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NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

Student Name

Capella University

NURS-FPX 6218 Leading the Future of Health Care

Prof. Name


Change Proposal Summary Report


The primary objective of this executive summary report is to propose a change in the management of peripheral neuropathy in diabetic patients within healthcare organizations in Colorado. Through comprehensive research on peripheral neuropathy and a comparative analysis of management approaches in non-U.S. healthcare systems, this report aims to suggest effective measures and strategies to enhance the quality of health for individuals with diabetes by reducing complications associated with peripheral neuropathy.

Executive Summary

Proposed Change

Peripheral neuropathy poses significant challenges for individuals with diabetes, leading to pain, sensory loss, and paraesthesia. Diabetic peripheral neuropathy (DPN) affects approximately 50% of diabetics, with a 25% risk of foot ulcers, potentially resulting in leg amputations (Hicks & Selvin, 2019). Given the severe consequences of inadequate care, it is imperative to advocate for aggressive screening and management of diabetes, including regular HbA1c monitoring, foot examination, and pain management.

Local healthcare systems in Colorado are grappling with an increasing prevalence of peripheral neuropathy among diabetic patients, resulting in issues such as numbness, foot pain, ulcers, and amputations. Addressing this concerning trend is crucial to improving the health and quality of life for individuals with diabetes. By focusing on enhancing diabetes management through annual foot examinations, glycemic control, and patient education on foot care and self-management behaviors, the onset and progression of peripheral neuropathy can be mitigated (American Diabetes Association Professional Practice Committee, 2021; Alahakoon et al., 2020).

Desired Outcomes

The proposed changes aim to achieve several desired outcomes:

  1. Prevention of neuropathy complications: Timely management of diabetes and peripheral neuropathy can prevent complications such as infections, delayed healing, foot ulcers, and amputations (Selvarajah et al., 2019).
  2. Enhanced sensation: By improving glycemic control and preventing peripheral neuropathy, individuals with diabetes can experience enhanced sensation, reducing the risk of injuries (Agarwal et al., 2019).
  3. Improved mobility and preservation of limb function: Lifestyle modifications and glycemic control promote mobility, balance, and coordination in individuals with diabetes, reducing the risk of falls and promoting an active lifestyle (Zilliox & Russell, 2019).

Achieving these outcomes necessitates adequate resources and collaboration among stakeholders. Healthcare organizations must prioritize attentive care, while external resources such as Medicare and Medicaid programs can provide additional support (Duru et al., 2020).

Health Care System Comparative Analysis

A comparative analysis of healthcare systems in the United Kingdom and Australia reveals valuable insights into managing peripheral neuropathy. Both systems emphasize regular foot examinations, patient education, and preventive measures, offering valuable lessons for improving care in Colorado.

Rationale for the Proposed Change

The proposed changes are expected to improve outcomes for diabetic patients by preventing complications and promoting self-care. By following established guidelines and recommendations, individuals with diabetes can lead healthier lives with reduced risks of amputations and complications (Selvarajah et al., 2019).

Financial and Health Implications

Implementing the proposed changes can have significant financial and health implications, including cost savings from early intervention and improved quality of life for patients. Failure to implement these changes may result in increased healthcare costs and reduced productivity due to complications (Kiyani et al., 2020).


In conclusion, addressing peripheral neuropathy in diabetic patients is crucial for improving health outcomes in Colorado. By adopting strategies from other healthcare systems and prioritizing preventive measures, healthcare organizations can significantly enhance the well-being of individuals with diabetes.


Aalaa, M., Amini, M. R., Delavari, S., Mohajeri Tehrani, M. R., Adibi, H., Shahbazi, S., Shayeganmehr, Z., Larijani, B., Mehrdad, N., & Sanjari, M. (2022). Diabetic foot workshop: A strategy for improving the knowledge of diabetic foot care providers. Diabetes & Metabolic Syndrome: Clinical Research & Reviews16(7), 102543. 

Agarwal, P., Sharma, B., & Sharma, D. (2019). Tarsal tunnel release restores sensations in sole for diabetic sensorimotor polyneuropathy. Journal of Clinical Orthopaedics and Trauma11(3). 

Alahakoon, C., Fernando, M., Galappaththy, C., Matthews, E. O., Lazzarini, P., Moxon, J. V., & Golledge, J. (2020). Meta‐analyses of randomized controlled trials reporting the effect of home foot temperature monitoring, patient education or offloading footwear on the incidence of diabetes‐related foot ulcers. Diabetic Medicine37(8), 1266–1279.

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NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change

Duru, O. K., Harwood, J., Moin, T., Jackson, N. J., Ettner, S. L., Vasilyev, A., Mosley, D. G., O’Shea, D. L., Ho, S., & Mangione, C. M. (2020). Evaluation of a national care coordination program to reduce utilization among high-cost, high-need Medicaid beneficiaries with diabetes. Medical Care, p. 58, S14–S21. 

Hicks, C. W., & Selvin, E. (2019). Epidemiology of peripheral neuropathy and lower extremity disease in diabetes. Current Diabetes Reports19(10). 

Kiyani, M., Yang, Z., Charalambous, L. T., Adil, S. M., Lee, H.-J., Yang, S., Pagadala, P., Parente, B., Spratt, S. E., & Lad, S. P. (2020). Painful diabetic peripheral neuropathy: Health care costs and complications from 2010 to 2015. Neurology: Clinical Practice10(1), 47–57. 

NICE. (2019, October 11). Overview | Diabetic foot problems: prevention and management | Guidance | NICE

Rodríguez-Sánchez, B., Peña-Longobardo, L. M., & Sinclair, A. J. (2019). Cost-effectiveness analysis of the neuropad device as a screening tool for early diabetic peripheral neuropathy. The European Journal of Health Economics21(3), 335–349.  

Selvarajah, D., Kar, D., Khunti, K., Davies, M. J., Scott, A. R., Walker, J., & Tesfaye, S. (2019). Diabetic peripheral neuropathy: Advances in diagnosis and strategies for screening and early intervention. The Lancet Diabetes & Endocrinology7(12), 938–948. 

Zilliox, L. A., & Russell, J. W. (2019). Physical activity and dietary interventions in diabetic neuropathy: A systemic review. Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society29(4), 443–455. 

NURS FPX 6218 Assessment 1 Proposing Evidence-Based Change