NURS FPX 6021 Assessment 3 Quality Improvement Presentation Poster

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Capella university

NURS-FPX 6021 Biopsychosocial Concepts for Advanced Nursing Practice 1

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Date

Change Strategy and Implementation

 Renal failure is a complicated medical condition that can arise due to uncontrolled diabetes and Chronic Kidney Disease (CKD). In this state of health, kidneys cannot efficiently eliminate nitrogenous waste from the blood. There can be two types of renal failure: chronic and acute renal failure (Bindroo et al., 2023). According to the World Health Organization (WHO) report, diabetes and kidney complications from diabetes resulted in approximately 2 million fatalities in a year (WHO, 2023). This assessment aims to analyze the current patient healthcare data to propose a change strategy. The later part of the assessment also discusses effective means to improve outcomes in renal failure patients with uncontrolled diabetes for a long time.

Data Table Reflecting Clinical Outcomes

The table below outlines the current and desired states of several clinical outcomes related to kidney failure caused by uncontrolled diabetes. Furthermore, it suggests interventions to improve and achieve optimal results in improving a patient’s condition. By using the outlined evidence-based strategies, nurses can enhance patient healthcare safety. They can also reduce the incidence of kidney failure resulting from unmanaged diabetes. 

Current Outcomes	Expected Outcomes	Change Strategies
Rising incidences of late-stage diabetic nephropathy diagnosis (Goro et al., 2019).	Reducing late-stage diabetic nephropathy incidences through management of diabetic symptoms (Burrows et al., 2020)	Implement an awareness campaign to educate on early symptoms and the importance of routine check-ups (Hussain et al., 2019).
Insufficient patient knowledge of diabetes, kidney health, and stress management (Hussain et al., 2019).	Enhance patient understanding of the diabetes-kidney connection with emotional health (Numsang et al., 2023).	Implementation of patient education workshops focusing on diabetes management, renal health, and mental health (Burrows et al., 2020).
Inadequate infrastructure for renal care in remote areas (Higa et al., 2020).	Improve renal care through remote monitoring in diabetes patients (Higa et al., 2020).	Mobilize resources to establish mobile renal care clinics for outreach in remote areas (McLendon et al., 2019).
Delay in referrals from general physicians to renal specialists (Goro et al., 2019).	Engage diabetic patients with renal experts to overcome the problem (McLendon et al., 2019).	Conduct training sessions for general physicians on when to refer patients and streamline referral processes (Goro et al., 2019).

 

Areas of Uncertainty

The current analysis has various areas of ambiguity and uncertainty that need further data to clarify. To understand diabetic renal failure risk factors, nurses need comorbidity data. Furthermore, there is a requirement for data regarding the efficacy of interventions and their influence on patient outcomes, which could inform the creation of more focused initiatives (McLendon et al., 2019). For informed decision-making, longitudinal data on diabetic renal failure rates and patient care is essential (Numsang et al., 2023). Also, a cost analysis of the proposed interventions is needed to show whether the interventions are economically feasible. Moreover, patient viewpoints and experiences can help determine the acceptability and feasibility of clinical environment modifications (Burrows et al., 2020). 

Proposed Change Strategy

The change strategy can enhance diabetic renal failure clinical outcomes. Evidence-based change methods can contribute to achieving the desired state of enhanced clinical outcomes in diabetic renal failure (Siaw & Lee, 2019). The below-discussed strategies aim to improve health outcomes by addressing prevention, early identification, education, accessibility, and patient participation.

Care Coordination and Interdisciplinary Teams

Implementing a multidisciplinary care team approach incorporates a diverse range of healthcare professionals, such as physicians, nurses, pharmacists, and others (Siaw & Lee, 2019). The collaborative approach promotes well-coordinated patient care by fostering improved communication and information sharing among healthcare team members (Numsang et al., 2023). By working together, healthcare specialists can effectively prevent medical errors and enhance patients’ adherence to the treatment process (Numsang et al., 2023).

 Patient-Centered Care and Shared Decision-Making

Nurses can promote patient-centered care by involving patients in the decision-making process regarding their treatment plans. A patient-centered approach empowers individuals to take a more active role in their healthcare and fosters informed decision-making and engagement (Galassi et al., 2019). Patients who collaborate with their care team and provide updates on their renal health management are more likely to receive timely treatment. Healthcare officials can enhance patient satisfaction by ensuring that patients are well-informed about their treatment intervention. It also ensures that the proposed intervention does not violate the ethical rights of patients (Galassi et al., 2019). 

Implementation of Telemedicine

 Through telemedicine, medical personnel can observe a patient’s renal health. The hospital administration needs to establish telemedicine platforms to facilitate remote consultations and monitoring of diabetic patients. It ensures that timely interventions can be implemented to reduce the risk of renal failure (Higa et al., 2020). The use of innovative technologies like conducting video meetings keeps the care team updated with patients’ current health status. Nurses can stay updated on patients’ conditions and guide self-management strategies (McLendon et al., 2019). Additionally, telemedicine allows patients to schedule appointments with renal specialists without disturbance. It ensures that patients can seek timely consultations without unnecessary delays that can be caused due to traveling (Higa et al., 2020). 

Potential Difficulties and Solutions

Understanding the possible challenges in adopting change strategies is essential for efficient planning and implementation. For instance, traditional care model-using healthcare providers may resist change. It is recommended to establish training and teaching programs for healthcare staff to address this issue. Furthermore, adding new technology, like telemedicine platforms, may require infrastructure and staff training (Hussain et al., 2019). This difficulty can be overcome by employing a systematic implementation strategy, which enables the workforce to adjust gradually. Due to health literacy and patient preferences, ensuring patient engagement in shared decision-making is challenging (Siaw & Lee, 2019). 

Tailored educational resources and assistance can be created to specifically target these variations, promoting the active involvement of patients. For ongoing improvement and optimization of change strategies, feedback systems will be needed to evaluate strategy effectiveness and mitigate emerging difficulties. Healthcare organizations can improve implementation and clinical outcomes by anticipating these issues (Galassi et al., 2019).

Justification of Change Strategy 

Interdisciplinary teams, patient-centered care, and telemedicine were chosen for diabetic renal care due to their proven efficacy in solving complex healthcare issues. These solutions are based on empirical evidence and research that indicates their beneficial effect on patient outcomes (Bindroo et al., 2023). Interprofessional teams use their experience to provide holistic and well-coordinated patient care. Reduced medical errors and improved team communication have optimized healthcare processes and patient happiness (Bandiera et al., 2022).

Furthermore, a patient-centered approach acknowledges the significance of engaging patients in care decisions and treatment regimens. Research has indicated that actively engaged patients are more likely to follow treatment regimens, improving clinical outcomes. This approach values patients’ autonomy and desires, giving them ownership of their health journey (Buades et al., 2021).

Furthermore, telemedicine has become increasingly prominent as an effective way to tackle accessibility challenges, specifically for patients residing in distant or underserved regions. Remote consultations and monitoring allow healthcare providers to reach more patients and reduce kidney problems (Parsegian et al., 2021). A well-rounded approach to diabetic renal care improvement requires impartially considering different views, such as potential downsides or problems, when implementing these solutions (Truong et al., 2020).

Change Strategy Leading to Quality Improvement

Implementing interdisciplinary teams, a patient-centered approach, and telemedicine will improve diabetic kidney care, especially safety, and equity. Interdisciplinary teams facilitate the collaboration of healthcare specialists from different fields, promoting a synergistic environment that improves patient safety (Bandiera et al., 2022). These teams can identify and prevent prescription mistakes and missed kidney health evaluations by communicating and making decisions together. Collaboration ensures that all patient care factors are considered, enhancing safety and providing more complete care (Parsegian et al., 2021). 

A patient-centered approach involves patients in care decisions and treatment regimens, enhancing safety. Patients are more likely to report adverse events, voice safety concerns, and follow safety measures when informed, engaged, and respected (Gembillo et al., 2021). This collaboration with patients improves the detection and avoidance of potential safety risks, resulting in a more secure healthcare setting (Buades et al., 2021).

Telemedicine also improves safety and equity by providing specialized consultations and monitoring. Renal care expertise is made equally accessible to patients in remote or underdeveloped areas, thereby minimizing gaps in healthcare delivery. Telemedicine also allows rapid interventions and monitoring to identify safety risks (Truong et al., 2020). Healthcare workers can deliver equitable and safe patient care across geographic areas using remote technology without disturbance. Healthcare systems can improve diabetic kidney care quality, safety, and equity by combining these measures (Awdishu et al., 2019).

Assumptions

 It assumes that healthcare personnel can align with the perspective of one another during interdisciplinary teamwork and adopt a patient-centered approach. They also acknowledge the advantages of proposed strategies to achieve better patient outcomes (Bandiera et al., 2022). It also assumes that patients are willing to participate in their care and that healthcare providers can engage and educate them (Buades et al., 2021). Furthermore, telemedicine technology is readily available and enables remote consultations and monitoring. That healthcare organizations have the infrastructure and resources to support these strategies is also assumed (Truong et al., 2020). 

Change Strategy Using Interprofessional Considerations

The effective implementation of change initiatives in diabetic renal care depends on properly considering interprofessional factors. Creating a culture of collaboration among healthcare providers is essential (Gembillo et al., 2021). This entails acknowledging and valuing each team member’s proficiency, responsibilities, and contributions. Healthcare practitioners from different fields can collaborate to treat diabetic renal patients by communicating and understanding each other. Regular interdisciplinary meetings and case discussions can help the healthcare team share information and make decisions to improve diabetic renal care patient outcomes.

Furthermore, interprofessional education and training are crucial elements for the effective execution of a plan. Healthcare practitioners must operate well in interdisciplinary teams (Awdishu et al., 2019). Training programs can improve team communication and patient care by closing knowledge gaps. Furthermore, interprofessional considerations also involve patients as active partners in the healthcare team. Empowering patients to ask questions and actively participate in shared decision-making promotes rights and ensures that their unique concerns are incorporated into the treatment plan. Interprofessional concepts in the healthcare team and patient involvement can help execute these change methods and improve diabetic renal care (Awdishu et al., 2019).

Assumptions

The assumption is that healthcare professionals are willing to collaborate across disciplines and change their techniques to function as a team. Furthermore, it assumes that healthcare institutions possess the necessary resources and dedication to offer their personnel interprofessional education and training initiatives (Gembillo et al., 2021). Successful patient engagement in interprofessional care teams requires patients to be responsive and capable of actively participating in their treatment decisions (Awdishu et al., 2019).

Conclusion 

Diabetic renal failure patient outcomes data shows the urgent need for targeted healthcare improvement initiatives. The research shows that uncontrolled diabetes causes kidney failure, requiring treatment adherence, expert access, and patient education. A comprehensive and diverse strategy for change is suggested to resolve these problems and attain the desired clinical results. This strategy optimizes care coordination, patient participation, and accessibility with interdisciplinary care teams. Furthermore, nurses also need to focus on adapting patient-centered care and telemedicine. The efficient cooperation among healthcare practitioners and the involvement of patients in their care can reduce the incidences of renal health complications in patients with diabetes.

References 

Awdishu, L., Moore, T., Morrison, M., Turner, C., & Trzebinska, D. (2019). A primer on Quality Assurance and performance improvement for interprofessional chronic kidney disease care: A path to joint commission certification. Pharmacy, 7(3), 83. https://doi.org/10.3390/pharmacy7030083

Bandiera, C., Lam, L., Locatelli, I., Dotta-Celio, J., Duarte, D., Wuerzner, G., Pruijm, M., Zanchi, A., & Schneider, M. P. (2022). Understanding reasons and factors for participation and non-participation to a medication adherence program for patients with diabetic kidney disease in Switzerland: A mixed methods study. Diabetology & Metabolic Syndrome, 14(1), 140. https://doi.org/10.1186/s13098-022-00898-7

NURS FPX 6021 Assessment 3 Quality Improvement Presentation Poster

Bindroo, S., Rodriguez, B. S. Q., & Challa, H. J. (2023). Renal Failure. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519012/#:~:text=The%20term%20renal%20failure%20denotes

Buades, J. M., Craver, L., Del Pino, M. D., Prieto-Velasco, M., Ruiz, J. C., Salgueira, M., de Sequera, P., & Vega, N. (2021). Management of kidney failure in patients with diabetes mellitus: What are the best options? Journal of Clinical Medicine, 10(13), 2943. https://doi.org/10.3390/jcm10132943

Burrows, N. R., Zhang, Y., Hora, I., Pavkov, M. E., Sheff, K., Imperatore, G., Bullock, A. K., & Albright, A. L. (2020). Sustained lower incidence of diabetes-related end-stage kidney disease among American Indians and Alaska Natives, blacks, and Hispanics in the U.S., 2000–2016. Diabetes Care, 43(9), 2090–2097. https://doi.org/10.2337/dc20-0495

Galassi, A., Ciceri, P., Fasulo, E., Carugo, S., Cianciolo, G., & Cozzolino, M. (2019). Management of secondary hyperparathyroidism in chronic kidney disease: A focus on the elderly. Drugs &Amp; Aging, 36(10), 885–895. https://doi.org/10.1007/s40266-019-00696-3

NURS FPX 6021 Assessment 3 Quality Improvement Presentation Poster

Gembillo, G., Ingrasciotta, Y., Crisafulli, S., Luxi, N., Siligato, R., Santoro, D., & Trifirò, G. (2021). Kidney disease in diabetic patients: From pathophysiology to pharmacological aspects with a focus on therapeutic inertia. International Journal of Molecular Sciences, 22(9), 4824. https://doi.org/10.3390/ijms22094824 

Goro, K. K., Wolide, A. D., Dibaba, F. K., Fufa, F. G., Edilu Tufa, B., & Mulisa Bobasa, E. (2019). Patient awareness, prevalence, and risk factors of chronic kidney disease among diabetes mellitus and hypertensive patients at Jimma University Medical Center, Ethiopia. BioMed Research International, 2019, 1–8. https://doi.org/10.1155/2019/2383508

Higa, C., Davidson, E. J., & Loos, J. R. (2020). Integrating family and friend support, information technology, and diabetes education in community-centric diabetes self-management. Journal of the American Medical Informatics Association, 28(2), 261–275. https://doi.org/10.1093/jamia/ocaa223

Hussain, S., Habib, A., & Najmi, A. K. (2019). Limited knowledge of chronic kidney disease among type 2 diabetes mellitus patients in India. International Journal of Environmental Research and Public Health, 16(8), 1443. https://doi.org/10.3390/ijerph16081443 

McLendon, S. F., Wood, F. G., & Stanley, N. (2019). Enhancing diabetes care through care coordination, telemedicine, and education: Evaluation of a rural pilot program. Public Health Nursing, 36(3), 310–320. https://doi.org/10.1111/phn.12601

Numsang, P., Oumtanee, A., Kurat, S., Sananok, R., Kraichan, S., & Sarapoke, P. (2023). Failure to control blood sugar experiences of persons with type 2 diabetes mellitus. International Journal of Nursing Sciences, 2023, 4. https://doi.org/10.1016/j.ijnss.2023.09.004

Parsegian, K., Trivedi, R., & Ioannidou, E. (2021). Renal diseases. Burket’s Oral Medicine, 579–626. https://doi.org/10.1002/9781119597797.ch16

NURS FPX 6021 Assessment 3 Quality Improvement Presentation Poster

Siaw, M. Y., & Lee, J. Y.-C. (2019). Multidisciplinary collaborative care in the management of patients with uncontrolled diabetes: A systematic review and meta-analysis. International Journal of Clinical Practice, 73(2), 13288. https://doi.org/10.1111/ijcp.13288

Truong, T., Dittmar, M., Ghaffari, A., & Lin, E. (2020). Policy and pandemic: The changing practice of nephrology during the coronavirus disease-2019 outbreak. Advances in Chronic Kidney Disease, 27(5), 390–396. https://doi.org/10.1053/j.ackd.2020.06.003

WHO. (2023). Diabetes. who.int. https://www.who.int/news-room/fact-sheets/detail/diabetes