NURS FPX 6030 Assessment 6 Final Project Submission

Name

Capella university

NURS-FPX 6030 MSN Practicum and Capstone

Prof. Name

Date

 

Final Project Submission

Abstract

This capstone project aimed to enhance diabetes mellitus control among adults (18-65 years) with type II diabetes by improving a lifestyle change program, which included diet, physical activity, and stress management at Riverside Community Hospital (RCH). The project aimed to answer the question of improved glycemic control and self-management skills by comparing lifestyle modification programs with conventional ones. Important findings showed a general improvement in glycemic status, according to lower levels of HbA1c and enhanced compliance with treatment regimens. This work also discusses the importance of lifestyle modification intervention to improve quality and advance healthcare delivery for diabetic patients.

Introduction

This capstone project aims to fill the gap in the management of type II diabetes in adults to minimize complications and improve the quality of life. The target population is adults, 18-65 years, with poorly controlled diabetes, and the project was implemented in an inpatient facility in RCH. The intervention plan involves multiple-component interventions that include diet and nutrition (dietary counseling), physical activity (structured exercise program), and stress control (mindfulness and counseling).

Some of the activities in the implementation plan include healthcare teamwork with team members in delivering patient-centered care through educational workshops, individual counseling, and follow-up. Potential measures that will be used to evaluate the effectiveness of the intervention include changes in HbA1c levels, patient compliance, and the number of people experiencing improved quality of life. Altogether, these elements are designed to promote sustainable results and can help achieve further objectives in diabetes care quality improvement.

Problem Statement (PICOT)

Need Assessment

This project aims to respond to the health promotion and management needs of patients with type II diabetes, particularly on achieving better glycemic control. Meeting this need is important because diabetes is a health problem that causes significant morbidity and mortality and increases the likelihood of developing severe complications such as cardiovascular disease, renal failure, and blindness. Currently, 38.4 million people in the United States have been diagnosed with diabetes.

Moreover, new diagnoses occur annually to 1.2 million people (American Diabetes Association, 2023); many of them suffer from suboptimal glycemic control, which results in increased hospitalization and decreased quality of life. This evidence supports the need to address diabetes type II through structured interventions that can enhance HbA1c results and prevent complications associated with diabetes. For instance, research reveals that clinical trials with well-defined lifestyle improvement programs (diet, exercise, and stress) can enhance glycemic control and quality of life efficiency (O’Donoghue et al., 2021). 

Population and Settings

This project focuses on adult patients aged 18-65 diagnosed with type II diabetes, a population increasingly affected by the rising prevalence of this condition. Early-onset type II diabetes now represents 15-20% of global adult cases (Barker et al., 2022) and poses heightened risks of complications, including cardiovascular diseases. Many patients in this age group face challenges in achieving optimal glycemic control, emphasizing the need for effective interventions to improve health outcomes, reduce healthcare costs, and enhance quality of life. The project will be implemented in RCH’s inpatient units, targeting patients with uncontrolled diabetes or diabetes-related complications.

The inpatient setting is ideal for providing immediate interventions, stabilizing conditions, and introducing specialized management protocols to support a smooth transition to outpatient care (ElSayed et al., 2022). This controlled environment allows patients to receive continuous supervision and guidance on implementing dietary changes, structured exercise programs, and stress management techniques.

Intervention Overview

The proposed intervention is a comprehensive lifestyle modification program that includes tailored dietary plans, structured exercise routines, and stress management strategies. This program targets adults aged 18-65 with type II diabetes to improve glycemic control, enhance self-management skills, and reduce complications by fostering lasting behavioral changes (O’Donoghue et al., 2021). The intervention is well-suited for this population, as most adults in this age group can actively participate in lifestyle changes with proper guidance.

By addressing key contributors to poor glycemic control, the program directly targets the challenges faced by individuals with type II diabetes. This intervention aligns effectively with the inpatient setting at RCH, where patients are more conscious of their health and receptive to structured programs (ElSayed et al., 2022). The hospital’s controlled environment enables consistent reinforcement, education, and close supervision, ensuring adherence to the program. 

Comparison of Approaches 

An alternative to the comprehensive lifestyle modification program is a telehealth-based diabetes management program. This intervention involves teleconsultations and telemonitoring and provides personalized support for glycemic management (De Groot et al., 2021). The program encourages the interprofessional care delivery system, allowing nurses, doctors, dietitians, exercise physiologists, and mental health professionals to work in a coordinated approach to address dietary, physical activity, and stress management. Telehealth broadens access to care, particularly benefiting patients with mobility challenges or those living in remote areas.

This alternative fits the target population by accommodating individual needs and preferences, which may enhance adherence to diabetes self-management (Dhediya et al., 2022). Telehealth in the inpatient environment is less important than the direct care on-site staff delivers. However, telehealth is useful when it is applied as one of the care delivery strategies, as a complementary approach to face-to-face treatment and support, which is integrated to enhance the treatment of type II diabetes.

Initial Outcome Draft

The primary goal of this program is to achieve improved glycemic control, measured by HbA1c levels. This aligns with the project’s focus on enhancing diabetes management through a lifestyle modification program encompassing diet, exercise, and stress management (O’Donoghue et al., 2021). The program addresses poor glycemic control and prevents complications by optimizing patients’ self-management skills. Improved HbA1c levels signify the effectiveness of behavior change, self-management support, and patient activation while demonstrating the program’s potential for replication in other healthcare settings.

The outcome aligns with the patient-first perspective, provides tangible objectives for the interprofessional healthcare teams, and focuses on collaborative work. In measuring success, the HbA1c levels before and after the intervention, patient compliance, and the feasibility and effectiveness of the intervention will be used, as per patient feedback. Other factors, including weight, blood pressure, and quality of life, improve the program’s effectiveness. This approach is important in enhancing the quality, safety, and care of patients with type II diabetes. 

Time Estimate

Developing and implementing a comprehensive lifestyle modification program for managing type II diabetes will take six months and will be divided into two phases: as a strategy, in its development and implementation. The development phase (Months 1–3) starts with a needs assessment of the target group’s demographic data, preferences, and records (18–65 years) in the context of RCH inpatient care. In the second month, content for dietary plans, exercise, stress management, and patient information will be developed, and hospital management and stakeholders’ approval will be obtained. The third month will involve sensitizing the healthcare providers on the program, the concepts of the program, interprofessional, using a small sample of patients to test the materials, and integrating their feedback.

The implementation phase is Months 4–6, during which the full program is launched, patients are recruited, and health information technology is employed to track outcomes. Month 5 is focused on the supervision of the program implementation process, the main issues that may arise, such as patients’ compliance with the program and technology issues, and potential modifications. Lastly, Month 6 covers an assessment of the outcomes as part of the program, including the HbA1c, and then compiling a formal report. The time may be affected by challenges like delayed staff training, lack of resources, and staff resistance to change in work processes. Such activities will help keep to the six-month schedule because there will be constant monitoring and early intervention of any issues.

Literature Review

Several pieces of evidence support the need to improve glycemic control among type II diabetic adults through comprehensive lifestyle modification programs focusing on diet, exercise, and stress management in inpatient hospital settings. For example, Bin Rakhis et al. (2022) proved that the main curative goal in diabetic patients is to maintain stable glycemic levels to avoid the disease’s macrovascular and microvascular complications, supporting the project’s identified need. Dimore et al. (2023) estimated that in 2019, 463 million (9.3%) of the population of adults aged 20-79 years had diabetes, and expected to reach 578 million (10.2%) in 2030.

The statistical data substantiate the need to address diabetes management in our target population. Furthermore, this population is most at risk for diabetes complications, including cardiovascular risks, retinopathy, and renal diseases. A structured intervention for this age group is crucial to limit these complications, improve quality of life, and reduce healthcare costs (Barker et al., 2022). According to ElSayed et al. (2022), diabetes care programs in hospital settings are efficient in controlling blood glucose and complications in diabetic patients. Diabetes self-management interventions are best delivered by a team approach and in a controlled environment that will facilitate compliance, and they are only available in inpatient settings.

Several studies support a comprehensive lifestyle management program for diabetes that includes dietary changes, physical activity, and stress management. Chaib et al. (2023) proved that the therapeutic education of diet and nutrition had a positive effect on the decrease of BMI (0.8 kg/m2) and HbA1c levels (1.1%) in diabetic patients. Another research showed sustained glycemic improvements through tailored exercise and diet regimens (O’Donoghue et al., 2021). The study emphasizes age-specific programming and its suitability for this population, reinforcing the project’s focus on a working-age demographic. An article by Hamasaki (2023) found that stress reduction activities, such as mindfulness interventions, enhance glycemic control, as indicated by improved HbA1c levels and alleviating stress and depression. This supports implementing such programs within RCH. 

Evaluation and Synthesis of Relevant Health Policies

The Affordable Care Act (ACA) emphasizes preventive care and chronic disease management. It is a relevant health policy for addressing type II diabetes management (Furmanchuk et al., 2021) through a comprehensive lifestyle modification program. The ACA encourages hospitals to integrate preventive measures and quality improvement initiatives into patient care, which aligns with the project’s focus on inpatient settings. The policy incentivizes reducing readmissions and improving patient outcomes through evidence-based interventions, thus supporting the development and implementation of such programs at RCH.

The ACA impacts the approach by emphasizing patient education and coordinated care as critical components of diabetes management (Furmanchuk et al., 2021). The proposed intervention can be supported by new technologies in healthcare, including remote patient monitoring (RPM), telehealth platforms, and electronic health records (EHRs). EHRs allow assessment of glycemic levels, patient compliance with the recommended lifestyle changes, and overall patient progress. Telehealth platforms include follow-up education and support post-discharge to maintain the continuity of diabetes care and patients’ adherence to the plans (Dhediya et al., 2022). In addition, effective communication, including culturally appropriate patient information and interprofessional relations, is critical (Walkowska et al., 2023). 

Interventional Plan

Intervention Plan Components

The intervention plan for this project involves developing a comprehensive lifestyle modification program consisting of three key components: The three areas of intervention are diet and nutrition, physical activity, and stress. The diet and nutrition component involves the development of food plans for low glycemic index foods, portion control, and a low amount of processed sugars (Petroni et al., 2021). It will include initial and follow-up counseling on dietary change and providing educational materials on recommended diets. Within the second physical activity component, patients will engage in structured programs of aerobic, strength, and flexibility exercises according to their fitness profile. Guided group meetings and informative sessions will promote physical activity as a part of the daily plan (O’Donoghue et al., 2021).

Lastly, the third component focuses on stress control through coping activities such as mindfulness, meditation, and yoga. People will have mental health counseling services to help them with stress issues that interfere with glycemic control (Hamasaki, 2023). These components will effectively respond to the identified need for glycemic control in adult type II diabetes because they will treat the causes of the disease, including poor diet, lack of exercise, and stress. These components are the best options because the holistic diabetes plan ensures that the body is handled fully in preventing and managing diabetes.

Cultural Needs and Characteristics of Population and Setting

The target population of adult patients aged 18–65 is multicultural, multilingual, polyethnic, and multireligious, and they can have different eating habits, perceptions of health and illness, and income levels. Some of the patients may be from minority groups that are most affected by type II diabetes and, therefore, require culturally sensitive treatment. For instance, there might be specific traditional foods or certain forms of conventional perspectives that must be included in the dietary plans. Language differences may also need support through multiple education materials translated into different languages.

Simultaneously, in the healthcare setting, RCH serves a multicultural population in an urban area. These cultural features of the hospital are equality and diversity, hospital staff, and interpreters. This environment supports the use of culturally appropriate interventions. However, due to the limited time spent on patients in inpatient care settings, the interventions must be culturally sensitive and realistic in the acute care environment. By addressing these cultural characteristics, the intervention provides fair, efficient, and patient-centered diabetes care, which promotes patient participation and improved results.

Theoretical Foundations 

The Health Promotion Model (HPM) further underpins the intervention plan. HPM focuses on how an individual’s beliefs, experiences, and the environment affect their health behaviors and, therefore, suitable for lifestyle change interventions. This model can accommodate individual goal-setting, dealing with perceived obstacles, and enhancing self-efficacy. For example, it can be easily integrated with diet and physical activity interventions where the client’s beliefs about food and exercise affect compliance. Secondly, a behavioral strategy from psychology, such as the Transtheoretical Model (TTM), is also relevant to the intervention plan. It assists in evaluating an individual’s stage of change about the suggested healthier behaviors so that the interventions can reach the participant at the appropriate stage (Raihan & Cogburn, 2023).

For instance, patients still at the ‘preparation’ level may need elaborate action plans to be provided. In contrast, another person at the ‘maintenance’ level may need follow-up reminders to sustain his/her progress. Lastly, mobile health technologies (mHealth) are imperative for observing progress and compliance with the set interventions. These tools also help healthcare providers track patients’ progress from a distance, bring about accountability, and modify intervention plans appropriately. A key limitation of mHealth technologies is the issue related to patient engagement and technology availability and reliability, including digital literacy and privacy concerns, as well as the variability in the availability of the appropriate devices and the internet (Giebel et al., 2024).

Justification of Interventional Plan

The Health Promotion Model (HPM) provides the rationale for the intervention plan by emphasizing personal attributes, actions, and environmental factors. Evidence supports that HPM-driven interventions addressing self-efficacy and perceived barriers yield better results in promoting lifestyle changes. This rationale underpins the program’s use of tailored educational materials and personal goal-setting. The Transtheoretical Model (TTM), derived from psychology, complements the design by assessing a patient’s readiness to change.

Research indicates that stage-based interventions tailored to an individual’s specific stage of change enhance effectiveness and sustain interest in lifestyle modifications over time (Raihan & Cogburn, 2023). Additionally, incorporating mHealth technologies justifies the intervention design by leveraging real-time data and feedback to improve compliance with lifestyle changes. Studies reveal that mHealth apps for chronic illnesses like diabetes significantly boost patient engagement and self-management outcomes, reinforcing the importance of technology integration. 

Stakeholders, Policy, and Regulations 

The stakeholders involved in the intervention plan include nurses, physicians, dietitians, fitness trainers, mental health counselors, administrative staff, and patients. Their needs significantly influence the intervention’s design and implementation. Nurses and physicians require evidence-based protocols and comprehensive training to ensure effective execution. Dietitians and fitness trainers need culturally and demographically tailored tools to create accessible and practical dietary and exercise plans. Mental health counselors require seamless integration of stress management techniques into the program.

Administrative staff need streamlined workflows, adequate resources, and logistical support to manage program implementation efficiently. Patients require personalized support, clear communication, and accessible tools to ensure their engagement, adherence, and improved outcomes. Regulatory frameworks and policies also shape the intervention. The Affordable Care Act (ACA) emphasizes preventive measures and chronic illness management, reinforcing health promotion programs’ integration into care models (Furmanchuk et al., 2021).

Health Insurance Portability and Accountability Act (HIPAA) regulations ensure data privacy, influencing the design and use of electronic tools for patient care and follow-up. The Joint Commission’s focus on patient safety and quality of care mandates that all components, including education, align with accreditation standards. These considerations ensure the intervention is patient-centered, compliant with regulations, and equipped to deliver sustainable improvements in glycemic control for type II diabetes patients.

Ethical and Legal Implications 

The project’s ethical considerations include patient autonomy, confidentiality, and equitable care distribution. Patient autonomy ensures individuals can make informed decisions about their participation, aligning with ethical principles of self-determination. Confidentiality is critical, particularly with mHealth technologies, as data privacy is central to moral and legal data management practices. Equity in care delivery guarantees all patients, regardless of economic status or background, equal access to necessary resources such as dietary plans, exercise programs, and stress management tools, essential for success in intervention.

To address these considerations, healthcare personnel will receive specialized training in maintaining privacy and cultural sensitivity and addressing health inequities. Organizational policies must also support diversity, inclusivity, and robust data protection mechanisms like encrypted mHealth applications. Patient-centered components, such as individualized meal plans and counseling, will foster ethical care delivery, encouraging patient engagement and adherence. Legal considerations focus on privacy, data security, and voluntary consent.

HIPAA mandates safeguarding patient health information, especially when using mHealth technologies to collect, store, and transmit data (Edemekong et al., 2024). Encrypted data storage and secure technologies are necessary to ensure compliance. Additionally, informed consent must be obtained to clarify how patient data will be used and shared. These legal requirements impact healthcare practices by necessitating robust privacy measures and transparent communication regarding data usage. Healthcare providers will require training in legal compliance and secure data management, while organizations must implement secure technologies and policies aligned with HIPAA. These considerations ensure ethical, legal, and patient-focused care, enhancing trust and program effectiveness.

Implementation Plan

Management and Leadership

• Leadership Strategies: The transformational Leadership (TL) approach helps to achieve a shared vision, increase communication, and empower the staff (Ystaas et al., 2023). This approach enhances participation, focuses the team’s efforts, and fosters engagement, augmenting interprofessional practice within project implementation. 
• Management Strategies: Effective management relies on structured coordination, clear workflows, and task distribution. Project management tools support meeting timelines and efficient resource allocation. Regular feedback sessions encourage adaptive planning, allowing staff to voice concerns and identify barriers. These strategies foster interprofessional collaboration since people working in different fields are more accountable and open with each other. 
• Professional Nursing Practice: Using nursing concepts such as evidence-based practice (EBP) enhances the quality of care because it involves implementing patient-centered interventions and using the latest research evidence in decision-making (Engle et al., 2021). This approach is useful in improving collaboration because it closes communication bridges, builds trust, and brings together disciplines with the common purpose of attaining the best results. Implications of these Strategies 

TL approaches, such as team decision-making and decentralization, enhance collaboration within inpatient care, improving care coordination and quality (Ystaas et al., 2023). Involving a multidisciplinary team in decision-making fosters accurate patient assessments and ensures the delivery of appropriate treatments from various specialists. This approach builds trust, reduces confusion, and enhances the patient experience. Additionally, team involvement optimizes resource utilization, streamlines workflows, and minimizes unnecessary procedures or delays, ultimately controlling costs. Focusing on resource prioritization and efficient processes, these strategies help provide timely interventions and reduce wait times, improving patient satisfaction and operational discipline. From a cost perspective, these strategies reduce waste and avoid duplication, ensuring the best use of hospital resources without compromising quality. Evidence-based practices, patient education, and clear communication improve care quality, leading to better patient outcomes, reduced complications, and more cost-effective care (Engle et al., 2021).

Delivery and Technology 

Delivery Methods 

Two key delivery methods are proposed to improve type II diabetes management: current educational interventions such as patient education workshops and mHealth applications. The workshops will focus on lifestyle modifications, including personalized meal planning, structured exercise programs, and stress management through counseling and mindfulness techniques (O’Donoghue et al., 2021). Group education by different health care professionals, with the focus of imparting useful diabetes knowledge and skills in the management of the disorder. It will promote patient involvement, enhance knowledge in diabetes care, and enable the patient to make proper timeless for improved diabetes management. Monitoring through mHealth tools will supplement the flow of work in workshops.

This approach assumes patient willingness, basic health literacy, and commitment to attend sessions, encouraging sustainable, long-term behavioral changes for effective diabetes management. Another suitable mode of delivering the intervention is using mobile health (mHealth) technology. An app or a wearable device can assist patients in logging their diet, activity, and stress level and get feedback simultaneously (Giebel et al., 2024). This method enables constant supervision and compliance with the individual health plan that patients should follow. It also allows communication with the healthcare providers and receive support between visits. Employing mHealth technology, the intervention maintains the patient’s interest and motivation towards adopting a healthier lifestyle and, thus, better glycemic control and other well-being results. 

Current and Emerging Technologies 

Current technological options for patient education include video conferencing tools like Zoom and Microsoft Teams, which enhance accessibility for patients with mobility restrictions or those far from the hospital. Presentation tools such as PowerPoint further engage patients by making learning interactive. Emerging technologies like virtual reality (VR) and augmented reality (AR) could revolutionize education by providing immersive, hands-on learning experiences, such as cooking healthy meals in VR or demonstrating exercise techniques via AR (Gandedkar et al., 2021).

For mHealth technologies, apps like MyFitnessPal and wearable devices like Fitbit and the Apple Watch provide real-time feedback, helping patients track diet, exercise, and sleep. These tools enhance personalization and patient compliance. Looking forward, AI-powered algorithms could offer even more individualized care by analyzing patient data to make personalized recommendations. However, the best methods for applying AI in patient management are still under investigation (Gandedkar et al., 2021).

Stakeholders, Policy, and Regulations

Implementing the intervention plan for type II diabetes management involves several stakeholders, including nurses, physicians, dietitians, fitness trainers, mental health counselors, administrative staff, and patients. Nurses and physicians require training on mHealth technology and updates on best practices for diabetes management. Dietitians, fitness trainers, and counselors need defined workflows and resources to align with program goals. At the same time, administrative staff must handle logistics such as scheduling workshops, procuring devices, and ensuring data privacy. Patients need access to education, mHealth tools, and personalized care plans to engage fully with the intervention. Meeting these needs is important for having individuals’ approval and support in the implementation process. Healthcare regulations, such as the HIPAA and Medicare/Medicaid reimbursement for diabetes programs, are crucial for successful implementation.

HIPAA regulates the use and protection of patient data in mHealth, thus demanding effective cybersecurity for the platforms (Edemekong, et al., 2024). The reimbursement policies determine the funding of the workshops and the patients. Implementing these regulations may cause higher initial expenses and increase the need to educate personnel. Additional support considerations include leadership endorsement, interprofessional collaboration, and financial backing. Leadership drives resource allocation and organizational alignment, while collaboration ensures cohesive teamwork. Financial support, such as grants or reimbursements, sustains the program. Addressing funding gaps or stakeholder misalignment is essential for success.

Existing and New Policy Considerations 

Current policies like the HIPAA play a role in the improvement of implementation through the protection of information to enhance the trust of patients in mHealth applications as well as the involvement of the patients. Another relevant policy is the Affordable Care Act (ACA), which supports preventative care and diabetes management programs (Furmanchuk et al., 2021). The ACA supports the intervention by providing insurance coverage of preventative care and promoting better health knowledge and practices. A new policy consideration is institutional policies requiring using mHealth tools in chronic disease management and encouraging attendance at diabetes workshops. This would positively impact implementation by affording a framework for technology adoption, improving patient and staff involvement, and directing organizational objectives to support the program. 

Timeline 

The six-month timeline for implementing the type II diabetes intervention plan is divided into two phases: development (three months) and implementation (three months). The development phase focuses on assessing patient needs, creating educational materials, and obtaining necessary approvals. Staff training on interdisciplinary workflows and technology use is also conducted. The implementation phase starts with recruiting patients, launching interventions, and using mHealth tools to monitor progress. This realistic timeline provides ample time for planning, resource allocation, staff training, and patient engagement, with the flexibility to make adjustments if needed. Several factors can impact the timeline.

Resource availability, such as mHealth tools, educational materials, and staff, can delay development if procurement or approval processes are slow. Staff training may also be hindered by scheduling conflicts or resistance to new workflows. Patient adherence and engagement in the implementation phase may vary, requiring additional support to motivate patients. Technological barriers could cause delays. These factors may necessitate extended timelines for troubleshooting, retraining, or adjusting resources, causing revisions to the implementation timeline. 

Evaluation Plan

Outcomes of the Interventional Plan 

The first objectives of the intervention plan are better glycemic control and patient involvement. Glycemic control by reducing HbA1c levels is an essential measure of diabetes and the effectiveness of the intervention in encouraging the right lifestyle changes (O’Donoghue et al., 2021). These outcomes also position the organization to improve the quality, safety, and care experience. Better HbA1c levels mean better disease control and fewer chances of complications and hospitalization. The patient’s engagement ensures that the intervention is personalized and uses the patient-physician relationship. Due to its flexibility, this framework can be implemented in different healthcare organizations, focusing on collaborative practice and systems modifications to treat chronic diseases.

Evaluation Plan 

To assess these outcomes, there will be a need for pre-and post-intervention HbA1c levels, patient compliance status, response to the feasibility of the intervention, and incidence of diabetic complications. Clinical rating scales, questionnaires, and patient interviews will be used in data collection. By employing mobile health (mHealth) apps, patients will document their improvement to monitor their diet, physical activity, and stress in real time. Quantitative data will be analyzed using statistical tools and software such as SPSS or Excel to compare pre-and post-intervention metrics and identify trends or improvements. Patient information will be collected in the form of qualitative information, and the data will be analyzed by focusing on the themes that patients have reported on their experiences. The evaluation plan will highlight the intervention’s impact by demonstrating measurable improvements in clinical outcomes and patient-reported benefits. 

Discussion 

Advocacy 

Nurses are key in change, care quality, and experience enhancement. In this project, nurses lead the change by promoting patient care initiatives for diabetes management, including lifestyle modification programs. They only act as patient advocates and coordinate the working relationships between the patient and other various qualified interprofessional teams of physicians, dietitians, fitness trainers, and mental health counselors. Nurses are responsible for teaching patients self-management techniques, assessing patients’ self-management, solving patients’ lack of adherence, and being closely involved and empowering patients (Awang Ahmad et al., 2020).

Finally, nurses thus apply evidence-based practice (EBP) in delivering quality improvements by supporting particular practices such as diet changes and patient coping mechanisms. They add value to care by comforting and attending to sensitive patients and as joyful supporters of their needs while guaranteeing they are met holistically. The role played here enhances the provision of timely and proper coordination of the assessment and actual implementation of the interventions by the team, including the nurse. The intervention plan is most influential in nursing, encouraging the patient’s learning modes regarding their chronic illnesses and the resulting patient self-care behaviors that follow. For nurses, the project provides chances to develop motivational interviewing, behavior change knowledge and skills, and interprofessional communication, thus raising the standard of their practice.

The plan also re-emphasizes nurses’ advocacy and leadership responsibilities in advocating for and implementing evidence-based approaches to glycemic control and other health-related determinants (Awang Ahmad et al., 2020). This intervention plan requires interprofessional collaboration for it to be successful. Coordination is a concept that creates a multidisciplinary working relationship between nurses, physicians, dietitians, fitness trainers, and mental health counselors. It can optimize resource use, cut unnecessary duplication, and deliver bundled care services to enhance the treatment efficacy of patients diagnosed with type II diabetes. The healthcare field has benefited from this project by reducing complications and hospitalization and increasing patient satisfaction. This demonstrates that the lifestyle modification approach alongside a chronic disease management model can work and could be replicated in other chronic diseases like cardiovascular diseases.

Future Steps 

The intervention plan could be expanded to include culturally tailored resources and community outreach programs to create a bigger impact. This would entail developing lifestyle change programs that meet the various needs of the target population (adults 18-65 years) and making them easily available to those in vulnerable groups. Supplementing with group education sessions and developing peer support, outcome: modifying behavior patterns through patients’ cooperative learning. Of the existing components, the intervention could enhance how it implements emerging technologies in wearable health devices like continuous glucose monitors and fitness trackers.

Such devices offer patients data as they progress through the program and help them stay responsible. Furthermore, artificial intelligence coaching and risk prediction components could improve the mHealth applications by identifying potential threats and offering recommendations to avoid them (Gandedkar et al., 2021). The new care delivery methods, including patient-centered medical homes (PCMHs) and care integration networks, could also enhance the results and safety. Thus, integrating the intervention in the above-said models makes care coordination and patient follow-up easier. Telemedicine could facilitate multidisciplinary team meetings to enhance the efficiency of care while maintaining the coherence of the care plan.  

Reflection on Leading Change and Improvement

Throughout this capstone project, I have gained a deeper understanding of how to lead change in my practice and a broader care setting. The experience has equipped me with the skills to plan and implement change using evidence-based interventions while collaborating with others to create meaningful patient impacts. One of the key insights I gained was how to link an intervention plan with organizational goals and patient-centered care. Designing, implementing, and evaluating the intervention allowed me to focus on improving patient outcomes while ensuring that my actions align with larger system objectives.

This project has also built my capacity towards future leadership positions since it has developed me in the best way that could enable me to foster interdisciplinary collaboration and introduce change within the health care systems. I have acquired effective problem-solving skills, learned how to manage stakeholders, and enhanced my understanding of using technology and data in decision-making. Further, I expect to build my leadership competencies, increase my knowledge in healthcare sciences, and learn more about motivating others to produce the best outcome. Therefore, this project’s structure can be used in other chronic diseases such as hypertension or cardiovascular diseases.

Behavioral intervention and self-organization techniques could be easily transferred to another care environment, such as outpatient or nursing homes. Interference with factors such as HbA1c levels, patient compliance, and quality of life can be measured across continents to evaluate the impact of such interventions. Telemedicine and other healthcare technology applications may intensify the effects of these plans in the future. These strategies can be made to fit the local environment where resources are limited so that the quality improvements achieved are as effective as possible across different healthcare facilities.

Conclusion 

In conclusion, this project focused on implementing a comprehensive lifestyle modification program for managing type II diabetes, aiming to improve glycemic control through dietary changes, exercise, and stress management. The intervention was designed to align with patient readiness and self-efficacy by leveraging proven models. Technological tools supported patient engagement and compliance. Stakeholders played a crucial role in the program’s success. Ultimately, the project aimed to enhance patient outcomes, improve care coordination, and offer a cost-effective solution for managing type II diabetes in adults at Riverside Community Hospital. 

References

American Diabetes Association. (2023, November 2). Statistics about diabetes. Diabetes.org; American Diabetes Association. https://diabetes.org/about-diabetes/statistics/about-diabetes

Awang Ahmad, N. A., Sallehuddin, M. A. A., Teo, Y. C., & Abdul Rahman, H. (2020). Self-care management of patients with diabetes: Nurses’ perspectives. Journal of Diabetes & Metabolic Disorders, 19(2), 1537–1542. https://doi.org/10.1007/s40200-020-00688-w

Barker, M. M., Zaccardi, F., Brady, E. M., Gulsin, G. S., Hall, A. P., Henson, J., Htike, Z. Z., Khunti, K., McCann, G. P., Redman, E. L., Webb, D. R., Wilmot, E. G., Yates, T., Yeo, J., Davies, M. J., & Sargeant, J. A. (2022). Age at diagnosis of type 2 diabetes and cardiovascular risk factor profile: A pooled analysis. World Journal of Diabetes, 13(3), 260–271. https://doi.org/10.4239/wjd.v13.i3.260

Bin Rakhis, S. A., AlDuwayhis, N. M., Aleid, N., AlBarrak, A. N., & Aloraini, A. A. (2022). Glycemic control for type 2 diabetes mellitus patients: A systematic review. Cureus, 14(6). https://doi.org/10.7759/cureus.26180

Chaib, A., Zarrouq, B., El Amine Ragala, M., Lyoussi, B., Giesy, J. P., Aboul-Soud, M. A. M., & Halim, K. (2023). Effects of nutrition education on metabolic profiles of patients with type 2 diabetes mellitus to improve glycated hemoglobin and body mass index. Journal of King Saud University – Science, 35(1), 102437. https://doi.org/10.1016/j.jksus.2022.102437 

De Groot, J., Wu, D., Flynn, D., Robertson, D., Grant, G., & Sun, J. (2021). Efficacy of telemedicine on glycaemic control in patients with type 2 diabetes: A meta-analysis. World Journal of Diabetes, 12(2), 170–197. https://doi.org/10.4239/wjd.v12.i2.170

Dhediya, R., Chadha, M., Bhattacharya, A. D., Godbole, S., & Godbole, S. (2022). Role of telemedicine in diabetes management. Journal of Diabetes Science and Technology, 17(3), 193229682210811. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10210114/

NURS FPX 6030 Assessment 6 Final Project Submission

Dimore, A. L., Edosa, Z. K., & Mitiku, A. A. (2023). Glycemic control and diabetes complications among adult type 2 diabetic patients at public hospitals in Hadiya zone, Southern Ethiopia. PLOS ONE, 18(3), e0282962. https://doi.org/10.1371/journal.pone.0282962 

ElSayed, N. A., Aleppo, G., Aroda, V. R., Bannuru, R. R., Brown, F. M., Bruemmer, D., Collins, B. S., Hilliard, M. E., Isaacs, D., Johnson, E. L., Kahan, S., Khunti, K., Leon, J., Lyons, S. K., Perry, M. L., Prahalad, P., Pratley, R. E., Seley, J. J., Stanton, R. C., & Gabbay, R. A. (2022). 16. diabetes care in the hospital: Standards of care in diabetes—2023. Diabetes Care, 46(Supplement_1), S267–S278. https://doi.org/10.2337/dc23-s016

Edemekong, P. F., Annamaraju, P., Afzal, M., & Haydel, M. J. (2024). Health Insurance Portability and Accountability Act (HIPAA) compliance. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK500019/ 

Engle, R. L., Mohr, D. C., Holmes, S. K., Seibert, M. N., Afable, M., Leyson, J., & Meterko, M. (2021). Evidence-based practice and patient-centered care: Doing both well. Health Care Management Review, 46(3), 174–184. https://doi.org/10.1097/HMR.0000000000000254

Furmanchuk, A., Liu, M., Song, X., Waitman, L. R., Meurer, J. R., Osinski, K., Stoddard, A., Chrischilles, E., McClay, J. C., Cowell, L. G., Tachinardi, U., Embi, P. J., Mosa, A. S. M., Mandhadi, V., Shah, R. C., Garcia, D., Angulo, F., Patino, A., Trick, W. E., & Markossian, T. W. (2021). Effect of the Affordable Care Act on diabetes care at major health centers: newly detected diabetes and diabetes medication management. BMJ Open Diabetes Research & Care, 9(Suppl 1), e002205. https://doi.org/10.1136/bmjdrc-2021-002205 

Gandedkar, N. H., T. Wong, M., & Darendeliler, M. A. (2021). Role of virtual reality (VR), augmented reality (AR) and artificial intelligence (AI) in tertiary education and research of orthodontics: An insight. Seminars in Orthodontics, 27(2), 69–77. https://doi.org/10.1053/j.sodo.2021.05.003 

Giebel, G. D., Abels, C., Plescher, F., Speckemeier, C., Schrader, N. F., Börchers, K., Wasem, J., Neusser, S., & Blase, N. (2024). Problems and barriers related to the use of mhealth apps from the perspective of patients: Focus group and interview study. Journal of Medical Internet Research, 26, e49982. https://doi.org/10.2196/49982 

Hamasaki, H. (2023). The effects of mindfulness on glycemic control in people with diabetes: An overview of systematic reviews and meta-analyses. Medicines, 10(9), 53. https://doi.org/10.3390/medicines10090053 

O’Donoghue, G., O’Sullivan, C., Corridan, I., Daly, J., Finn, R., Melvin, K., & Peiris, C. (2021). Lifestyle interventions to improve glycemic control in adults with type 2 diabetes living in low-and-middle-income countries: A systematic review and meta-analysis of randomized controlled trials (RCTs). International Journal of Environmental Research and Public Health, 18(12), 6273. https://doi.org/10.3390/ijerph18126273

Petroni, M. L., Brodosi, L., Marchignoli, F., Sasdelli, A. S., Caraceni, P., Marchesini, G., & Ravaioli, F. (2021). Nutrition in patients with type 2 diabetes: Present knowledge and remaining challenges. Nutrients, 13(8), 2748. https://doi.org/10.3390/nu13082748

Raihan, N., & Cogburn, M. (2023). Stages of change theory. In StatPearls. StatPearls Publishing. http://www.ncbi.nlm.nih.gov/books/NBK556005/

NURS FPX 6030 Assessment 6 Final Project Submission

Walkowska, A., Przymuszała, P., Stępak, P. M., Nowosadko, M., & Baum, E. (2023). Enhancing cross-cultural competence of medical and healthcare students with the use of simulated patients—a systematic review. International Journal of Environmental Research and Public Health, 20(3). https://doi.org/10.3390/ijerph20032505 

Ystaas, L. M. K., Nikitara, M., Ghobrial, S., Latzourakis, E., Polychronis, G., & Constantinou, C. S. (2023). The impact of transformational leadership in the nursing work environment and patients’ outcomes: A systematic review. Nursing Reports, 13(3), 1271–1290. https://doi.org/10.3390/nursrep13030108