. John, really appreciated my efforts for him as I arranged a CGM device for him and developed an app with the help of the IT department in my hospital. He was so excited to use these applications as they looked really fun to him and he thought it would be a great way for him to manage his diabetes. Besides this, he felt assured that even if he is apart from the hospital, he will timely receive his consultation and coaching using telecommunication methods. 

We also discussed some of the lifestyle modification methods and his compliance with his medication. We did not only discuss dietary changes and physical activities but also discussed with him the ways he can control his sugar cravings, like going for natural sugar in fruits, eating regularly, and maintaining quality over quantity. He was also recommended adding short time-period exercises to his routine. Furthermore, he was given advice on medication compliance like keeping reminders. This part thrilled him as he has been trying lifestyle changes but couldn’t improve because of a lack of consistency and compliance. 

Use of Evidence and Peer-Reviewed Literature for Implementation of Capstone Project

Next, I will discuss how the evidence and peer-reviewed literature were used throughout the capstone project. So, from the start of the project, every intervention, strategy, policy, and implementation were conducted based on evidence-based literature. The Healthy People 2030 objectives for the management of diabetes advocated the need for planning and implementing this project. Some of these objectives include the reduction of diabetes cases and mortality associated with the condition, enhancement of formal diabetes education for adults, an increase in the number of people receiving type II diabetes prevention programs, and increasing the number of people who monitor their sugar daily (U.S Department of Health and Human Services, n.d.). So, these objectives highlighted the need to use evidence-based strategies to ensure that the patient received maximum support for his diabetes management.

NURS FPX 4900 Assessment 5 Intervention Presentation and Capstone Video Reflection

A literature was found that provided the importance of continuous glucose monitoring as it provides real-time glucose readings and trends of glucose which results in better management of glycemic levels and diabetes as a whole (Di Mario et al., 2022). Furthermore, the self-management of diabetes and the use of various smartphone applications have been presented by the studies as effective interventions to improve patients’ compliance with their condition. These technologies have proven to improve health outcomes and reduce the risk of complications (Doupis et al., 2020). These evidence-based practices were something that were discovered during the project and thought to use them on John so that his complications could be reduced and his diabetes is managed effectively. 

Use of Healthcare Technology to Improve the Outcomes

Further in this video, the healthcare technologies that were leveraged will be discussed. One of the technologies that is used in the patient’s home is his smartphone. An application was developed which was downloaded on John’s phone and was set up for telecommunication between the patient and the provider. Research has also focused on the use of mobile phones for the effective management of diabetes by motivating patients and bringing self-care changes among them (Al-Ozairi et al., 2018). Additionally, these apps can also be used for telehealth purposes where healthcare providers can certainly help their patients with consultation and medical treatment in cases where patients are far from their healthcare facilities. This improves healthcare accessibility and patient satisfaction. 

NURS FPX 4900 Assessment 5 Intervention Presentation and Capstone Video Reflection

Another healthcare technology that was used in this capstone project is continuous glucose monitoring devices. It has been researched that CGM has resulted in lowering the HBA1c levels in diabetic patients after consistent use for 8 months (Martens et al., 2021). These technologies were successfully implemented in John’s case which resulted in patients’ satisfaction and also improved his quality of life by reducing stress and improving glycemic control. More technologies that can be used are Alexa/Siri for medication reminders, appointment reminders as well as notifications for physical exercises and dietary updates. 

However, there are certain barriers to the generalized implementation of these evidence-based technologies in clinical practices – cost and hospital coverage. Healthcare facilities should perform a cost-benefit analysis to introduce these technologies in the hospitals. They must work together with public health organizations like FDA and CDC to make the technologies accessible to everyone (Jiao et al., 2022).    

Influence of Health Policy on Planning and Implementation of Capstone Project

Next, I will explain how health policies influence the planning and implementation of this project. In the case of diabetes, the Diabetes Prevention Programs and Diabetes Self-management Education Support Program (DSMES) by CD have been influential throughout the project. This program helps patients to gain practical skills, stay motivated, seek support, and increase their confidence in self-management. DSMES assists individuals to manage their blood glucose levels, prevents complications, reduces the costs associated, and provides education for self-care (CDC, 2022). 

Another health policy that influenced the project is the Affordable Care Act (ACA). This act is purposed for improving healthcare access and removing disparities among the population. Prevention of diseases and maintaining wellness among people are two essential components of ACA (HealthCare.gov, n.d.). These objectives and provision of healthcare access impacted the project of diabetes management in the case of John to make diabetes management affordable and accessible for John within his home using various technologies.  

HIPAA, which is a law called the Health Insurance Portability and Accountability Act, is to protect patient’s sensitive health information using three principles – privacy, security, and confidentiality (Edemekong et al., 2023).  This act has been one of the most influential in the case of John as care coordination and the technologies introduced for him had higher chances of information leakage. Thus, it was essentially considered throughout that the smartphone apps and telehealth mediums are free of security issues and that whatever information is distributed among healthcare providers is with confidentiality, maintaining John’s privacy. 

Outcomes of the Project

Lastly, I will share if the outcomes of the project met my initial predictions. I think it was quite a successful project as it developed an insight into John to take care of his health especially his diabetes and his lifestyle so that he can prevent future complications. Although the technologies were new to him, I made sure to answer all of his questions related to the use of these devices and even provided him with references for his readings where he can access the importance and effectiveness of the technology. I think I was well equipped with the research and evidence to support my claims so that John doesn’t feel uncomfortable in using those interventions. I concisely presented all the information and refrained from using medical jargon so that its easy-to-understand to him. 

NURS FPX 4900 Assessment 5 Intervention Presentation and Capstone Video Reflection

Moreover, the re-demonstration of the use of CGM was successful as he presented it exactly the way it was demonstrated to him. Moreover, his statements proved that he has developed a comprehensive understanding of why self-management of diabetes is essential and how lifestyle modification, telehealth, and medication compliance will help him achieve better outcomes for his physical and mental health. John is now able to monitor his glucose regularly, he is well aware of the changes he needs to make in his diet and exercise routine, and most importantly he now sets alarms for his medication reminders.

The telehealth appointments and the live coaching has helped him a lot with providing education, improvising his pharmacological treatment, and continuous monitoring have been started for improvement in his glycemia and I believe that this continuous monitoring and support from the multidisciplinary team will assist him in the areas of improvement. 

Professional Growth throughout a Capstone Project

As a nursing student, I believe that such a capstone project helps us to develop various in terms of interacting with real patients and dealing with chronic diseases. This capstone project specifically improved my research skills where I was able to find evidence-based and peer-reviewed articles to support my points throughout.

Moreover, it enhances my knowledge about diabetes and its management which will help me in the future to deal with more diabetic patients. Through this project, I was able to build on my communication skills with the patients which is also beneficial for me in future clinical practices. Lastly, this project developed an insight that nurses play a critical role not only on the frontline of hospitals but as well as in communities to improve public health outcomes, promote education, prevent illness, and provide care and assistance to the people so that their quality of life is improved. 

Conclusion 

Diabetes is a chronic health condition that requires extensive interventions for the management of the disease. Patients must be taught about self-management by lifestyle modifications (diet and exercise) and use specific technologies for continuous monitoring of their glycemic levels. Healthcare providers play a critical role in ensuring that patients are well-educated about their self-management of diabetes and are provided with in-person and telehealth support. Various healthcare policies also support these diabetes and other chronic conditions management programs to improve patients’ quality of life and enhance patient satisfaction.

References

Adhikari, B. I., & Santosh, B. (2021). Self-care management among patients with type 2 diabetes mellitus in Tanahun, Nepal. Archives of Community Medicine and Public Health, 037–042. https://doi.org/10.17352/2455-5479.000131  

Al-Ozairi, E., Ridge, K., Taghadom, E., de Zoysa, N., Tucker, C., Stewart, K., Stahl, D., & Ismail, K. (2018). Diabetes and telecommunications (dates) study to support self-management for people with type 2 diabetes: A randomized controlled trial. BMC Public Health18(1). https://doi.org/10.1186/s12889-018-6136-8 

Centers for Disease Control and Prevention. (2022). Type 2 diabetes. Retrieved April 27, 2023, from https://www.cdc.gov/diabetes/basics/type2.html 

Centers for Disease Control and Prevention. (2022). DSMES services. Retrieved April 27, 2023, from https://www.cdc.gov/diabetes/dsmes/index.html 

Di Mario, C., Genovese, S., Lanza, G. A., Mannucci, E., Marenzi, G., Sciatti, E., Pitocco, D., Avogaro, A., Bertuzzi, F., Bonora, E., Borghi, C., Buzzetti, R., Carugo, S., Capodanno, D., Consoli, A., Conti, A., Danesi, R., Bartolo, P., Ferrari, G. M., … Uguccioni, M. (2022). Role of continuous glucose monitoring in diabetic patients at high cardiovascular risk: An expert-based multidisciplinary Delphi Consensus. Cardiovascular Diabetology21(1). https://doi.org/10.1186/s12933-022-01598-2 

Doupis, J., Festas, G., Tsilivigos, C., Efthymiou, V., & Kokkinos, A. (2020). Smartphone-based technology in diabetes management. Diabetes Therapy11(3), 607–619. https://doi.org/10.1007/s13300-020-00768-3 

Edemekong, P. F., Annamaraju, P., & Haydel, M. J. (2023). Health insurance portability and accountability act. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK500019/

NURS FPX 4900 Assessment 5 Intervention Presentation and Capstone Video Reflection

HealthCare.gov. (n.d). Affordable care act (ACA) – glossary. Retrieved April 27, 2023, from https://www.healthcare.gov/glossary/affordable-care-act/ 

Jiao, Y., Lin, R., Hua, X., Churilov, L., Gaca, M. J., James, S., Clarke, P. M., O’Neal, D., & Ekinci, E. I. (2022). A systematic review: Cost‐effectiveness of continuous glucose monitoring compared to self‐monitoring of blood glucose in type 1 diabetes. Endocrinology, Diabetes & Metabolism5(6). https://doi.org/10.1002/edm2.369 

Martens, T. W., Beck, R. W., & Bergenstal, R. M. (2021). Continuous glucose monitoring and glycemic control in patients with type 2 diabetes treated with basal insulin—reply. JAMA326(13), 1330. https://doi.org/10.1001/jama.2021.13478 

Miller, E. M. (2020). Using continuous glucose monitoring in clinical practice. Clinical Diabetes38(5), 429–438. https://doi.org/10.2337/cd20-0043 

U.S. Department of Health and Human Services. (n.d.). Browse objectives. Browse Objectives – Healthy People 2030. (n.d.). Retrieved April 27, 2023, from https://health.gov/healthypeople/objectives-and-data/browse-objectives#health-behaviors 

U.S Department of Health and Human Services (n.d.). Diabetes. Diabetes – Healthy People 2030. Retrieved April 27, 2023, from https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes 

Westman, E. C. (2021). Type 2 diabetes mellitus: A pathophysiologic perspective. Frontiers in Nutrition8. https://doi.org/10.3389/fnut.2021.707371 

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