NURS FPX 6021 Assessment 2 Change Strategy and Implementation

Change Strategy and Implementation

Name
Capella University
FPX6021
Instructor’s Name
November 2023

This assessment centers on the critical task of evaluating and implementing change strategies to enhance patient outcomes in the context of renal failure resulting from uncontrolled diabetes. Renal failure is a severe condition significantly influenced by diabetes, and its effective management is essential. By examining existing data and proposing change strategies, healthcare practitioners can work toward improved care experiences and outcomes for patients. This assessment involves the development of a data table representing current and desired clinical outcomes, the proposal of change strategies, justification of those strategies, and exploration of their potential for quality improvement. The interprofessional considerations for successful strategy implementation are also addressed, all with the ultimate goal of enhancing patient care in the face of renal failure related to diabetes.

Data Table

Current State Desired State Change strategy
Uncontrolled blood sugar levels, with frequent spikes and lows. Achieve stable blood sugar levels within the target range Implement a personalized diabetes management plan that includes a well-balanced diet, regular physical activity, and proper medication adherence. Regularly monitor blood glucose levels (Murali et al., 2019).
Sedentary lifestyle with poor dietary choices, leading to obesity and insulin resistance. Achieve a healthy body weight and improve insulin sensitivity (Murali et al., 2019). Develop a comprehensive lifestyle modification program that includes dietary counseling, regular exercise, and behavioral therapy. Encourage the patient to make healthier food choices (Wadden et al., 2020).
Lack of understanding about their diabetes diagnosis, leading to non-compliance with medication and self-monitoring. Have a clear understanding of diabetes management and be actively engaged in their care. Provide diabetes education and self-management training to the patient. Use patient-centered education materials, involve a diabetes educator or nurse for guidance, and ensure the patient comprehends the importance of regular check-ups and medication adherence.

Areas of Ambiguity

• Additional data could be gathered through clinical trials or observational studies to determine the most effective components of the structured diabetes education program and its impact on reducing the incidence of renal failure in patients with uncontrolled diabetes (Beaubien-Souligny et al., 2022).
• Further research is needed to clarify the cost-effectiveness and patient engagement in regular kidney function tests and the extent to which these tests can identify early signs of renal failure.

• Data on the effectiveness

of medication reconciliation programs in improving adherence to medication regimens and reducing the risk of complications in patients with diabetes should be studied (Beaubien-Souligny et al., 2022).
• The impact of establishing partnerships with renal specialists on the coordination of care between primary care providers and specialists needs to be assessed.

Proposed Change Strategies

To achieve the desired state of reduced renal failure incidence due to improved diabetes control, a structured diabetes education program is proposed. This program will focus on educating patients with uncontrolled diabetes about healthy eating, physical activity, glucose monitoring, and effective medication management. While this change strategy has great potential to enhance patient outcomes, it may face challenges such as securing funding for the education program, ensuring patient engagement, and effectively measuring the program’s effectiveness (Ory et al., 2020).

Addressing these challenges will require collaboration with healthcare administrators, stakeholders, and educators to secure necessary resources and develop a program that is engaging and tailored to patients’ needs. Moreover, ongoing assessments and feedback mechanisms will be implemented to measure patient knowledge and adherence to the program, ensuring it leads to improved diabetes control and a reduced incidence of renal failure (Ory et al., 2020).

The change strategy to improve monitoring of kidney function will involve implementing regular kidney function tests, including glomerular filtration rate (GFR) tests and urine protein tests. Challenges may include the cost and accessibility of these tests, patient resistance to regular testing, and difficulty interpreting results (Sammut‐Powell et al., 2022).

To address these challenges, measures will be taken to ensure that these tests are affordable and accessible for patients, and patient education will be intensified to emphasize the importance of regular testing (Sammut‐Powell et al., 2022). Training and professional development for healthcare practitioners on interpreting test results will also be provided to enhance the implementation of this change strategy. These measures will ensure that monitoring kidney function is more effective, reducing the risk of renal failure for patients with diabetes.

Justification of Change Strategies

The specific change strategies proposed for achieving desired outcomes in managing renal failure due to diabetes have been selected based on strong evidence and best practices within the healthcare field. The structured diabetes education program has demonstrated its effectiveness in improving patient knowledge and skills related to diabetes management, which can significantly reduce the risk of complications, including renal failure. Similarly, monitoring kidney function and improving medication adherence are established best practices for diabetes care, leading to a lower risk of adverse events and improved health outcomes (Murali et al., 2019). While other interventions may be considered, these strategies are well-supported and have the potential to benefit a wide range of patients. Nonetheless, healthcare professionals should remain open to alternative perspectives and consider individual patient needs, preferences, and circumstances when implementing these strategies to ensure comprehensive and patient-centered care (Murali et al., 2019).

How Change Strategy will lead to Quality Improvement
The change strategies proposed for managing renal failure due to diabetes aim to lead to quality improvement in safety and equitable care. By implementing a structured diabetes education program, patients will have the knowledge and skills to manage their diabetes effectively, reducing the risk of complications, including renal failure. This results in improved patient safety and equitable care as more individuals receive consistent education and support (Smokovski, 2020).

Monitoring kidney function and enhancing medication adherence will also contribute to safety by identifying early signs of renal issues and ensuring patients receive timely and appropriate treatment. Assumptions underlying this explanation include that structured education, regular monitoring, and improved adherence lead to better patient outcomes and that providing these interventions consistently promotes equitable care for all patients.

How Change Strategies Will Utilize Interprofessional Considerations

The proposed change strategies for managing renal failure due to diabetes will leverage interprofessional considerations to ensure successful implementation. The structured diabetes education program will involve a team of healthcare professionals, including nurses, dietitians, and endocrinologists, working collaboratively to provide patients with comprehensive support and education.

This interprofessional approach ensures that patients receive consistent and well-rounded care, drawing upon the expertise of various professionals (De La Rosa et al., 2019).

Similarly, monitoring kidney function and improving medication adherence will involve physicians, nurses, and pharmacists working together to deliver the appropriate treatment and monitoring, enhancing the safety and effectiveness of patient care (De La Rosa et al., 2019). Assumptions underlying this explanation include that an interprofessional team approach results in more coordinated care, better patient outcomes, and a reduced risk of adverse events

Conclusion

The assessment has explored change strategies aimed at enhancing patient outcomes in cases of renal failure resulting from uncontrolled diabetes. These strategies, supported by existing evidence, offer a comprehensive approach to care, focusing on education, monitoring, and medication adherence. The successful implementation of these strategies hinges on interprofessional collaboration, where various healthcare professionals work together to ensure patients receive coordinated and effective care. The assumptions underpinning these strategies include the belief in the value of interprofessional teamwork and the potential for improved patient outcomes. Overall, these change strategies have the potential to reduce the incidence of renal failure, improving both patient safety and equitable care in the context of diabetes-related kidney disease.

References

Beaubien-Souligny, W., Leclerc, S., Verdin, N., Rizwana Ramzanali, & Fox, D. E. (2022). Bridging gaps in diabetic nephropathy care: a narrative review guided by the lived experiences of patient partners. Canadian Journal of Kidney Health and Disease, 9, 205435812211279-205435812211279. https://doi.org/10.1177/20543581221127940

De La Rosa, M., Pitts, S., & Chen, P.-H. (2019). An interprofessional collaboration of care to improve clinical outcomes for patients with diabetes. Journal of Interprofessional Care, 34(2), 1–3. https://doi.org/10.1080/13561820.2019.1643297
Murali, K. M., Mullan, J., Roodenrys, S., Hassan, H. C., Lambert, K., & Lonergan, M. (2019).

Strategies to improve dietary, fluid, dialysis or medication adherence in patients with end stage kidney disease on dialysis: A systematic review and meta-analysis of randomized intervention trials. Plos One, 14(1), e0211479. https://doi.org/10.1371/journal.pone.0211479

Ory, M. G., Lee, S., Towne, S. D., Flores, S., Gabriel, O., & Smith, M. L. (2020). Implementing a diabetes education program to reduce health disparities in south Texas: Application of the re-aim framework for planning and evaluation. International Journal of Environmental Research and Public Health, 17(17), 6312. https://doi.org/10.3390/ijerph17176312

Sammut‐Powell, C., Sisk, R., Budd, J., Patel, N., Edge, M., & Cameron, R. A. (2022). Development of minimal resource pre-screening tools for chronic kidney disease in people with type 2 diabetes. Future Healthcare Journal, fhj.2022-0020. https://doi.org/10.7861/fhj.2022-0020
Smokovski, I. (2020).

Importance of structured diabetes education. Managing Diabetes in Low Income Countries, 63–72. https://doi.org/10.1007/978-3-030-51469-3_6
Wadden, T. A., Tronieri, J. S., & Butryn, M. L. (2020). Lifestyle modification approaches for the treatment of obesity in adults. American Psychologist, 75(2), 235–251. https://doi.org/10.1037/amp0000517