NURS FPX 9040 Assessment 3

• NURS FPX 9040 Assessment 3.

NURS FPX 9040 Assessment 3

Capella University

NURS-FPX 9040

Instructor Name

Due Date

Slide 1

NURS FPX 9040 Assessment 3 VCI Summary 9040 with Presentation

Hi, I am ___________. Good day, everyone, and thanks for joining my doctoral project presentation on the structured follow-up protocol of the ADA and how it is helping to achieve better glycemic control in adults with type 2 diabetes. This project emphasized the importance of evidence-based nursing interventions, patient education, and interdisciplinary cooperation towards improving the outcomes of patients and the quality of nursing care. Today, I’ll share with you the goal of this project and the process we went through, as well as some of the important things we learned about nurse-led diabetes care and how it affected people’s health and quality of life, and how it impacted clinical practice.

Slide 2

Introduction

The doctoral project centered on enhancing glycemic levels of adults with type 2 diabetes via the execution of a structured follow-up program as recommended by the American Diabetes Association (ADA) in an outpatient primary care clinic. This project was designed to meet a significant need in clinical practice in that 42% of the patients had HbA1c levels > 9%, whereas only 36% had HbA1c levels < 7%.

The aim of the project was to find out if an ADA-compliant nurse-led follow-up protocol would yield better glycemic results than it would without the protocol over an 8-week period. The project has clearly and successfully accomplished its goal by decreasing the HbA1c levels from 9.95% to 8.22%, which is a 1.52% decrease greater than the targeted successful decrease of 0.5%.

Slide 3: Practice Problem and Clinical Significance

Inadequate glycemic control (AGC) is a tremendous public health problem all over the world in patients with type 2 diabetes (T2D). While consistent follow-up care and education can prevent complications like cardiovascular disease, neuropathy, kidney failure, and hospitalizations, such care and education are not happening in many outpatient primary care settings. From the doctoral project, various contributing factors to the poor diabetes management at the clinical site were identified. Factors identified were disjointed scheduling practices, underutilisation of reminders in electronic health records (EHRs), poor guidance and failure of evidence to be used by multiple disciplines, and minimal patient education. The intervention in this project did just that, performing an intervention that was a blend of evidence-based nursing practices and organizational quality improvement strategies.

Slide 4

Purpose of the Doctoral Project

The main objective of the doctoral project was to see if the introduction of a structured ADA diabetes follow-up protocol would improve glycaemic control in the short term (over an 8-week period) in adults with type 2 diabetes. The project specifically focused on outpatient diabetes care, where care is often inadequate, with patients often not receiving the follow-up visits or diabetes education they need, and not keeping to their medication regimens. Baseline measurements at the project site showed that the hemoglobin A1c (HbA1c) levels of patients were higher than 9%, which represents poor glycemic control, in 42% of cases. Moreover, only 36% of the patients met the target HbA1c level of below 7%, indicating an urgent need for intervention. The results surpassed those in the nation in terms of glycemic control, indicating that a lot of problems in the management approach exist.  The project met its objectives and goals. The average level of HbA1c dropped from 9.95% to 8.22%, which was a clinically significant drop of 1.52 percentage points after implementing the intervention. This result was much better than the preestablished success rate of the project, which was a 0.5% drop in HbA1c. In addition, follow-up adherence rates were high, with 89.2% of the patients being engaged in the treatment process, which was also very feasible.

Slide 5

PICOT Question

The project’s PICOT question is: When considering a nursing staff working with adult patients who have a diagnosis of diabetes (P), what is the impact of implementing the ADA diabetes follow-up protocol (I), versus current practices (C), on glycemic control (O) over the span of 8 weeks (T)?

Carewards diabetic adult (P) is in the nursing staff’s care.

Notification of any patient on this protocol: I: ADA Diabetes Follow-up Protocol

•       C: Current Practices

O: Affects glycemic control – treats diabetes.

•       T: 8 weeks

Slide 6

Evidence-Based Intervention

The project’s intervention was an eight-week diabetes follow-up protocol, which was structured and delivered via ADA. Multiple evidence-based interventions were found in the intervention (employed to improve glycemic control and patient self-management behaviors). Educational sessions on diabetes pathophysiology, medication management, patient education techniques, and documentation in EHR were held for the nursing staff. SIM exercises, case-based learning, and peer mentoring exercises were added to enhance nursing competency and promote clinical competence by following ADA guidelines. This was checked on patients’ health through a weekly checkup done by the nursing staff and health workers. On the visits, the nurses would check the blood glucose monitoring charts, remind parents/ carers about medication, and give individual education and advice on lifestyle changes relating to diet and exercise. Additionally, the project involved technology-enhanced interventions such as telehealth consultation and computer-based reminders using EHRs. Using these tools helped increase appointment attendance,  improved the way patients communicate, and also improved the continuity of care for patients with transportation issues or difficulties with appointments.

Slide 7 and 8

Outcomes of the Doctoral Project

The results of the doctoral project resulted in substantial gains in all three areas of the clinical, behavioral, and operational. The main endpoint was a measure of the reduction in the HbA1C level in patients who enrolled in the trial. The mean HbA1c level was slightly lowered by 1.52 percent after implementation of the structured ADA follow-up protocol, which showed a clinically significant result in the control of HbA1c level. There were several secondary outcomes that supported the effectiveness of the intervention. The mean scores of the nurses ranged from 59.0% prior to training to 85.4% after the nurses attended the educational program. Seven of the eight nursing staff members participated, and all of them scored more than 80% on the competency.

There was a significant improvement in patient self-management behaviors as well during the project period. About 70% of the patients showed complete adherence to medicines, and 65% of patients performed well with frequent (routine) blood glucose monitoring. Also, the completion of the follow-up visits was high, with 89.2% of them actually being completed. While 10% of patients had HbA1c levels under 7% after the eight-week period, the results of this project were significant and showed that results may be even more pronounced if implemented over longer periods of time.

Slide 9

Contribution to Nursing Knowledge and Best Practices

The doctoral project expanded the nursing knowledge and best practices on the management of chronic diseases. The project highlighted the need for nurse-led interventions that are structured and can enhance patient outcomes, and the effectiveness of embedding evidence-based practice protocols into the routine care of patients. Some major findings from the project included the following aspects of healthcare practices that were conducive to greater glycemic control: The use of a standardized diabetes follow-up system was shown to improve glycemic control. Education through nurses improves knowledge of patients’ self-management behaviors.  Besides, telehealth and EHR systems help increase ease of access and follow-up adherence. Developing competencies in a structured way enhances the performance of nurses. Working in an interdisciplinary team helps to promote continuity and quality of care.  The project also helped to develop the body of knowledge regarding quality improvement, specifically by showing that this model of combining various elements of clinical education, technology integration, and patient-centered care strategies in outpatient primary care settings is effective.

Slide 10

Key Audience Takeaways

The doctoral project offers several pearls for healthcare professionals, nursing leaders, educators, and healthcare organizations. First, project results showed that when using evidence-based nurse-led interventions (ENLIs), there is measurable change in chronic disease outcomes within relatively short time frames of implementation. Appropriate follow-up care gave patients better control of their blood sugar levels, better adherence to care, and improved nurses’ competency. Second, this project emphasized the need for continual education and self-management assistance for patients. Patients who were consistently educated and reinforced with an instruction to adhere to medication and blood sugar monitoring showed increased adherence to medication and blood sugar monitoring. Third, the project highlighted the importance of using technology for chronic disease management. Telehealth consultations and EHR reminders increased patients’ access to services, patients’ rate of follow-up completion, and helped with the continuity of care. Thirdly, the project showed the need for interdisciplinary health teamwork and collaboration to improve health care. Effective interprofessional working with nurses, providers, care coordinators, and teachers was a factor in the success of implementation and engagement of patients. Last, but not least, the project highlighted the importance of nursing leadership in the enactment of change within the organization, in the advancement of evidence-based nursing practice, and in the improvement of health care outcomes.

Slide 11

Conclusion

The doctoral project successfully proved that it was possible to monitor and deliver the diabetes follow-up according to a structured ADA diabetes follow-up protocol, and this had a beneficial effect on the glucose control of adult patients with type 2 diabetes in an outpatient clinic of the GPs. The project made significant improvements in the outcomes of the patients, nursing competency, and follow-up adherence through evidence-based nursing interventions, structured education, integration with telehealth, and interdisciplinary collaboration. Overall, the project met its goal of lowering average (HA1C) levels (from 9.95% to 8.22%), nurse competency scores, and patient self-management behaviors. The conclusions were useful for advancing nursing knowledge by confirming the importance of using nurse-led chronic disease management and evidence-based quality improvement strategies. In broad terms, the doctoral project showed that the higher level of nursing leadership, evidence-informed practice, and systematic approach to healthcare quality improvement can lead to sustainable changes in healthcare that resonate with the organization’s vision and the national theme in disease management of chronic conditions.

Related assessments for this class:

NURS FPX 9040 Assessment 1
NURS FPX 9040 Assessment 2
NURS FPX 9040 Assessment 4
NURS FPX 9040 Assessment 5