NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations

Technology, Care Coordination, and Community Resources Consideration

Diabetes mellitus type 2 occurs due to insulin insufficiency in the body to maintain normal blood sugar levels. Insulin is a hormone produced by the pancreas that helps glucose to enter the body’s cells, where it is used for energy production. Symptoms (NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations) may include increased thirst, frequent urination, hunger, fatigue, blurred vision, and slow healing of cuts or wounds (Padhi et al., 2020).

In today’s fast-paced healthcare environment, technology has become an integral part of care coordination and community resource management for nurses. By leveraging the power of technology, being a nurse, I can effectively manage patient care across various settings, facilitate communication between providers, and connect patients with community resources that can help support their care.

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NURS FPX 4900 Assessment 2 Quality, Safety, and Cost Considerations

Impact of Technologies on Patient

During my two-hour practicum with Mr. Andrew, a fifty-nine-year-old male patient with T2DM, I took the opportunity to learn about his medical history and current health status. As we engaged in conversation, I also asked him about his thoughts regarding the new technologies available for managing his condition. It became clear that not everyone is aware of the latest advancements in disease management, and some may be hesitant to adopt new technologies for various reasons.

Mr. Andrew had been dealing with type 2 diabetes for fifteen years and was admitted to the hospital three times in the last six months. To address his complex medical needs, I arranged a meeting with other healthcare professionals, including the vice president of the organization, to discuss the best course of treatment for Andrew’s condition.

As a healthcare professional, I have to stay up-to-date with the latest advancements in our field and help our patients understand the importance of utilizing new technologies and treatments for the speedy recovery and management of their conditions. By working together and providing the best possible care, we can help improve overall health outcomes and quality of life of Andrew. Following are the impact of some technologies on Andrew’s health. 

  • Continuous Glucose Monitoring (CGM) devices allow Andrew with type 2 diabetes to monitor blood sugar levels in real-time, helping him to better manage his condition and make more informed decisions about his diet and medication. CGM devices can also help to identify trends in blood sugar levels and alert patients and their healthcare providers to potential complications (Freckmann, 2020).
  • Insulin pumps are small devices that deliver insulin to the body continuously, allowing Andrew to better regulate his blood sugar levels throughout the day. This pump can assist Andrew in regulating his blood sugar levels throughout the day. By delivering insulin continuously, the pump reduces the need for frequent injections and makes it easier for Andrew to maintain stable blood sugar levels. This would lead to better overall health outcomes and improve Andrew’s quality of life (Freckmann et al., 2020)
  • Telehealth allows patients with type 2 diabetes to connect with us, a healthcare provider, remotely, using video conferencing and other communication tools. This can be especially helpful for patients who have difficulty traveling to appointments or who live in rural areas without easy access to healthcare. Telehealth could help Andrew to stay connected with us and receive the care he needs without having to physically travel to appointments (Lewinski et al., 2022).
  • Mobile apps are available that can help to track blood sugar levels, monitor diet and exercise, and manage medication schedules. These apps can provide valuable information to healthcare providers and help Andrew to better manage their condition on a daily basis (Shan et al., 2019).
  • Electronic health records (EHRs) are digital records of Andrew’s medical history, including information about their type 2 diabetes diagnosis, treatment plans, and medication history. By accessing this information, we can make more informed decisions about a patient’s care and ensure that they receive the most appropriate and effective treatments (Nguyen et al., 2019). 

Overall, these healthcare technologies have had a significant impact on the management and treatment of type 2 diabetes mellitus, making it easier for Andrew to monitor his condition, connect with us, and receive the best possible care.

Advantages of  Technologies

Healthcare technologies such as continuous glucose monitoring (CGM), insulin pumps, and mobile apps can help patients to better manage their condition and achieve more stable blood sugar levels. This can lead to fewer complications and better overall health outcomes (Kho et al., 2019). Healthcare technologies can help patients to become more engaged in their care by providing them with more information about their condition and treatment options. This can empower patients to take a more active role in managing their condition and lead to better health outcomes.

Technologies such as electronic health records (EHRs) and telehealth can help healthcare providers to deliver care more efficiently and effectively. EHRs can provide healthcare providers with a comprehensive view of a patient’s medical history, while telehealth can improve access to care and reduce the need for in-person appointments (Li et al., 2020). 

Disadvantages/ Barriers of Health Technologies

Healthcare technologies such as continuous glucose monitoring (CGM) and insulin pumps can be expensive, making them inaccessible for some patients. In addition, the cost of implementing new technologies in healthcare systems can be a barrier for healthcare providers.

Some patients lack the technological literacy required to effectively use healthcare technologies. This can lead to difficulties using these tools and ultimately result in poorer health outcomes (Bults et al., 2023).

Healthcare technologies such as EHRs often involve the collection and sharing of sensitive medical information. Patients have concerns about the security and privacy of their personal health information. The implementation of new healthcare technologies can be challenging for healthcare providers. This includes issues with integration with existing systems, staff training, and workflow changes. Healthcare technologies are often developed by different companies and not be compatible with each other. This can lead to difficulties in integrating different technologies and can result in a fragmented healthcare system (Keshta & Odeh, 2020). 

Telehealth and other remote care technologies require access to reliable internet. In areas with limited access to the internet, these technologies are not accessible. (Jeffrey et al., 2019).

Some patients have cultural or language barriers that prevent them from effectively using healthcare technologies or communicating with healthcare providers. This can lead to difficulties in accessing care and ultimately result in poorer health outcomes (Yingling et al., 2019).

Care Coordination and Community Resources Utilization

In the case of Andrew, the patient with type 2 diabetes mellitus who had been admitted to the hospital multiple times in the past six months, care coordination and the utilization of community resources can be essential to addressing his problem. Firstly, care coordination can help to ensure that all members of Andrew’s healthcare team are on the same page regarding his care plan. This can involve regular meetings between Andrew’s primary care physician, endocrinologist, and other healthcare professionals involved in his care to discuss his treatment plan, medications, and any necessary lifestyle changes.

This can help to prevent miscommunications that can lead to gaps in care or adverse events. Secondly, the utilization of community resources can help Andrew to better manage his condition and reduce the likelihood of future hospital admissions. Organizations like the American Diabetes Association, Centers for Disease Control and Prevention, CMC, National Institute of Health, and Juvenile Diabetes Research Foundation work to raise awareness about type 2 diabetes, promote early detection and prevention, improve access to treatment and care, and support research to develop new therapies and interventions.

They also provide education and resources for patients and healthcare providers and advocate for policies that support diabetes prevention and management. For example, Andrew could attend a diabetes self-management program that provides education on healthy eating, exercise, and medication management (Boltri et al., 2023). By working together to develop a comprehensive care plan and connecting patients with necessary resources, we can help to improve outcomes and reduce the likelihood of future hospital admissions.

Evidence-Based Approach 

A systematic review of 36 studies found that care coordination interventions for patients with diabetes led to improved glycemic control and reduced hospitalizations and emergency room visits (Powell et al., 2021).

A randomized controlled trial published in the Canadian Journal of Diabetes found that a community-based diabetes self-management program led to improved glycemic control and reduced healthcare utilization among patients with diabetes (Sherifali et al., 2020). 

The American Diabetes Association (ADA) recommends the use of care coordination and community resources in the management of diabetes. The ADA’s Standards of Medical Care in Diabetes state that collaboration among providers, patients, and their families to implement and support self-management is a cornerstone of diabetes care (Association, 2019).

These studies provide credible and balanced evidence of the benefits of care coordination and the use of community resources in managing type 2 diabetes mellitus. By providing patients with access to education, support, and resources, healthcare providers can help patients to better manage their condition and reduce the likelihood of adverse health outcomes.

Potential Barriers to Care Considerations

In professional practice, care coordination and the use of community resources for patients with type 2 diabetes mellitus are becoming increasingly common. Many healthcare systems have implemented care coordination programs that involve regular communication and collaboration between healthcare providers, patients, and their families to develop and implement a comprehensive care plan. These programs often involve the use of technology, such as electronic health records, to facilitate communication and coordination.

Barriers in implementation of care coordination include the lack of reimbursement for care coordination services. Many healthcare providers are not reimbursed for the time and effort required to coordinate care for patients, which can make it difficult to implement care coordination programs (Powers et al., 2020).

Another barrier is the lack of resources and infrastructure to support community-based interventions. Some patients may live in areas where community resources for diabetes management are limited or not available, which can make it difficult to implement interventions. Additionally, there are challenges in engaging patients and their families in care coordination and community-based interventions. Patients become hesitant due to concerns about privacy or time. There are also cultural or language barriers that make it difficult to engage patients and their families. These barriers must be addressed to fully realize the benefits of these interventions in professional practice (Powers et al., 2020). 

State Board Nursing Practice Standards and Government and Organizational Policies 

The American Nurses Association (ANA) Code of Ethics for Nurses emphasizes the importance of using technology responsibly and ethically. This includes using technology to promote patient safety and improve patient outcomes, as well as protecting patient privacy and confidentiality (Linton & Koonmen, 2020).

The National Council of State Boards of Nursing (NCSBN) provides guidelines for nursing practice. These guidelines address issues such as informed consent, patient assessment, and documentation in the use of telehealth technologies for patient care (Rutledge & Gustin, 2021).

The Centers for Medicare & Medicaid Services (CMS) has developed policies to promote the use of care coordination and community resources in the management of chronic conditions such as type 2 diabetes mellitus. These policies include the Chronic Care Management program, which provides reimbursement for care coordination services for patients with multiple chronic conditions (Shao et al., 2022).

The Affordable Care Act (ACA) includes provisions to promote the use of care coordination and community resources in the management of chronic conditions. These provisions include the creation of insurance coverage, which is tasked with developing and testing new models of care coordination and delivery (Myerson et al., 2019).

Ethical Professional Practice

Guidelines and policies by healthcare providers can ensure that they are providing efficient care. For instance, healthcare providers can help to ensure that patients receive safe and effective care. This includes taking steps to protect patient privacy and confidentiality, as well as ensuring that patients are fully informed about the risks and benefits of different treatment options.

Providers can assist in fostering trust with patients and their families. This includes ensuring that patients are treated with respect and dignity and that their concerns are taken seriously. Nurses can ensure that patients are meeting legal and regulatory requirements for the management of type 2 diabetes mellitus. This includes complying with laws and regulations related to patient privacy and data security, as well as reimbursement requirements for care coordination services.

Conclusion – NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations

The effective management of type 2 diabetes mellitus requires a comprehensive approach that integrates health technology, care coordination, and community resources. The use of health technology can help to improve patient outcomes by providing real-time monitoring and analysis of patient data. In contrast, care coordination can help to ensure that patients receive integrated and high-quality care. In addition, the utilization of community resources can help to address social determinants of health and promote patient engagement in self-management. By adhering to established standards and policies and promoting ethical professional practice, healthcare providers can help to ensure that patients with type 2 diabetes mellitus receive safe, effective, and patient-centered care.

References

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Association, A. D. (2019). 1. Improving care and promoting health in populations: Standards of medical care in diabetes—2020. Diabetes Care, 43(Supplement 1), S7–S13. https://doi.org/10.2337/dc20-s001

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Boltri, J. M., Tracer, H., Strogatz, D., Idzik, S., Schumacher, P., Fukagawa, N., Leake, E., Powell, C., Shell, D., Wu, S., & Herman, W. H. (2023). The national clinical care commission report to congress: Leveraging federal policies and programs to prevent diabetes in people with prediabetes. Diabetes Care, 46(2), e39–e50. https://doi.org/10.2337/dc22-0620 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Bults, M., Leersum, C. M. van, Olthuis, T. J. J., Bekhuis, R. E. M., & Ouden, M. E. M. den. (2023). Mobile health apps for the control and self-management of type 2 diabetes mellitus: Qualitative study on users’ acceptability and acceptance. JMIR Diabetes, 8(1), e41076. https://doi.org/10.2196/41076 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Freckmann, G. (2020). Basics and use of continuous glucose monitoring (CGM) in diabetes therapy. Journal of Laboratory Medicine, 0(0). https://doi.org/10.1515/labmed-2019-0189 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Freckmann, G., Buck, S., Waldenmaier, D., Kulzer, B., Schnell, O., Gelchsheimer, U., Ziegler, R., & Heinemann, L. (2020). Insulin pump therapy for patients with type 2 diabetes mellitus: Evidence, current barriers, and new technologies. Journal of Diabetes Science and Technology, 15(4), 193229682092810. https://doi.org/10.1177/1932296820928100 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Jeffrey, B., Bagala, M., Creighton, A., Leavey, T., Nicholls, S., Wood, C., Longman, J., Barker, J., & Pit, S. (2019). Mobile phone applications and their use in the self-management of Type 2 Diabetes Mellitus: a qualitative study among app users and non-app users. Diabetology & Metabolic Syndrome, 11(1), 1–17. https://doi.org/10.1186/s13098-019-0480-4 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Keshta, I., & Odeh, A. (2020). Security and privacy of electronic health records: Concerns and challenges. Egyptian Informatics Journal, 22(2), 177–183. https://doi.org/10.1016/j.eij.2020.07.003 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Kho, S. E. S., Lim, S. G., Hoi, W. H., Ng, P. L., Tan, L., & Kowitlawakul, Y. (2019). The development of a diabetes application for patients with poorly controlled type 2 diabetes mellitus. CIN: Computers, Informatics, Nursing, 37(2), 99–106. https://doi.org/10.1097/cin.0000000000000485 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Lewinski, A. A., Walsh, C., Rushton, S., Soliman, D., Carlson, S. M., Luedke, M. W., Halpern, D. J., Crowley, M. J., Shaw, R. J., Sharpe, J. A., Alexopoulos, A.-S., Tabriz, A. A., Dietch, J. R., Uthappa, D. M., Hwang, S., Ball Ricks, K. A., Cantrell, S., Kosinski, A. S., Ear, B., & Gordon, A. M. (2022). Telehealth for the longitudinal management of chronic conditions: Systematic review. Journal of Medical Internet Research, 24(8), e37100. https://doi.org/10.2196/37100 

Li, R., Chen, Y., Ritchie, M. D., & Moore, J. H. (2020). Electronic health records and polygenic risk scores for predicting disease risk. Nature Reviews Genetics. https://doi.org/10.1038/s41576-020-0224-1 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Linton, M., & Koonmen, J. (2020). Self-care as an ethical obligation for nurses. Nursing Ethics, 27(8), 1694–1702. https://doi.org/10.1177/0969733020940371 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Myerson, R., Romley, J., Chiou, T., Peters, A. L., & Goldman, D. (2019). The affordable care act and health insurance coverage among people with diagnosed and undiagnosed diabetes: Data from the national health and nutrition examination survey. Diabetes Care, 42(11), e179–e180. https://doi.org/10.2337/dc19-0081 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Nguyen, B. P., Pham, H. N., Tran, H., Nghiem, N., Nguyen, Q. H., Do, T. T. T., Tran, C. T., & Simpson, C. R. (2019). Predicting the onset of type 2 diabetes using wide and deep learning with electronic health records. Computer Methods and Programs in Biomedicine, 182, 105055. https://doi.org/10.1016/j.cmpb.2019.105055 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Padhi, S., Nayak, A. K., & Behera, A. (2020). Type II diabetes mellitus: A review on recent drug based therapeutics. Biomedicine & Pharmacotherapy, 131, 110708. https://doi.org/10.1016/j.biopha.2020.110708 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Powell, R. E., Zaccardi, F., Beebe, C., Chen, X. M., Crawford, A., Cuddeback, J., Gabbay, R. A., Kissela, L., Litchman, M. L., Mehta, R., Meneghini, L., Pantalone, K. M., Rajpathak, S., Scribner, P., Skelley, J. W., & Khunti, K. (2021). Strategies for overcoming therapeutic inertia in type 2 diabetes: A systematic review and meta‐analysis. Diabetes, Obesity and Metabolism, 23(9), 2137–2154. https://doi.org/10.1111/dom.14455 

Powers, M. A., Bardsley, J. K., Cypress, M., Funnell, M. M., Harms, D., Hess-Fischl, A., Hooks, B., Isaacs, D., Mandel, E. D., Maryniuk, M. D., Norton, A., Rinker, J., Siminerio, L. M., & Uelmen, S. (2020). Diabetes Self-management Education and Support in Adults With Type 2 Diabetes: A Consensus Report of the American Diabetes Association, the Association of Diabetes Care and Education Specialists, the Academy of Nutrition and Dietetics, the American Academy of Family Physicians, the American Academy of PAs, the American Association of Nurse Practitioners, and the American Pharmacists Association. Diabetes Care, 43(7), dci200023. https://doi.org/10.2337/dci20-0023 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Rutledge, C., & Gustin, T. (2021). Preparing nurses for roles in telehealth: Now is the time! OJIN: The Online Journal of Issues in Nursing, 26(1). https://doi.org/10.3912/ojin.vol26no01man03 

NURS FPX 4900 Assessment 3 Problem: Technology, Care Coordination, and Community Resources Considerations: Shan, R., Sarkar, S., & Martin, S. S. (2019). Digital health technology and mobile devices for the management of diabetes mellitus: state of the art. Diabetologia, 62(6), 877–887. https://doi.org/10.1007/s00125-019-4864-7 

Shao, Y., Stoecker, C., Hong, D., Nauman, E., Fonseca, V., Hu, G., Bazzano, A. N., Kabagambe, E. K., & Shi, L. (2022). The impact of reimbursement for non-face-to-face chronic care management on health utilization among patients with type 2 diabetes in louisiana. Value in Health. https://doi.org/10.1016/j.jval.2022.09.002 

Sherifali, D., Brozic BPHE, A., Agema, P., Punthakee, Z., McInnes, N., O’Reilly, D., Usman Ali, R. M., Ibrahim, S., & Gerstein, H. C. (2020). The effect of diabetes health coaching on glycemic control and quality of life in adults living with type 2 diabetes: a community-based randomized controlled trial. Canadian Journal of Diabetes, 45(7). https://doi.org/10.1016/j.jcjd.2020.11.012 

Yingling, L., Allen, N. A., Litchman, M. L., Colicchio, V., & Gibson, B. S. (2019). An evaluation of digital health tools for diabetes self-management in hispanic adults: Exploratory study. JMIR Diabetes, 4(3), e12936. https://doi.org/10.2196/12936

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