NURS FPX 6011 Assessment 1: Patient-Centered Needs Assessment Based on Evidence
With the population in general aging, diabetes is becoming more common among people of age 65 and above. The diabetes mortality rate for people 65 and older will be 33. Older adults are more likely than younger people to have diabetic complications, such as heart disease, renal failure, and hypoglycemia (low blood sugar). New and emerging information can help physicians be better placed to detect and treat diabetes in the elderly. These variables should be considered as a way of enhancing health and life quality. The elderly are at a greater risk of developing cognitive decline, cardiovascular disease, and other conditions and it is more difficult to teach and manage diabetes in elderly people. The older adults are in need of hypertension, hyperlipidemia, and glucose control drugs. People with diabetes who get self-management support (SMS) are more likely to take their drugs as directed, experience less stress from their illness, and live healthier lives. Whether or not the SMS models are viable, sustainable to primary care clinics and acceptable by patients remains to be unclear. It is necessary to translate this research into practice as it is patient centered care evidence based practice described in NURS FPX 6011 Assessment 1.
Importance of Attending to Patient Involvement in Diabetes Management
Patient engagement (PE) is increasingly being acknowledged as a component of bettering health behaviors and results as chronic illnesses such as type 2 diabetes are managed (Rutten et al., 2020). As highlighted in the evidence-based patient-centered concept map, In the context of chronic illnesses, patient participation is generally recognized as an essential element of delivering high-quality healthcare. Patient involvement in the treatment and management of type-2 diabetes, especially high-risk individuals, has not diminished in importance. The patients with diabetes indicated that
whole-person-centered treatment resulted in an increase in activity, a more positive attitude towards diabetes, and a somewhat improved clinical result (Rutten et al., 2020). Person-centered care could also be characterized by increased patient participation, but given NURS FPX 6011 Assessment 1, rapid health outcome changes should be rethought. The immediate outcomes of patient engagement are better health outcomes and lower healthcare costs: patients become active participants in their care.
However, the risks to patients who are not involved are poor clinical outcomes and waste of healthcare resources. According to the patient-centered concept map, involving patients in treatment planning and taking into account their values and preferences has improved services and results (Rutten et al., 2020). One of the strategies that are currently used with older adults with diabetes is care coordination that entails the provision of social and health care in an integrated and personalized manner. Self-management of diabetics is a concept incorporated in diabetes management (Northwood et al., 2022). Since relatives can significantly contribute to the treatment of diabetes, the inclusion of relatives in the process of self-care can enhance the outcome of the disease. Improving blood glucose levels and preventing the onset of complications are associated with self-treatment of type 2 diabetes. One of the most important components of diabetes management is the patient’s social and familial support (Northwood et al., 2022). Given that most adult diabetes treatment is done at home, family dynamics should always be considered when developing treatments for NURS FPX 6011 Assessment 1.
With a greater understanding of the role that engagement plays in promoting positive health behavior and clinical outcomes, as evidenced by evidence-based
concept maps, the healthcare industry is looking for new ways to support the individual role in the treatment process. The American Diabetes Association and the European Association of the Study of Diabetes also support a person-centered approach to motivate patients to take an active role in their own care (Rutten et al., 2020). To achieve this, diabetics need diabetes education, self confidence, skills as well as motivation. The requirements are linked to the term patient activation. As diabetic patients are specifically at a high risk of coronary heart disease, the patient-centered approach must encompass the detailed plans to prevent the risk of heart attacks and strokes prevention by targeting the measures of hypertension and cholesterol levels, preventing and quitting smoking, treating weight, physical activities, and appropriate lifestyle practices. The results of the research on the care coordination of elderly diabetic patients have been encouraging (Northwood et al., 2022). In order to identify the best practices, as described in the patient-centered care concept map, future research in this group should evaluate comprehensive healthcare planning, system navigation across the health and social care sectors, the role of healthcare coordinators and their relationship to patients, and caregiver support.
Information and Communication Tools: Their Use and Effects
Thanks to advancements in technology and the expansion of cost-optimization services, older diabetic patients now have additional options (Doupis et al., 2020). The availability of telemedicine services, which can greatly improve the communication between patients and medical professionals, has been made possible by the Internet and mobile devices. The diabetes counseling app BlueStar is accessible through the corresponding iOS and Android apps. This is the first FDA-approved mobile app for
prescription drugs in the United States. Patients can remotely or manually enter their blood glucose readings into the BlueStar app to receive real-time coaching (Doupis et al., 2020). They also can be assisted in their medication schedule, dietary and health advice. Other variables (weight, blood pressure, etc.) are also not excluded (Gurung and Neupaney, 2020). Also, patients will be able to get over 25,000 automated coaching messages, personal guidance, and progress reports sent to them by their healthcare providers. The quantity of the mobile medical applications covering a diabetes topic has grown drastically over the past decade. Basal and bolus insulin control functions are present in the majority of commercial apps (Flors-Sidro et al., 2021). Along with a secure way to communicate with other medical professionals, they also provide automated feedback based on the study of blood glucose patterns.
The most popular technological tools for self-management are smartphones, laptops, and personal computers (Rutten et al., 2020). These gadgets are used to visit websites that contain useful text, audio, or video content about diabetes. Diabetics can therefore take care of their illness whenever it is most convenient for them. In the same way, self-management strategies have been improved by smartphone apps that check blood sugar levels outside of a clinical environment. Wearable technology has led to an increase in the number of people utilizing continuous glucose monitoring in recent years. Wearable technology includes things like eye lenses, skin patches, smart watches, and bracelets. As the patient-centered care concept map shows, these tools help people deal with their everyday situations, even though they may not be able to eliminate the need for ongoing care.
By lowering low health literacy, information and communication technology can help older people with diabetes achieve better health outcomes (Doupis et al., 2020). Adjustments to diet, medication, and other facets of daily living may be necessary for a chronic condition such as diabetes. The utilization of contemporary information and communication technology has significantly improved the care of elderly diabetics. One of the most recent studies suggests that diabetic patients who actively participate in their care may experience better outcomes and less acute problems (Gurung and Neupaney, 2020). Through the numerous communication technologies and the best-developed communication tools in care management, the patients find themselves in a better position to understand their illness and take proactive action through the knowledge and skills they have learned. The online platforms and the increased application of information and communication technology in health care are effortlessly lessening the burden of diabetes which has already become imminent. ICTs have contributed to patient-centered treatment, which promotes the cooperative work between medical workers and elderly patients with diabetes. Also, it has enabled raising awareness and communication between the senior patients with diabetes and the medical team. It is currently becoming an effective tool to provide quality medical care (Flors-Sidro et al., 2021). The elderly (patients over 65) will also have a place to follow the diabetes data and receive customized treatment recommendations.
As noted in NURS FPX 6011 Assessment 1, technological advancements like portals, cellphones, and mobile applications are opening up potential to improve access to and continuity of treatment for people with diabetes and other chronic diseases. However, it necessitates assessing and developing a variety of health-literate
technology. Although apps are useful for managing diabetes, it is unknown if they are also utilized to help people with type 1 diabetes (T1DM) safely drink alcohol. According to the patient-centered concept map, people with low health literacy will typically recognize and use tactics used by for-profit applications. Ways to improve the accessibility and usefulness of free diabetic mobile applications could be the subject of future study.
The significance and worth of the technological modalities
Users of iOS and Android devices can download the Diabetes Pal app to help manage their condition (Gurung and Neupaney, 2020). According to NURS FPX 6011 Assessment 1, customers have the option of manually entering their blood glucose readings or having their glucose meter read them wirelessly via Bluetooth. This telemedicine program allows the physician to monitor the patient’s blood sugar in real time (Watson, 2020). It also has comprehensive instructions on how to manage hypoglycemia situations.
With the introduction of web-based solutions, telemedicine, and the most recent mobile health applications, managing diabetes in the elderly has grown easier and more automated (Gurung & Neupaney, 2020). Blood glucose was formerly measured with a fingerstick blood sample. Nowadays, diabetic individuals can check their blood sugar levels with a straightforward wireless sensor that is applied to their skin. The gadget transmits digital information to the computer network locally. The amount of glucose in the subcutaneous fluid is determined using the results of this information. Some advanced CGMs can also measure blood sugar levels by waving the reader over the
sensor (Watson, 2020). A sensor’s light signal is followed to determine the blood sugar level.
Excessive insulin can cause a potentially deadly decline in blood sugar levels and is used to treat diabetes (Gurung and Neupaney, 2020). It is now feasible to predict a drop in blood sugar and immediately stop insulin transfers thanks to recent technological developments. A preset amount of insulin can be released via insulin pumps, and this amount can be manually adjusted to take into consideration changes in the patient’s calorie intake. According to Gurung and Neupaney (2020), contemporary automated insulin pumps are closed-loop devices with an algorithm that tracks blood sugar levels and administers insulin as needed. Although it is difficult to obtain a stable form of glucagon that can be utilized in a pump, there are currently efforts on to build a completely accurate closed loop insulin/glucagon administration device.
Pumps need to be used all the time by the patient despite the ability to measure blood sugar levels and insulin administration (Watson, 2020). According to the example of NURS FPX 6011 Assessment 1, a smart pen is another alternative to a tethered pump because it possesses every feature of a pump, such as memory. It also has Bluetooth and a smartphone app that the user uses to document the timing and dosage of insulin. This data can be useful in accessing many applications of diabetes monitoring. Games involving movement video games may have led to increased exercising in people with diabetes. Various researches on type 1 diabetes among the elderly population have resulted in development of several video games such as Nintendo Wii Fit Plus. Virtual and augmented reality can simplify self-management of care by performing particular tasks, including the selection of the optimal manner of
administering insulin (Gurung and Neupaney, 2020). It can help people to know how the level of their blood sugar is influenced by the food they consume (through the glycemic index).
It is not clear to what extent the diabetic applications comply with the privacy and data security laws. The findings confirm the view that further education is needed to provide physicians and patients with information on the privacy issues related to diabetic applications (Flors-Sidro et al., 2021). This paper therefore highlights the importance of adequate and proper training of the users. The second recommendation is that data privacy laws by governments and regulatory bodies must be enforced to the letter. It is also vital to set stricter security requirements and operations in the Android and the Google play store as well as engage and oversee all parties in the application development process.
Innovative Strategies for Leveraging Telehealth
Telephone-based approaches can be used to enhance symptom monitoring and coping by palliative care nurses. In a web-based approach, it was found that the remote medication delivery could be of use when cancer patients were involved. The composition of the multidisciplinary team should be identified using the diagnosis of the patient and the needs of the family (Gordon et al., 2022). Interprofessional approaches are more comprehensive in approaches in which they make use of the knowledge of multiple professions to attain the objectives of client-centered care. With the application of an interprofessional approach, patients with diabetes will be in a better position to access healthcare providers because they could be monitored and treated at a distance.
Telehealth has become rampant in treatment of emotional distress and mental health problems. Nurses who are trained in telehealth assist patients in solving spiritual or religious issues (Gordon et al., 2022). Cultural consideration can be prioritized when it comes to telehealth services since patients will no longer have to drive long distances to get care. As an example, a virtual visit or family reunion of a patient can involve family members and traditional healers. Telehealth is capable of addressing the health demands of underdeveloped remote locations and indigenous people. The utilization of web-based technology for remote cancer patient management is quite successful.Gordon et al. (2022) found that telehealth enhanced the quality of care and the capacity to treat symptoms including nausea, hunger, and discomfort. Patients are assisted in understanding the ethical and legal implications of their treatment by filling out online DNR/DN forms, advance directives, and health care proxies.
Adverse Risks Will Be Reduced by the Suggested Strategies
One study claims that patient data security and privacy are the main barriers to the broad adoption of telehealth (Dzau, Mate, and O’Kane, 2022). The most recent security measures must be put in place to help ease concerns because telehealth data is extremely sensitive. Comprehensive security measures are necessary to reduce the risks. Telehealth systems should be particularly secure since they handle sensitive data, as required by the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health (HITECH) Act (Dzau, Mate, and O’Kane, 2022). Protected health information (PHI) is one of the most important parts of electronic medical records, and HIPAA makes sure that its privacy and confidentiality are upheld.
Firewalls are the most commonly mentioned security mechanism for safeguarding healthcare businesses’ IT networks (Dzau, Mate, & O’Kane, 2022). Even while firewalls have been shown to be highly successful in protecting networks and PHI, their cost varies greatly depending on the size and scope of a company. Confidential data has been encrypted to protect electronic medical records. In this instance, the security of electronic health records during their transit between healthcare facilities has been improved by encryption (Dzau, Mate, & O’Kane, 2022). According to the patient centered care concept map, meaningful use constraints require that companies provide a standard format for sending medical records and track exchange information, such as whether encryption is being used or not.
Access to data that may be accessed by mobile agents can be encrypted and decoded using secure methods (Dzau, Mate, and O’Kane, 2022). Electronic health data are availed and secured by ensuring the protection of mobile agents in cases where patients are receiving treatment in different institutions. Using a username and password is another way to encrypt data. Customers should frequently update their passwords, which are considered to be very secret information, to lessen the possibility of information leaks (Dzau, Mate, and O’Kane, 2022). A memorable date or the user’s name shouldn’t be used as a password. A provider can apply role-based constraints using credentials such as usernames and passwords. Using login credentials that are supplied by a system administrator, role-based access control allows users to access data. The measures make sure that electronic health records (EHRs) cannot be accessed or altered without permission (Dzau, Mate, and O’Kane, 2022). I shall be required to exit the system at the end of every use as an employee so as to avoid the
possibility of unauthorized individuals gaining access. The contribution that cloud computing can make to cooperating and integrating with EHR systems has gained more significance as technology has improved. Due to the infrastructural advancements that result in the separation of storage, software, and processing power, which are rented in cloud computing, data could be shared and stored digitally (Dzau, Mate, and O’Kane, 2022). As NURS FPX 6011 Assessment 1 says, the cost of implementing an EHR system can be lower when healthcare companies switch to this platform to assist in shifting ownership and maintenance expenses. To assure secure cloud access, cryptographic measures are provided.
References
Asgari, P., & Nazari, E. (2019). Review of the effectiveness of information and communication technology (ICTs) in the treatment of type 1 and type 2 diabetes. Frontiers in Health Informatics, 8(1), 12. DOI: 10.30699/fhi.v8i1.182
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.
doi: 10.1007/s13300-020-00768-3
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
Flors-Sidro, J. J., Househ, M., Abd-Alrazaq, A., Vidal-Alaball, J., Fernandez-Luque, L., & Sanchez-Bocanegra, C. L. (2021). Analysis of diabetes apps to assess privacy-related permissions: A systematic search of apps. JMIR diabetes, 6(1), e16146. doi: 10.2196/16146 doi: 10.2196/16146
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
