NURS FPX 6011 Assessment 1: Evidence-Based Patient-Centered Needs Assessment
Diabetes among the elderly of 65 years and above is on the increase with the general ageing of the population. The mortality rate of diabetics among the aged 65+ will be 33%. The elderly are at risk of complications of diabetes, which include low blood sugar (called hypoglycemia), kidney failure, and heart disease, more than younger individuals with diabetes. New and emerging information could enable physicians to diagnose and treat the elderly with diabetes more effectively. These factors should be taken into consideration in order to enhance health and quality of life. The elderly are prone to cognitive impairment, cardiovascular disease, and other illnesses, which make it more difficult to educate and control diabetes. The elderly need Glycemic management, hyperlipidemia and hypertension treatment. Diabetic patients receiving self- management support (SMS) tend to take their medication as prescribed, experience less stress due to their condition, and experience better health. The question of whether the SMS models are acceptable to patients, practical, and sustainable to the primary care practices remains unclear. Therefore, there is a need to provide translation of this research into practice as outlined in NURS FPX 6011 Assessment 1.
Significance of Addressing Patient Engagement in the Management of Diabetes
Patient engagement (PE) is becoming an increasingly credited element of improvement in health behaviors and results as chronic diseases are treated, such as type 2 diabetes (Rutten et al., 2020). Patient engagement is generally accepted as a key element of high-quality healthcare provision in the situation of chronic conditions, as emphasized in the evidence-based patient-centered concept map. Patient involvement as a means of treating and controlling type-2 diabetes and more so in high-risk individuals has not declined in significance. Whole-person-centered treatment resulted in increased amounts of activity, a more optimistic attitude towards diabetes, and a slightly improved clinical outcome, as reported by patients with
diabetes (Rutten et al., 2020). Person-centered care may also involve increased participation of patients, but fast health outcomes improvements must be reconsidered in the context of NURS FPX 6011 Assessment 1. The direct impact of patient engagement is better health results and lower healthcare expenses, turning people into active participants in their treatment.
On the other hand, wastage of healthcare resources and poor clinical outcome are the threats to uninvolved patients. Patient participation in treatment planning by incorporating the values and preferences of patients has enhanced the services and outcomes, as highlighted in the patient centered concept map (Rutten et al., 2020). Care coordination of older persons with diabetes, providing both health and social care in a tailored, integrated manner is a popular strategy.
The concept of self-care in individuals with diabetes is part of diabetes management (Northwood et al., 2022). Engaging the family in the process of self-care could enhance the outcomes of diabetes due to the significant contribution that family members can make in managing the disease. Self-management of diabetes is linked to improved glucose control and prevents diabetes related complication of individuals with type 2 diabetes. The social and family support of the patient plays a major role in managing diabetes (Northwood et al., 2022). Because the majority of diabetes treatment in adults takes place at home, the family-related dynamics must always be taken into account during the development of interventions in NURS FPX 6011 Assessment 1.
The healthcare industry is seeking new methods of supporting the individual role in the treatment process as there is an increased awareness of the role of engagement in the promotion of positive health behavior and clinical outcomes, as demonstrated in evidence-based concept maps. Rutten et al. (2020) also suggest the use of a person-centered approach as prescribed by
the European Association of the Study of Diabetes as well as the American Diabetes Association to make patients more active in self-care. Diabetics need diabetes education, motivation, skills, and self-assurance to accomplish this. The necessary conditions are related to the term patient activation. The patient-centered approach should incorporate the comprehensive plans to reduce risk of heart attacks and strokes by addressing issues of hypertension and cholesterol level, preventing smoking and quitting, managing weight, physical activities and appropriate lifestyle practices in diabetic patients because they stand at significantly elevated risk of coronary heart diseases. The results of the research assessing the care coordination of older diabetic patients are positive (Northwood et al., 2022). Further investigations into future prevention in this group should assess detailed healthcare planning, system navigation across health and social care sectors, the role of healthcare coordinators and connection to patients, and caregiver support to help determine the best practices, as outlined in the patient centered care concept map.
Use and Impacts of Information and Communication Tools
There are new opportunities in the field of people of advanced age with diabetes because technology has developed, and, at the same time, cost-optimization services have spread (Doupis et al., 2020). The Internet and mobile phones have enabled the use of telemedicine services that can significantly enhance the communication between the patients and the medical professionals. BlueStar is a diabetes counseling which is available through the Android and iOS application with the same name. This is the first app to receive FDA clearance in the United States as a mobile prescription treatment. The blood glucose of patients can be inputted (wirelessly or manually) into the BlueStar app to receive real-time coaching (Doupis et al., 2020). They can also receive assistance in their drug schedule and nutrition and health tips. There are other factors that are taken into account, like blood pressure and weight (Gurung & Neupaney, 2020).
Moreover, the patients can also be provided with more than 25,000 automated coaching messages, individual instructions, and inform their healthcare providers about their progress. The past ten years have seen a dramatic rise in the amount of diabetes-themed mobile medical applications available. The majority of the commercial apps have basal and bolus insulin control (Flors-Sidro et al., 2021). Besides the secure way of transferring data with other health professionals, they also offer automatic feedback depending on the examination of blood glucose patterns.
The most commonly used technology equipment that is used in self-management practice is personal computers, laptops, and mobile phones (Rutten et al., 2020). These devices are accessed to open websites that provide useful information on diabetes in audio, video, or text. This consequently brings about the ease with which diabetes patients can manage their condition on their own. In a similar manner, the online applications on mobile phones, which measure blood glucose levels not within a clinical environment, have become useful in improving self-management practice. The continuous glucose monitors that come in form of wearable devices have increased in the recent years. Such wearable technologies may be bracelets, smart watches, skin patches, and even eye lenses to mention but a few. Even though such tools might fail to cancel the fact that constant caretaking is needed, they assist in coping with the daily circumstances, as illustrated in the patient centered care concept map.
Poor health literacy has opportunities which can be mitigated using the information and communication technologies to improve the health outcomes of older people with diabetes (Doupis et al., 2020). A change in nutrition, drugs, and other components of daily life are just some of the many changes that may be needed during the management of a chronic condition like diabetes. The new information and communication technology has had a very significant
role in the care of older people with diabetes. According to one of the latest studies, the patients with diabetes who actively contribute to the process of managing their condition could exhibit improved results and reduce the occurrence of the acute complications (Gurung and Neupaney, 2020). The education and skills obtained help the patients to sharpen their knowledge about their disease and proactive measures and all this with the help of the vast communication technologies, and the technologically advanced communication tools in care management. The increased prevalence of information and communication technologies and online platforms in healthcare is easily lowering the burden of diabetes that has already turned into a certainty. ICTs have resulted in patient centered care which fosters the cooperation between elderly diabetic patients and healthcare workers. It has also enabled communication and understanding between the medical staff and the elderly diabetes patients to be improved. It is now turning out to be a valuable tool in providing superior health care (Flors-Sidro et al., 2021). Aging patients (above 65) will have a place to monitor their diabetes data and receive specific treatment advise.
Technological advances such as portals, smartphones, and mobile applications are creating opportunities to enhance access to and continuation of treatment among persons with diabetes and other chronic conditions, as highlighted in NURS FPX 6011 Assessment 1. Nevertheless, it requires evaluation and creation of various types of technology that would be health literate. Even though apps are beneficial in diabetes self-management, there is no information on whether they are used to assist patients with type 1 diabetes (T1DM) consume alcohol safely. Individuals whose health literacy is poor will tend to identify and implement strategies that are employed by paid applications, as highlighted in the patient centered concept map. Further research could look at ways of enhancing the usability and accessibility of free diabetic mobile applications.
The value and relevance of the technology modalities
The Diabetes Pal app (Gurung and Neupaney, 2020) can be downloaded by Android and iOS users to assist them in dealing with their condition. It is capable of being manually inputted by users who can enter their blood glucose readings or receive them wirelessly via Bluetooth as read by their glucose meter, as discussed in NURS FPX 6011 Assessment 1. The app is a telemedicine application that enables the doctor to check the blood sugar of his/her patient real-time (Watson, 2020). Moreover, it contains some written instructions on how to treat the instances of hypoglycemia.
The introduction of the latest mobile health applications, telemedicine, and web-based solutions has significantly simplified and mechanized the management of diabetes in the elderly (Gurung & Neupaney, 2020). Previously, glucose levels were monitored with the help of a fingerstick blood sample. Diabetic patients can now take the form of a small wireless sensor which is implanted under the skin to check the sugar level in the blood. This gadget transmits information in digital format to local computer network. The result of this information is utilized in determining glucose levels in the subcutaneous fluid. Some advanced CGMs can also identify the levels of sugar by waving the reader over the sensor (Watson, 2020). A sensor produces a light signal that is followed to monitor the level of blood sugar.
Excessive insulin, which is prescribed to treat diabetes, can cause a life-threatening reduction in blood sugar levels (Gurung & Neupaney, 2020). The latest technological breakthroughs have allowed predicting a blood sugar drop and immediately stopping insulin transfers. Insulin pumps can be programmed to discharge a fixed amount of insulin that can be manually adjusted to match with the fluctuations in caloric intake of the patient. Modern automated insulin pumps are closed-loop systems that use an algorithm to monitor blood sugar levels and vary the insulin delivery at any time (Gurung & Neupaney, 2020). There are fully
Although the pumps could administer insulin and check the blood sugar rates, the patient should wear them continuously (Watson, 2020). Another substitute for a tethered pump is a smart pen because such a product has all the features of a pump, including memory, as highlighted in NURS FPX 6011 Assessment 1. It also operates via Bluetooth with a mobile application to document the time and doses of insulin. Several diabetes monitoring applications can find it useful to have access to this information. By playing video games involving movement, diabetic persons may have exercised more. Type 1 diabetes in the elderly population has been examined widely and this has resulted in development of various video games, among them Nintendo Wii Fit Plus. Virtual and augmented reality can simplify self-management of care by performing certain tasks such as identifying the most optimal system of administering insulin (Gurung and Neupaney, 2020). It can be used by people to determine the impact of the food they eat on their blood sugar levels (via the glycemic index).
It is not known how well the diabetic applications comply with the privacy and data security standards. The findings underpin the assumption that patients and doctors should be educated about the privacy issues of diabetes applications more (Flors-Sidro et al., 2021). Thus, the importance of the adequate and adequate user training is emphasized in this study. The second line of advice is that governments and regulatory bodies should apply data privacy regulations in strict control. The involvement and oversight of all stakeholders in the development of the applications are also extremely important and establishing higher security standards and procedures in Android and the Google Play Store.
Innovative Strategies for Leveraging Telehealth
Nurses working in palliative care can increase symptom monitoring and coping through telephone-based approaches. The remote administration of medicine was found to be able to benefit cancer patients through a web-based solution. The multidisciplinary team composition must be identified using the diagnosis of the patient and the requirements of the family (Gordon et al., 2022). The more comprehensive approach to meeting the objectives of client- centered care could be found in the interprofessional approaches, which are based on the expertise of multiple professions. Provided that the diabetic patients can be remotely monitored and treated with the help of an interprofessional approach, the latter will receive more access to the care professionals.
Mental health conditions and emotional distress are highly treated with the use of telehealth. Nurses who are telehealth trained assist patients who have acquired religious or spiritual issues (Gordon et al., 2022). Due to the need of patients not to travel long distances to obtain care, cultural considerations can be prioritized in the context of telehealth services. As one example, the family member and traditional healers may also be present at the virtual visit or family reunion of a patient. The remote areas that are underserved and indigenous populations can have their health requirements addressed through telehealth services. It is highly effective to use web-based solutions to remotely manage cancer patients. Gordon et al. (2022) conducted research that found that telehealth enhanced the quality of care and symptom management, such as nausea, hunger, and pain. Patients are taken through the legal and ethical aspects of their care by filling out online DNR/DN forms, health care proxies and advance directives.
Proposed Strategies Will Mitigate the Adverse Risks
As per a study, privacy and security of patient data are the most significant hindrances to the extensive use of telehealth (Dzau, Mate, and O’Kane, 2022). Telehealth data is highly sensitive and requires the adoption of advanced security measures which can help alleviate such
concerns. Security measures need to be all-encompassing in dangers mitigation. Both the Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economic and Clinical Health (HITECH) Act have required extra security of telehealth systems because the information stored within them is sensitive (Dzau, Mate, and O’Kane, 2022). One of the most important elements of the electronic medical records is the concept of protected health information (PHI), and the HIPAA guarantees the privacy and confidentiality of such information.
The most frequently discussed security measure is using firewalls to protect the IT networks of healthcare businesses (Dzau, Mate, & O’Kane, 2022). Firewalls have proven to be very effective in securing networks and PHI; however, they are notoriously expensive and can occupy a wide price range based on the extent and size of an organization. Electronic medical records have been secured by encryption of confidential information. In this case, encryption, in particular, has enhanced the safety of EHRs during their transfer between medical facilities (Dzau, Mate, & O’Kane, 2022). The meaningful use conditions demand that businesses track exchange information, such as the presence or absence of use of encryption, and offer a standard format in which medical records should be sent, as outlined in the patient centered care concept map.
Encryption and decryption of the information that may be accessed by mobile agents can be done through secure methods (Dzau, Mate, & O’Kane, 2022). Electronic health data are accessible and are secured by protecting the mobile agents during the treatment of patients across institutions. Another form of encryption is to use a username and password. To minimize the risks of security breaches, it is advisable that users should frequently replace their passwords and passwords are considered as confidential data (Dzau, Mate, and O’Kane, 2022). The password
must have other than the name of the user or an important date. Role-based restrictions may be implemented by a provider through credentials such as usernames and passwords. Role-based access control allows the access to data with the help of credentials like login and password granted by a system administrator. The measures deter the unauthorized access/manipulation of electronic health records (EHRs) (Dzau, Mate, and O’Kane, 2022). As an employee, I will be required to exit the system at the end of every usage to avoid any unauthorized access to the system by unauthorized personnel. As technology developed further, there has been an increased focus on the role that cloud computing can play in cooperating and integrating with the EHR systems. Data can be stored and shared in the digital form due to the infrastructures that cloud computing has created that enable renting of storage, software, and processing power (Dzau, Mate, and O’Kane, 2022). The use of this platform can help healthcare organizations save on the cost of installing an EHR system by helping transfer ownership and the maintenance expenses, as discussed in NURS FPX 6011 Assessment 1. To further guarantee secure cloud access the cryptographic measures are provided.
References
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Dzau, V. J., Mate, K., & O’Kane, M. (2022). Equity and quality—Improving health care delivery requires both. JAMA, 327(6), 519-520. doi:10.1001/jama.2022.0283
Doupis, J., Festas, G., Tsilivigos, C., Efthymiou, V., & Kokkinos, A. (2020). Smartphone-based technology in diabetes management. Diabetes Therapy, 11, 607-619.
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Gordon, B., Mason, B., & Smith, S. L. (2022). Leveraging telehealth for delivery of palliative care to remote communities: A rapid review. Journal of palliative care, 37(2), 213–225. doi: 10.1177/08258597211001184
Gurung, S., & Neupaney, P. (2020). Use of information and communication technology in diabetes management: A descriptive literature review. https://urn.fi/URN:NBN:fi:amk-202004094843
Northwood, M., Shah, A. Q., Abeygunawardena, C., Garnett, A., & Schumacher, C. (2022). Care coordination of older adults with diabetes: A scoping review. Canadian Journal of Diabetes. https://doi.org/10.1016/j.jcjd.2022.11.004
Rutten, G. E., Van Vugt, H., & de Koning, E. (2020). Person-centered diabetes care and patient activation in people with type 2 diabetes. BMJ Open Diabetes Research and Care, 8(2), e001926. http://dx.doi.org/10.1136/bmjdrc-2020-001926
Watson, S. (2020). How technology is changing life with diabetes. Retrieved 1 16, 2020, from WebMD, Available at: https://www.webmd.com/diabetes/features/technology-changing-life-withdiabetes#3