NURS-FPX6021 Analyze a professional environment and relevant data, and develop a change strategy (3-5 pages) and discuss how to implement it successfully | Assignment Solution

Analyze a professional environment and relevant data, and develop a change strategy (3-5 pages) and discuss how to implement it successfully.

Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, it is recommended that you complete the assessments in this course in the order in which they are presented.

Knowing the best practice for our patients is very important in providing safe and effective care. Understanding best practices can help nurses identify areas of care that need to be improved. To identify areas of need, nurses must use evidence from various sources, such as the literature, clinical practice guidelines (CPG), professional organization practice alerts or position papers, and protocols. These sources of evidence can also be used to set goals for improvement and best practices with an eye toward improving the care experience or outcomes for patients.

The challenge facing many care environments and health care practitioners is how to plan for change and implement changes. For if we cannot effectively implement changes in practice or procedure, then our goals of improving care will likely amount to nothing. This assessment focuses on allowing you to practice locating, assessing, analyzing, and implementing change strategies in order to improve patient outcomes related to one or more clinical goals.

This assessment will take the form of a data table to identify areas for improvement and to set one or more outcome goals, as well as a narrative describing a change plan that would help you to achieve the goals you have set.

Professional Context

One area in health care that it is necessary to consider is the environment in which nurses work. It is important that this environment evolves and changes so that all patients are adequately supported. For this assessment, you will develop a change strategy to improve the health care environment. These changes can be rooted in a desire to improve clinical outcomes and data related to assessment accuracy, drug administration, or disease recovery rates. A key skill for master’s-level nurses is to be able to evaluate clinical data and create a change plan to help drive improvements in the data to reach set goals.

Scenario

Consider a current environment. This could be your current care setting, the care setting presented in the scenario Vila Health: Using Concept Maps for Diagnosis, or a care setting in which you are interested in working. For the setting that you choose you will need to have a data set that depicts sub-optimal outcomes related to a clinical issue.

This data could be from existing sources in the course, a relevant data set that already exists (a data set from the case study you used as a basis for your previous Concept Map assessment or from your current place of practice), or an appropriate data set that you have created yourself. (Note: if you choose to create your own data set, check with your instructor first for approval and guidance.)

After you have selected an appropriate data set, use your understanding of the data to create at least one realistic goal (though you may create more) that will be driven by a change strategy appropriate for the environment and goal.

Potential topics for this assessment could be:

• • Consider ways to help minimize the rate of secondary infections related to the condition, disease, or disorder that you focused on for your previous Concept Map assessment. As a starting point, you could ask yourself, “What could be changed to facilitate safety and minimize risks of infection?”
  • Consider how to help a patient experiencing traumatic stress or anxiety over hospitalization. As a starting point, you could ask yourself, “How could the care environment be changed to enhance coping?”

Once you determine the change you would like to make, consider the following:

• • What data will you use to justify the change?
  • How can the team achieve this change with a reasonable cost?
  • What are the effects on the workplace?
  • What other implementation considerations do you need to consider to ensure that the change strategy is successful?
  • How does your change strategy address all aspects of the Quadruple Aim, especially the well-being of health care professionals? Get Individual Success Plan Homework Help Now!!
    
  • Once the change strategy is implemented, how would you evaluate the efficiency and effectiveness of the care system if the desired outcomes are met?

Instructions

Your assessment submission should include a data table that illustrates the current and desired states of the clinical issue you are attempting to improve through your application of change strategies. Additionally, you will need to explain the rationale for your decisions around your chosen change strategies, as well as how the change strategies will be successfully implemented.

The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your change strategy addresses all of them. You may also want to read the Change Strategy and Implementation scoring guide and Guiding Questions: Change Strategy and Implementation [DOCX] to better understand how each grading criterion will be assessed.

• • Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.
  • Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.
  • Justify the specific change strategies used to achieve desired outcomes.
  • Explain how change strategies will lead to quality improvement with regard to safety and equitable care.
  • Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.
  • Communicate the change plan in a way that makes the data and rationale easily understood and compelling.
  • Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.

Example assessment: You may use the assessment example, Assessment 2 Example [PDF], to give you an idea of what a Proficient or higher rating on the scoring guide would look like.

Submission Requirements

• • Length of submission: 3–5 double-spaced, typed pages, not including the title and reference pages. Your plan should be succinct yet substantive.
  • Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that supports your goal setting, proposed change strategies, quality improvement, and interprofessional considerations. Resources should be no more than five years old.
  • APA formatting: The APA Template Tutorial [DOCX] can help you in writing and formatting your analysis. No abstract is required.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• • Competency 1: Design patient-centered, evidence-based, advanced nursing care for achieving high-quality patient outcomes. 

• • • Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.

• • Competency 2: Develop change strategies for improving the care environment. 

• • • Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.

• • • Justify the specific change strategies used to achieve desired outcomes.

• • Competency 3: Apply quality improvement methods to practice that promote safe, equitable quality of care. 

• • • Explain how change strategies will lead to quality improvement with regard to safety and equitable care.

• • Competency 4: Evaluate the efficiency and effectiveness of interprofessional care systems in achieving desired health care improvement outcomes. 

• • • Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.

• • Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards. 

• • • Convey purpose of the assessment narrative in an appropriate tone and style, incorporating supporting evidence, and adhering to organizational, professional, and scholarly communication standards.

SAMPLE ANSWER

Change Strategy and Implementation

Alexandra Sanders Capella University

NURS-FPX6021 Biopsychosocial Concepts for Advanced Nursing Practice 1 Dr. Katie Hooven

November 2021

Change Strategy and Implementation

An overwhelming 10.5 percent of the American population has been diagnosed with diabetes (National Institute of Diabetes and Digestive and Kidney Diseases, n.d.) Diabetes is a chronic metabolic disease characterized by elevated blood glucose levels that can lead over time to severe damage to the heart, blood vessels, eyes, kidneys, and nerves (World Health Organization [WHO], 2021). When blood glucose levels run too high, diabetes occurs. There are three main types of diabetes: type I, type II, and gestational.

In type I, the body does not produce insulin. People with type I are placed on insulin and a proper diet and exercise to live productive lives. Type II diabetes is the most common form of diabetes. In type II, bodies do not use insulin properly. A proper diet and exercise regimen helps treat type II along with insulin or oral medication. Gestational diabetes occurs in women who are pregnant who have never had a diagnosis of diabetes. It is treated much like type II (American Diabetic Association [ADA], 2021).

Diabetes is very underrated as a global health issue. It is considered the greatest epidemic in human history, affects the highest number of people globally, and costs the most money in treatment and research (Zimmet, 2017). Nearly 422 million people worldwide have diabetes, the majority living in low-and middle-income countries, and 1.5 million deaths are directly attributed to diabetes each year (World Health Organization [WHO], 2021). Globally the target goal is to stop the rise in diabetes and obesity by 2025.

Several factors come into play to improve quality of life and longevity when dealing with diabetes and patients with diabetes. Patients need to understand what diabetes is and how it affects their bodies; they need support from family, friends, and healthcare staff. One of the most critical factors in diabetes is understanding the ramifications of being non-compliant with their diabetes.

Kidney Disease and Diabetes

Chronic kidney disease (CKD) is a common diagnosis in patients with diabetes. CKD can be a devastating diagnosis and lead to shorter life spans and poor quality of life (McFarlane et al., 2018). Damage to the kidneys can lead to kidney failure and ultimately need for dialysis or transplant. Ensuring that blood glucose levels are kept under control, eating a healthy diet, and maintaining a healthy weight can help decrease the chances of a diabetic developing CKD (The Cleveland Clinic, n.d.).

Depression and Diabetes

Being diagnosed with diabetes can lead to emotions of stress, grief, and frustration. These emotions can trigger depression. In newly diagnosed patients, depression is commonly seen but can also affect patients who have had diabetes a long time. Emotional issues can lead to poor diet, lack of exercise, and higher blood glucose levels (The Cleveland Clinic, n.d.). Patients with diabetes are more likely to suffer from depression than a patient without diabetes.

Change Strategies

When patients are diagnosed with diabetes, they must understand and make an effort to learn more about diabetes and its diagnosis. Education is the foundation for the management and care of diabetes and is an essential part of health planning. It involves the patient and their family, diabetes care team, community, and decision-makers in the education process (Rashed et al., 2016). Healthcare providers should enhance the quality of patient care by providing multimedia diabetes health education (Huang et al., 2016). Teaching patients about a healthy diet, exercise, taking medications, and reducing stress are some of the critical components to controlling diabetes (Centers for Disease Control and Prevention [CDC], 2021).

The Diabetes Knowledge Questionnaire ( DKQ-24) is a tool used to test patients’ knowledge of diabetes. In one, 50 patients took the DKQ-24, and they got sixty percent of the questions correct. The majority of these participants had had prior diabetes education. The study showed that providing adequate education is imperative to reduce the burden of this condition (Formosa & Muscat, 2016). For patients to understand diabetes, a multidisciplinary team is necessary. The team would consist of a primary care physician, nurse educator, dietician, and patient family. If indicated, an endocrinologist and podiatrist could be added to the team.

Diabetic foot care is one of the number one needs of a diabetic patient. Proper footwear and proper care of the feet can decrease the chances of diabetic foot ulcers and potential loss of limbs. A nurse and or podiatrist can teach about foot care. A dietician and diabetic education are crucial members of the team. They help pave the way for proper nutrition and food selection and teach how food affects blood glucose levels. Teaching how to check blood glucose levels and how to take medication are essential roles of these clinicians. Having this multidisciplinary team helps the primary care physician and the patient to manage diabetes better.

Ensuring patients have support from family and mutual trust for the healthcare team aids in giving a positive outlook for the patient regarding the diabetes diagnosis and necessary lifestyle changes. The support leads to compliance from the patient also. Noncompliance in diabetes can lead to kidney disease, heart disease, loss of eyesight, and loss of limbs, to name a few (Lofty et al., 2017).

Teaching patients about checking blood glucose levels regularly, the importance of taking medications, coping mechanisms, and overall understanding and managing the disease will help patients to lead healthier lives. It is crucial to know a patient’s educational level when teaching begins and to assess learning frequently. Difficulties may arise if patients are unable to comprehend teaching. In these cases, the educators will need to work with the patient and understand how they best learn and apply the education in a form that is understandable to the patient.

Treating the depression may necessitate placing the patient on medications. Including psychotherapy may also be helpful. Support groups may also be beneficial. Feeling physically good with diabetes is half the battle and feeling mentally sound is the other half (American Diabetic Association [ADA], 2021). Not all patients are willing to admit they need help, and not all accept help. They may be embarrassed or not inclined to share their feelings with others. This may cause a challenge in getting help.

Conclusion

Diabetes, if not appropriately managed, can lead to heart and kidney issues, blindness, loss of limbs, and even death. When patients are appropriately educated on diabetes and the other risk factors related to the disease, they are more likely to live longer. Helping patients who develop depression due to the stress and emotional toll diabetes can have on them improves their quality of life.

All patients should have access to the healthcare and education they deserve, regardless of socioeconomic status. Assuming a patient does not want or can not afford treatments or medications places that patient in a position for increased complications. Making care easy to access and understand will help all patients suffering from diabetes and its comorbidities.

Having an open and trusting relationship with their healthcare provider will enable a patient to feel free to discuss issues and concerns. They may not want to take medications for depression or seek out support groups due to the stigma attached to reaching out for help (Martinez et al., 2017). A patient with an interprofessional team caring for them will have the best chance of succeeding and managing their diabetes.

References

American Diabetic Association. (2021). The path to understanding diabetes starts here.

https://www.diabetes.org/. https://www.diabetes.org/diabetes

Centers for Disease Control and Prevention. (2021, August 10). Diabetes education and support. https://www.cdc.gov. https://www.cdc.gov/diabetes/managing/education.html

Formosa, C., & Muscat, R. (2016). Improving diabetes knowledge and self-care practices.

Journal of the American Podiatric Medical Association, 106(5), 352–356. https://doi.org/10.7547/15-071

Huang, M.-C., Hung, C.-H., Yu, C.-Y., Berry, D. C., Shin, S.-J., & Hsu, Y.-Y. (2016). The effectiveness of multimedia education for patients with type 2 diabetes mellitus. Journal of Advanced Nursing, 73(4), 943–954. https://doi.org/10.1111/jan.13194

Lofty, M., Adeghate, J., Kalasz, H., Singh, J., & Adeghate, E. (2017). Chronic complications of diabetes mellitus: a mini review. Current Diabetes Reviews, 13(1), 3–10. https://www.ingentaconnect.com/content/ben/cdr/2017/00000013/00000001#expand/collapse

Martinez, L. R., Xu, S., & Hebl, M. (2017). Utilizing education and perspective taking to remediate the stigma of taking antidepressants. Community Mental Health Journal, 54(4), 450–459. https://doi.org/10.1007/s10597-017-0174-z

McFarlane, P., Cherney, D., Gilbert, R. E., & Senior, P. (2018). Chronic kidney disease in diabetes. Canadian Journal of Diabetes, 42, S201–S209. https://doi.org/10.1016/j.jcjd.2017.11.004

National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Diabetes Statistics. https://www.niddk.nih.gov. https://www.niddk.nih.gov/health-information/health-statistics/diabetes-statistics#:~:text=Diabetes%20Facts%20and%20Statistics%201%20Total%3A%20An%20estimated,are%20undiagnosed%20%2823.8%20percent%20of%20people%20with%20diabetes%29.

Rashed, O. A., Sabbah, H., Younis, M. Z., Kisa, A., & Parkash, J. (2016). Diabetes education program for people with type 2 diabetes: An international perspective. Evaluation and Program Planning, 56, 64–68. https://doi.org/10.1016/j.evalprogplan.2016.02.002

The Cleveland Clinic. (n.d.-a). Diabetes: stress & depression. https://my.clevelandclinic.org. https://my.clevelandclinic.org/health/articles/14891-diabetes-stress–depression

The Cleveland Clinic. (n.d.-b). Kidney disease / chronic kidney disease. https://my.clevelandclinic.org. https://my.clevelandclinic.org/health/diseases/15096-kidney-disease-chronic-kidney-disease

World Health Organization. (2021). Diabetes. https://www.who.int. https://www.who.int/health-topics/diabetes#tab=tab_1

Zimmet, P. Z. (2017). Diabetes and its drivers: The largest epidemic in human history? Clinical Diabetes and Endocrinology, 3(1). https://doi.org/10.1186/s40842-016-0039-3