1
Patient, Family, or Population Health Problem Solution Paulette Zelinsky Capella
University NURS-FPX4900 Capstone Project for Nursing
Relevance of Problem
There are over 100 million people in the United States living with prediabetes or
diabetes. (Centers for Disease Control and Prevention, 2017; Centers for Disease Control and
Prevention, n.d.-a). There were 7.2 million diabetic hospitalizations and 14.2 million diabetic
emergency room visits in 2014. (Smith et al., 2019). In the United States during 2015, diabetes
was the seventh leading cause of death. (Centers for Disease Control and Prevention, 2017;
Centers for Disease Control and Prevention, n.d.-a; Smith et al., 2019). It is higher in people with
less than high school education and is more significant in the southern united states (Centers for
Disease Control and Prevention, 2017; Centers for Disease Control and Prevention, n.d.-a) along
with the elderly. In addition, those who are 200% below the federal poverty level are at
increased risk of not being insured, and the median family insurance costs increased by 55%
over the past decade. (Adavelli, 2021).
Diabetes can be managed with diet, exercise, and correct medication usage; however, it
also increases the patient’s risk for amputations, death, heart disease, kidney failure, stroke,
and vision loss. (Centers for Disease Control and Prevention, 2017; Centers for Disease Control
and Prevention, n.d.-a). An individual with hyperglycemia will show weakness, vision changes,
increased appetite, thirst, and urination. (Belleza, 2020). They may also have neuropathy of the
extremities, dry skin, recurrent infections, and slow healing wounds. (Belleza, 2020).
Complications could be hypoglycemia, hyperglycemic hyperosmolar nonketotic syndrome
(HHNS), and diabetic ketoacidosis (DKA). (Belleza, 2020). The ability to have access to
healthcare for ethnic, racial, socioeconomic, and geographical patients is difficult. Many do not
, 2
have insurance, transportation, or providers within a reasonable distance. Nursing has the
opportunity to encourage patients with health changes and behavioral changes to reduce their
risk of diabetes type two. (Centers for Disease Control and Prevention, n.d.-b). The goal is to
educate and assist with prevention.
Intervention
Interventions can improve a patient’s health outcome among those with disparities. In
order to obtain success and patient responsiveness with an intervention, it needs to have
leadership training, assessments, family outreach, communal outreach, and follow-ups. The
introduction of consistent patient communication items includes verbal education with
simplified explanations of critical goals and behaviors, “teach-back” to assess the patient’s
comprehension and usage of picture-based education materials. The intervention consisted of
five components: 1) educational counseling and medication management; 2) evidence-based
treatment processes for glucose-lowering medications; 3) approaches to address barriers,
including lack of health insurance; 4) prevention of complications of blood glucose symptoms,
and 5) improve self-care. The patient will agree to come to sessions once a month for twelve
months.
Nursing leadership training shall be a clinician who is highly trained with substantial
resources. The nurse shall spend extra time and effort towards their training, support, and
supervision of their patients. The nurse needs to do a comprehensive assessment to determine
their patient's knowledge base and problem-solving skills, including their family, support
system, and communal resources. Assisting them with changing their behaviors for glycemic
control is lifelong and may be difficult to achieve. Using hands-on behavioral approaches in
education may be more effective as long as there are long-term follow-ups.
, 3
When influencing one’s behavior, it is important to develop trust and have them engaged.
(Markman, 2016). By engaging patients in the behaviors you would like them to do; you shall
lead by example. (Markman, 2016). Second, assist the patient with making goals, then help
them remember what those goals are. (Markman, 2016). Staring with short-term goals then
work into long-term goals. (Markman, 2016). Third, circumstances drive a person; when
working with a patient, it essential to show them different ways of doing things, not by telling
them to do them. (Markman, 2016). Thus the importance of giving them the autonomy of
making healthy decisions. Positive feedback and encouragement can increase their motivation.
(Markman, 2016).
Fourth, supporting good habits by creating consistent changes in the patient’s environment.
(Markman, 2016). Make the behaviors more desirable by making them as easy as possible to
perform. (Markman, 2016). Manipulation of the patient’s environment can assist with the
reduction of bad behaviors. (Markman, 2016). Finally, developing a good support network for
patients will assist with changing their behaviors. (Markman, 2016). Involving patient’s families
and other support systems will increase their outcomes exponentially.
Change Management
Transformational leadership in nurses can work when addressing disparities and working
with their patients. Nursing leadership wants their staff to take ownership of their roles (Cornell,
2020) to educate and treat diabetes. Including assisting the patient with the prevention of
adverse reactions to the disease. Teaching them how to think instead of being told to do.
(Cornell, 2020). It is an example of transformational leadership. (Cornell, 2020). It is a way of
motivating people to find better ways to achieve their goals. (Cornell, 2020). It can lift their
Patient, Family, or Population Health Problem Solution Paulette Zelinsky Capella
University NURS-FPX4900 Capstone Project for Nursing
Relevance of Problem
There are over 100 million people in the United States living with prediabetes or
diabetes. (Centers for Disease Control and Prevention, 2017; Centers for Disease Control and
Prevention, n.d.-a). There were 7.2 million diabetic hospitalizations and 14.2 million diabetic
emergency room visits in 2014. (Smith et al., 2019). In the United States during 2015, diabetes
was the seventh leading cause of death. (Centers for Disease Control and Prevention, 2017;
Centers for Disease Control and Prevention, n.d.-a; Smith et al., 2019). It is higher in people with
less than high school education and is more significant in the southern united states (Centers for
Disease Control and Prevention, 2017; Centers for Disease Control and Prevention, n.d.-a) along
with the elderly. In addition, those who are 200% below the federal poverty level are at
increased risk of not being insured, and the median family insurance costs increased by 55%
over the past decade. (Adavelli, 2021).
Diabetes can be managed with diet, exercise, and correct medication usage; however, it
also increases the patient’s risk for amputations, death, heart disease, kidney failure, stroke,
and vision loss. (Centers for Disease Control and Prevention, 2017; Centers for Disease Control
and Prevention, n.d.-a). An individual with hyperglycemia will show weakness, vision changes,
increased appetite, thirst, and urination. (Belleza, 2020). They may also have neuropathy of the
extremities, dry skin, recurrent infections, and slow healing wounds. (Belleza, 2020).
Complications could be hypoglycemia, hyperglycemic hyperosmolar nonketotic syndrome
(HHNS), and diabetic ketoacidosis (DKA). (Belleza, 2020). The ability to have access to
healthcare for ethnic, racial, socioeconomic, and geographical patients is difficult. Many do not
, 2
have insurance, transportation, or providers within a reasonable distance. Nursing has the
opportunity to encourage patients with health changes and behavioral changes to reduce their
risk of diabetes type two. (Centers for Disease Control and Prevention, n.d.-b). The goal is to
educate and assist with prevention.
Intervention
Interventions can improve a patient’s health outcome among those with disparities. In
order to obtain success and patient responsiveness with an intervention, it needs to have
leadership training, assessments, family outreach, communal outreach, and follow-ups. The
introduction of consistent patient communication items includes verbal education with
simplified explanations of critical goals and behaviors, “teach-back” to assess the patient’s
comprehension and usage of picture-based education materials. The intervention consisted of
five components: 1) educational counseling and medication management; 2) evidence-based
treatment processes for glucose-lowering medications; 3) approaches to address barriers,
including lack of health insurance; 4) prevention of complications of blood glucose symptoms,
and 5) improve self-care. The patient will agree to come to sessions once a month for twelve
months.
Nursing leadership training shall be a clinician who is highly trained with substantial
resources. The nurse shall spend extra time and effort towards their training, support, and
supervision of their patients. The nurse needs to do a comprehensive assessment to determine
their patient's knowledge base and problem-solving skills, including their family, support
system, and communal resources. Assisting them with changing their behaviors for glycemic
control is lifelong and may be difficult to achieve. Using hands-on behavioral approaches in
education may be more effective as long as there are long-term follow-ups.
, 3
When influencing one’s behavior, it is important to develop trust and have them engaged.
(Markman, 2016). By engaging patients in the behaviors you would like them to do; you shall
lead by example. (Markman, 2016). Second, assist the patient with making goals, then help
them remember what those goals are. (Markman, 2016). Staring with short-term goals then
work into long-term goals. (Markman, 2016). Third, circumstances drive a person; when
working with a patient, it essential to show them different ways of doing things, not by telling
them to do them. (Markman, 2016). Thus the importance of giving them the autonomy of
making healthy decisions. Positive feedback and encouragement can increase their motivation.
(Markman, 2016).
Fourth, supporting good habits by creating consistent changes in the patient’s environment.
(Markman, 2016). Make the behaviors more desirable by making them as easy as possible to
perform. (Markman, 2016). Manipulation of the patient’s environment can assist with the
reduction of bad behaviors. (Markman, 2016). Finally, developing a good support network for
patients will assist with changing their behaviors. (Markman, 2016). Involving patient’s families
and other support systems will increase their outcomes exponentially.
Change Management
Transformational leadership in nurses can work when addressing disparities and working
with their patients. Nursing leadership wants their staff to take ownership of their roles (Cornell,
2020) to educate and treat diabetes. Including assisting the patient with the prevention of
adverse reactions to the disease. Teaching them how to think instead of being told to do.
(Cornell, 2020). It is an example of transformational leadership. (Cornell, 2020). It is a way of
motivating people to find better ways to achieve their goals. (Cornell, 2020). It can lift their
