NURS FPX 6021 Assessment 2 Change Strategy and Implementation

Change Strategy and Implementation

Change strategy and implementation in healthcare refers to identifying and implementing changes to improve the care provided to patients with a particular condition. In the case of diabetes type 2 and kidney failure, change strategy and implementation would involve identifying and implementing changes to improve the care provided to patients with both conditions. Implementing change strategies in healthcare requires a systematic approach that includes planning, implementation, and evaluation. To make sure that the change strategies deployed fit the demands of the patient population and are sustainable over time, it is crucial to include stakeholders such as patients, healthcare professionals, and other essential stakeholders in the process (Powell et al., 2019).

NURS FPX 6021 Assessment 2 Change Strategy and Implementation

Diabetes Type 2 and Renal Failure

Chronic diabetes type 2 is defined by the body’s failure to produce enough insulin or use it effectively, which results in elevated blood sugar levels. Kidney failure, commonly known as diabetic nephropathy, is one of the long-term effects of untreated diabetes. Over time, high blood sugar levels can damage the kidneys’ microscopic blood capillaries, causing kidney damage and ultimately leading to renal failure. High blood pressure, heredity, and smoking are other risk factors for diabetic kidney damage. Diabetic kidney damage can be avoided or delayed by controlling blood sugar levels with medication, food, and exercise. Regular monitoring of kidney function through blood and urine tests is also important for the early detection and treatment of kidney damage (Bakris et al., 2020).

Case Study

A 52-year-old woman named Mrs. Smith has been diagnosed with type 2 diabetes and is currently experiencing severe renal problems that negatively impact her life. She relies on her daughter for assistance and often has poor eating habits when left alone. Her blood sugar levels have been consistently high, with readings of 120+ and reaching 300mg/dl after meals. She has been advised to take better care of herself and follow the guidelines for managing her condition. Mrs. Smith needs a proper and effective treatment plan to handle her various issues. This approach needs good collaboration among multiple stakeholders and interprofessional teams to attain effective and productive results for her. In this context, a dietician, nephrologist, and endocrinologist team will collaborate to bring a plan to handle her problem effectively (Powell et al., 2019).

Data Table

Clinical Results

There is a proper and effective treatment plan for Mrs. Smith, including an appropriate diet plan, with the dietician’s approval. This will ensure that her sugar level and urine discharge are normal. She was also taught self-management techniques to handle her situation more appropriately (Ericsson & Fridhammar, 2019). Further, a good team comprises a dietician, ENT specialist, Nephrologist, and Endocrinologist. This team ensured that every little aspect was considered for recommending any intervention. Similarly, telehealth was suggested to ensure effective and timely collaboration between nurse and patient (Hu et al., 2019). 

Areas of Uncertainties

The entire plan is based on the assumption that it will result in better health outcomes for the patient, but still, there are several uncertainties. Firstly, there is a lack of motivation from Mrs. Smith’s side which can cause problems in planning success. Further, the lack of staff in the organization is an additional problem. Lastly, the patient is concerned about her loneliness which can cause anxiety problems. So, all these issues must be handled effectively to bring better results (Ericsson & Fridhammar, 2019).

Projected Change Strategy for the Outcomes

New policies, practices, and technologies must be adopted in order to enhance patient outcomes, save costs, and raise the standard of care overall. Change strategies are essential in the healthcare industry for this reason. Healthcare organizations adopt change strategies to improve patient outcomes. These strategies can include implementing evidence-based practices (Ju, 2020). There are following change strategies which are being devised and recommended for Mrs. Smith 

Patient Education

 The patient will be educated on managing her diabetes and renal health. This includes the consequences of uncontrolled blood sugar levels, regular check-ups, and medication adherence. This can be done through pamphlets, videos, one-on-one sessions with a diabetes educator, and group classes (Ju, 2020).

Caregiver Education

The patient’s daughter will be educated on managing her mother’s diabetes and renal health, including monitoring her blood sugar levels, administering medications, and preparing healthy meals. This can be done through one-on-one sessions with a diabetes educator, group classes, and online resources. A self-management approach is also important, bringing better results for her and their family (Misra & Bloomgarden, 2020).

Medication Management and Telehealth

The patient will be placed on appropriate medication to manage her diabetes and renal health. The medication will be adjusted based on her blood sugar levels and renal function. Regular follow-up appointments with a healthcare provider will ensure the medication works effectively. A telehealth approach will also ensure effective communication between staff and patients (Michaud et al., 2021).

Lifestyle Modification

The patient must make significant modifications to manage her diabetes and renal health. This entails controlling stress, maintaining a nutritious diet, getting regular exercise, quitting smoking, and consuming no alcohol. The nurses will implement direct and indirect interventions to improve Mrs. Smith’s life (Misra & Bloomgarden, 2020).

NURS FPX 6021 Assessment 2 Change Strategy and Implementation

Nurses may also utilize various change models like Lewin’s Change Model. This model involves three stages: unfreezing, changing, and refreezing. Unfreezing involves breaking down the current mindset and attitudes towards diabetes and renal health, changing involves implementing new behaviors, and refreezing involves making the new behaviors a habit. Further, Kotter’s 8-Step Change Model can also be used by nurses. This model entails instilling a feeling of urgency, assembling a coalition, forging a strategic vision, communicating the vision, enabling people to act on the vision, achieving quick wins, consolidating successes and bringing about more change, and enshrining new ideas in the organizational culture (Harrison et al., 2021).

Potential Difficulties

The patient and her daughter may resist making the necessary changes to manage her diabetes and renal health. The patient and her daughter may not have access to the necessary resources, such as a diabetes educator or healthy food options. The healthcare system may not provide adequate support to the patient and her daughter, such as a lack of access to healthcare providers or ineffective medications.

Meeting Challenges

Effective communication with the patient and her daughter can help address resistance to change and ensure they understand the importance of managing her diabetes and renal health. Identifying and providing resources such as diabetes education, access to healthy food options, and healthcare providers can help address the lack of resources. Collaborating with the healthcare system to ensure that the patient and her daughter receive adequate support and care can address the inadequacies of the healthcare system (Ataguba & Ataguba, 2020).

Justification of the Change Approaches Used to Attain the Desired Outcomes

The entire plan and change strategies are very much useful for the patient. Several studies have highlighted the importance of strategies that are being opted for. The Community Preventive Services Task Force (CPSTF) advises using community health professionals in interventions to assist people in managing their diabetes. These strategies have been shown to decrease patient healthcare use while improving glycemic and lipid management These activities are economical, according to economic data. Interventions involving community health workers in managing diabetes may enhance health, reduce health inequities, and increase health equality because they are frequently carried out in impoverished areas (Ju, 2020).

The same is true of the Diabetes Self-Management Education and Support (DSMES) programs, which equip clients with the skills and knowledge necessary to manage their diabetes and related illnesses. The DSMES is based on criteria supported by evidence and is tailored to your own needs, goals, and experiences. They also provide you advice on how to manage the emotional effects of having diabetes, eat healthily, exercise, monitor your blood sugar levels, take medication, solve problems, reduce your risk of contracting other illnesses, and generally improve your health and quality of life. A diabetes educator, such as a licensed nurse, dietitian, or pharmacist, oversees DSMES (CDC, 2018).

NURS FPX 6021 Assessment 2 Change Strategy and Implementation

Further, an estimated 415 million people worldwide have diabetes. It accounts for around 9% of the world’s adult population. According to estimates, there might be 642 million people worldwide by 2040. Nowadays, 77% of people with diabetes reside in middle- or lower-income families, which costs nearly $550 billion annually. Telemedicine is crucial in the fight against this illness, particularly during COVID-19. It may help with complicated adult diabetes care, tracking the condition’s development, and early detection. When compared to conventional clinical care, research has demonstrated that telemedicine considerably lowers the HbA1c levels of the majority of patients. Five different investigations found that patients who chose telemedicine experienced a decrease in the frequency of hypoglycemia (Josh, 2021).

Assumption

The entire plan and strategies are based on the assumption that this will bring better health results for the patient. These interventions will ensure that Mrs. Smith has better control of her sugar level. Her kidney will work better, and she will be more aware of self-management approaches (Harrison et al., 2021).

Change Plans Leading to Quality Improvement Regarding Safety and Care

Implementing these change strategies for Mrs. Smith will lead to quality improvement regarding safety and equitable care. The patient and caregiver education will help them understand the condition better and learn how to manage it effectively. This will result in better health outcomes and reduced complications. The medication management and telehealth strategy will help Mrs. Smith access her medication and care from the comfort of her home. This will reduce the need for hospital visits and help her to manage her condition better. Mayo Clinic has successfully implemented this strategy, improving its medication management system using technology, resulting in better patient outcomes (Munday et al., 2019). Get free NURS FPX 6021 Assessment 2 Change Strategy and Implementation

The lifestyle modification strategy will help Mrs. Smith to make necessary changes to her diet and exercise routine. This will help her to manage her condition better and reduce the risk of complications. Cleveland Clinic has successfully implemented this strategy, launching a program called “Healthy Lifestyle Coaching” to help patients make necessary changes (Piao et al., 2019). Lewin’s Change Model and Kotter’s 8-Step Change Model can be used to implement these change strategies effectively. Lewin’s Change Model focuses on three steps to implement change: unfreezing, changing, and refreezing. Kotter’s 8-Step Change Model focuses on eight steps. It involves instilling a sense of urgency, assembling an effective team, developing a vision for change, communicating that vision, empowering others to carry out that vision, achieving quick victories, building on those successes to bring about more change, and ingraining new ideas into the organization’s strategy (Misra & Bloomgarden, 2020).

Assumptions

This explanation’s assumptions include that patient safety and equitable care are important goals for healthcare organizations. The change strategies can effectively improve the quality of care. Further, healthcare providers and patients can be engaged and motivated to participate in quality improvement initiatives (Munday et al., 2019).

Change Approaches Utilized in Interprofessional Considerations

Interprofessional considerations are essential for successfully implementing change strategies for Mrs. Smith’s case. The change strategies must involve a collaborative approach that involves different healthcare professionals, such as doctors, nurses, dieticians, and social workers, to ensure that all aspects of the patient’s care are covered (McHugh et al., 2020). The interprofessional team can collaborate to educate patients on managing diabetes and renal issues. The team can include a diabetes educator, a nurse, a dietician, and a pharmacist who can provide Mrs. Smith with information about her medications, lifestyle changes, and diet modifications. This will help Mrs. Smith to understand the importance of managing her diabetes and renal issues and the steps she needs to take to improve her health. Mrs. Smith’s family members and caregivers must also be educated on managing her diabetes and renal issues. The interprofessional team can educate caregivers on monitoring Mrs. Smith’s blood sugar levels, administering medication, and managing her diet. This will help to ensure that Mrs. Smith receives consistent care and support from her family and caregivers (Sy et al., 2020).

The interprofessional team can work together to manage Mrs. Smith’s medications and monitor her health using telehealth technology. The team can include a pharmacist, a nurse, and a physician who can work together to ensure that Mrs. Smith is taking her medications correctly and that her health is being monitored. Telehealth can monitor Mrs. Smith’s blood sugar levels and renal function. This information can be shared with the interprofessional team to make informed decisions about her care. The interprofessional team can work together to provide Mrs. Smith with lifestyle modification strategies to improve her health. The team can include a dietician, a physical therapist, and an occupational therapist who can provide Mrs. Smith with information on healthy eating, exercise, and ways to manage her daily activities. This will help Mrs. Smith make positive lifestyle changes to improve her health and quality of life (Sy et al., 2020).

Assumptions

It is based on the assumption that effective implementation of change strategies requires the involvement of a multidisciplinary team. The patient’s care should be viewed holistically, encompassing medical, social, and psychological aspects. Change strategies should be tailored to meet each patient’s unique needs and should be evidence-based. The success of change strategies relies on effective communication and collaboration among healthcare professionals (Munday et al., 2019).

Conclusion

In conclusion, implementing these change strategies will improve Mrs. Smith’s quality of life and ensure better management of her type 2 diabetes and renal issues. Implementing these change strategies requires a collaborative effort from the healthcare team, Mrs. Smith, and her caregivers. It is essential to ensure ongoing monitoring and support to sustain these changes and prevent potential complications.

References

Ataguba, O. A., & Ataguba, J. E. (2020). Social determinants of health: The role of effective communication in the COVID-19 pandemic in developing countries. Global Health Action, 13(1), 1788263. 

https://doi.org/10.1080/16549716.2020.1788263

Bakris, G. L., Agarwal, R., Anker, S. D., Pitt, B., Ruilope, L. M., Rossing, P., Kolkhof, P., Nowack, C., Schloemer, P., Joseph, A., Filippatos, G., & FIDELIO-DKD Investigators. (2020). Effect of finer enone on chronic kidney disease outcomes in type 2 diabetes. The New England Journal of Medicine, 383(23), 2219–2229. https://doi.org/10.1056/NEJMoa2025845

CDC. (2018, December 19). Managing Diabetes | Self-management education Programs | Self-management education: Learn more. Feel better. | CDC. Www.cdc.gov. https://www.cdc.gov/learnmorefeelbetter/programs/diabetes.htm#:~:text=Participating%20in%20a%20self%2Dmanagement

Ericsson, Å., & Fridhammar, A. (2019). Cost-effectiveness of once-weekly semaglutide versus dulaglutide and lixisenatide in patients with type 2 diabetes with inadequate glycemic control in Sweden. Journal of Medical Economics, 22(10), 997–1005. https://doi.org/10.1080/13696998.2019.1614009

Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement, and implementation meet? a systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, Volume 13(13), 85–108. NCBI. 

https://doi.org/10.2147/jhl.s289176

Hu, H., Feng, X., Shao, Z., Xie, M., Xu, S., Wu, X., & Ye, Z. (2019). Application and prospect of mixed reality technology in the medical field. Current Medical Science, 39(1), 1–6. 

https://doi.org/10.1007/s11596-019-1992-8

Josh, D. (2021, May 4). Telemedicine in complex diabetes management. Smart Clinix. https://smartclinix.net/telemedicine-in-complex-diabetes-management/#:~:text=Telemedicine%20helps%20keep%20diabetic%20patients

Ju, H.-H. (2020). Using telehealth for diabetes self-management in underserved populations. The Nurse Practitioner, 45(11), 26–33. https://doi.org/10.1097/01.npr.0000718492.44183.87

McHugh, S. K., Lawton, R., O’Hara, J. K., & Sheard, L. (2020). Does team reflexivity impact teamwork and communication in interprofessional hospital-based healthcare teams? A systematic review and narrative synthesis. BMJ Quality & Safety, 29(8), bmjqs-2019-009921. 

https://doi.org/10.1136/bmjqs-2019-009921

Michaud, T. L., Ern, J., Scoggins, D., & Su, D. (2021). Assessing the impact of telemonitoring-facilitated lifestyle modifications on diabetes outcomes: A systematic review and meta-analysis. Telemedicine and E-Health, 27(2), 124–136. https://doi.org/10.1089/tmj.2019.0319

Misra, A., & Bloomgarden, Z. (2020). Diabetes during the COVID ‐19 pandemic: A global call to reconnect with patients and emphasize lifestyle changes and optimize glycemic and blood pressure control. Journal of Diabetes, 12(7), 556–557. https://doi.org/10.1111/1753-0407.13048

Munday, J., Delaforce, A., Forbes, G., & Keogh, S. (2019). Barriers and enablers to the implementation of perioperative hypothermia prevention practices from the perspectives of the multidisciplinary team: A qualitative study using the Theoretical Domains Framework. Journal of Multidisciplinary Healthcare, Volume 12, 395–417. https://doi.org/10.2147/jmdh.s209687

Piao, M., Ryu, H., Lee, H., & Kim, J. (2019). Use of the Chatbot “Healthy Lifestyle Coaching” to promote stair climbing habit among office workers: An exploratory randomized controlled trial (preprint). JMIR MHealth and UHealth. https://doi.org/10.2196/15085

Powell, B. J., Fernandez, M. E., Williams, N. J., Aarons, G. A., Beidas, R. S., Lewis, C. C., McHugh, S. M., & Weiner, B. J. (2019). Enhancing the impact of implementation strategies in healthcare: A research agenda. Frontiers in Public Health, 7(3). https://doi.org/10.3389/fpubh.2019.00003

Sy, M., O’Leary, N., Nagraj, S., El-Awaisi, A., O’Carroll, V., & Xyrichis, A. (2020). Doing interprofessional research in the COVID-19 era: a discussion paper. Journal of Interprofessional Care, 34(5), 600–606. https://doi.org/10.1080/13561820.2020.1791808